[optimal] Re: No infiltration...no Fluorescein
- From: Hasan Omairah <shagroon@xxxxxxxxxxx>
- To: Optimal Freelist <optimal@xxxxxxxxxxxxx>
- Date: Tue, 8 Oct 2013 19:49:16 +0300
It happened to
me twice so far. Both were females, diabetics, and had weight problem.
We don’t use
butterfly needles anymore –quite rarely I guess - instead a nurse inserts an
angio-cath. On both cases the line was in place and there were no sign of
leakage or extravasation. Both patients had fairly good media, with nicely
dilated
pupils, their cooperation and fixation was very good though, nevertheless No
dye was visible during any stage, and I had to check the camera in-between
phases just to make sure all are OK. I used a drop from what was left in the FA
ampule, one a small piece of tissue, and another drop from
Benoxinate/fluorescein
on another piece of tissue, had it in-front of the camera and took few shots;
still both fluoresce, therefore I knew the filter,
barrier, camera and flash are fine, the culprit was something else!
We have seen
the patients on intervals of (1wk, 1month, 3months, and 1 year) post injection,
and they didn’t complain of any pain, skin necrosis, or any other sign of
extravasation, but strangely both experienced discoloration of their urine, and
the discoloration lasted over one day, which I believe was consistent with the
dye being pushed in ok. No skin discoloration on or near the injection site, no
swelling, or anything that is abnormal!
In our practice
we use AK-Fluor - fluorescein injection 10% for so many years and we didn’t have
any problem with its stability, and both of these cases were from two different
batches. Still; normal FA’s were obtained from both batches on different
patients.
Nothing we
can think of explained why no dye was visible.
Hasan
,-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-,
, Hasan Omairah AAS COT OCT-C CRA
, Department of Ophthalmology MBC (97)
, King Faisal Specialist Hospital & Research Center
, PO Box 3354
, Riyadh, 11211
, Saudi Arabia
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, Mobile-Pager within KFSH 44345
, +966 11-557-6131(work)
, +966 11 442-4975 (fax)
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"True wisdom comes to each of us when we realize how little we understand about
life, ourselves, and the world around us" -Socrates
Subject: [optimal] No infiltration...no Fluorescein
Date: Tue, 8 Oct 2013 09:39:57 -0400
From: slusk@xxxxxxxxxxxxx
To: optimal@xxxxxxxxxxxxx
No infiltration...no Fluorescein
Has anyone ever experienced a phenomenon where an FA injection did not
infiltrate, or at least we did not have any indication of infiltration, and no
dye infuses into the retinal blood vessels? All camera functions we're verified
and set correctly and the Color fundus and redfree images we're good.
Just curious.
Thanks
Steve Lusk, CRA
Vistar Eye Center Retina Consultants
5296 Peters Creek Road
Roanoke, VA 24019
Phone: (540) 342-3400 ext. 4731
Fax: (540) 362-1155
slusk@xxxxxxxxxxxxx
www.vistareye.com
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