What are the procedures for handling infusion reactions?

Infusion is a very common treatment method in life. The main principle is to use a large dose of normal saline combined with sufficient amount of medicine to enter the venous blood, so as to follow the blood to the diseased parts throughout the body for point-to-point anti-inflammatory treatment. The effect of infusion is very good, but some people with certain physical conditions are prone to infusion reactions during infusion. At this time, medical staff need to immediately carry out the reaction handling process. Let’s take a look at the infusion reaction handling procedures.

Handle infusion reactions with caution: Infusion reactions are dangerous, handle them with caution and don't panic. Infusion reactions are extremely common in medical practice and are not fatal in themselves. But it can cause the patient's underlying disease to worsen and pose a life-threatening risk. Prevention should be the key in clinical practice; once an incident occurs, the judgment must be accurate and the treatment must be decisive.

Once an infusion reaction occurs

1. Do not remove the intravenous needle and make sure to keep the intravenous access well in case of emergency medication. Once the intravenous access is removed, the opportunity for rescue will be missed if an intravenous access is established again when the patient needs rescue.

2. Replace the infusion tube with a new one and a liquid with different properties from the original one (e.g. sugar water should be replaced with saline solution). Do not add medicine for the time being and consider adding medicine after the patient's condition stabilizes.

3. Pentatherapy: ① Oxygen inhalation; ② Intravenous injection of dexamethasone 10-15 mg (0.5-1 mg/kg for children, once) or hydrocortisone 100 mg (5-10 mg/kg for children, once); ③ Intramuscular or intravenous injection of diphenhydramine 20-40 mg (0.5-1 mg/kg for children, once); ④ Intramuscular injection of compound aminopyrine 2 ml (0.1 ml/kg for children, once) or oral ibuprofen suspension; ⑤ Intramuscular or intravenous injection of 654-25 mg (0.1-0.5 mg/kg for children, once) if the patient has chills or pale skin. Generally, sweating and fever subside and stabilize 30 minutes after taking the medicine.

As for subcutaneous injection of epinephrine during infusion reaction, caution should be exercised. The reason is that infusion reaction is not an immediate allergic reaction, and the use of epinephrine goes against the pathological mechanism of infusion reaction. Epinephrine is a catecholamine drug with a rapid pressor effect, and it is correct to use it for immediate allergic reactions. In addition, the pressor effect of epinephrine will worsen the condition of patients with existing hypertension. Of course, when it is difficult to determine whether it is an infusion reaction or a rapid allergic reaction, it is not a bad idea to use it with caution; it is also correct to use it when the infusion reaction is accompanied by a rapid drop in blood pressure.

The use of sedatives in response to anxiety should also be used with caution. Practice has shown that most infusion reactions can be quickly calmed down after the above treatment, and sedatives are no longer needed; using sedatives for such patients will also mask changes in the condition.