IV Infiltrates, Iodine Pushed

[AnthonyM83]

Hi nurses.

I'm a paramedic student doing clinicals at ER. We're there to practice our skills before doing them during our field ambulance training. (Intubation, IV starts, blood draws, medication administration, assessments)

I was told to get blood and a lock on a patient. Went to the room, started my AC line, was having trouble aspirating, so asked nurse's room for help. He fiddled with it and said it was fine for meds, but couldn't draw blood. Told him she was going to CT and would it work for contrast. He assured me yes.

At this point, he took over. I was handing him stuff. He started a new line in hand and drew blood. Then, noticed a bubble at the AC site and pointed out that we actually couldn't use it. He started a new line on the right mid forearm, as I watched from the door. As he was taping it up, I left to start more lines.

Later, I find out, she went to CT with the bad line still on. The they used it (probably because it was directly at AC which is what they told me was needed for CT?) and the iodine contrast all leaked into the tissue. Then, apparently the nurse put a cold (rather than hot) compress and made it worse (I'm told...I don't know how it should be treated).

No one every officially talked to me about it, but I heard doctors and nurses discussing it and me. I don't know what the nurse told them (if he blamed it on me or if the blame IS on me?).

Just wondering how necrotic iodine is. What would usually come of this? Who would be at fault?

Feel, the nurse took over the show, so I backed off. He initially told me to leave the line in when I wanted to take it out (when I couldn't draw blood...before we saw the bubble). But when it comes down to it, the line WAS started by me. Approved as okay by nurse. Then, he noticed the bubble after I had backed off and was just watching from doorway. He was still working on the 2nd forearm one when I left.

Any advice...or anything at all.
We're not given much supervision during clinicals, so I feel a little unconnected with what's going on.

[Kdog]

The RN is licensed and is the responsible person for the outcome of the IV. It should have been removed either by this RN or they could have asked you..
Also the RN in Radilogy should have checked line patency. Again, another licensed nurse. Both of these nurses are trained in IV technique and they are accountable.
You are off the hook as you are in training and not licensed yet.
I don't believe the CT dye is a vesicant and probably ok. But again, The Radilogist should have been notified maybe they were and ordered ice.
Learn from it and remove any line that appears not working and let the RN know.

[AmandaWIRN]

I have seen many infiltrates from IV contrast, and while it might cause some redness, swelling, and irritation, it should not cause any permanent damage. And yes, the nurse supervising you should have removed or had you remove the bad IV right away, and patency should have been checked in radiology prior to giving contrast.