Median and ulnar neuropathy after streptokinase infusion

Article Abstract:

Streptokinase is a drug that dissolves blood clots. It is used to treat patients with medical conditions that are caused by blood clots, such as deep vein thrombosis (the formation of blood clots in the deep veins of the legs), pulmonary embolism (blood clots in blood vessels of the lungs) and myocardial infarction (heart attack). The drug is administered directly into the veins (intravenously) and in most cases it rapidly dissolves the blood clots. When any medication, solution or fluid is given intravenously, there always is the potential for a small amount of the fluid to leak out into the surrounding tissue, although it is uncommon. When sugar (dextrose) or salt (saline) solutions leak out into the surrounding tissue, they do not cause a problem. However, in this case, an 81-year-old woman had an adverse reaction to an intravenous infusion of streptokinase. The patient had pain in her chest and left arm. An electrocardiogram was performed to evaluate the condition of the patient's heart, and myocardial infarction was confirmed. The patient was treated with streptokinase, given intravenously in her right forearm, and her chest pain disappeared. Some of the solution containing streptokinase got into the tissue surrounding the vein at the site of infusion and caused local inflammation. The patient had swelling and pain in her right forearm at the site where the streptokinase had been administered. Over the next 24 to 48 hours the patient lost feeling and function in her right hand and fingers. Electromyelography (recording of nerve conduction involving the muscles) revealed damage to the median and ulnar nerves (two nerves that supply the hand and fingers). The patient received physical therapy for six months, but showed little improvement. A year and a half after the event, the woman still had difficulty using her right hand for every day tasks such as writing and opening jars. It is concluded that patients receiving intravenous infusions of streptokinase should be monitored closely to avoid leakage into soft tissue surrounding the puncture site. (Consumer Summary produced by Reliance Medical Information, Inc.)

Injuries, Complications and side effects, Intravenous therapy, Streptokinase, Median nerve, Ulnar nerve

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Itching for a solution

Article Abstract:

Health professionals in Oxfordshire, England, have developed an assessment tool for use with childhood eczema. Around 10% of young children have eczema. The exact cause is unknown, but heredity is an important factor, and 80% of sufferers have high levels of immunoglobulin E. The condition can create psychological and social problems for the child, and treatment regimes can cause family stress. The assessment tool offers a consistent approach when children are seen by a range of individuals. It covers all areas of assessment and management of eczema and its associated problems.

Analysis, Equipment and supplies, Nursing assessment, Eczema in children, Childhood eczema

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