Confirming extravasation from a peripheral venous catheter: Another role for ultrasonography

摘要

A 35-year-old intravenous drug user presented for re-exploration of a right-sided wrist fracture. We inserted a 20-G intravenous cannula into the left antecubital fossa with some difficulty. Initially, we obtained a flashback of blood but noted that free flow of blood into the cannula was absent. We then injected a few millilitres of saline 0.9% through the cannula, which did not cause any pain or tissue swelling. However, we still doubted the correct intravenous location of the peripheral cannula. So using a linear high frequency (5-10 MHz) ultrasound transducer and velocity colour Doppler (SonoSite, Bothell, WA, USA) we scanned the antecubital fossa while slowly injecting a few millilitres of saline through the cannula. This revealed medial/lateral extravasation of saline into the subcutaneous tissue adjacent to the brachial artery (Fig. 1).