Extravasation of a concentrated solution of potassium chloride can cause serious problems.
It is important to select an appropriate vein for infusing a potassium solution. If the concentration of the solution is high enough to cause tissue damage, then there is risk of venous injury as well. A central line may be more appropriate than a peripheral vein.
Additional risk factors for extravasation:
(1) high pressure applied to the infusing solution
(2) failure to anchor the needle or catheter
(3) patient motion
Risk factors for serious injury:
(1) delayed recognition and/or treatment
(2) large volume of fluid extravasated
(3) high potassium concentration
Injuries may include:
(1) local severe pain and swelling
(2) skin necrosis
Management:
(1) immediately stop the infusion
(2) wet application of magnesium sulfate
(3) local injection of papaverine and lidocaine
Prevention:
(1) dilution of the concentrated solution prior to infusion
(2) careful monitoring during the infusion
(3) careful selection of the infusion vein
