Profili di responsabilità infermieristica in un caso di amputazione dell’avambraccio da errata pratica infusionale in neonato prematuro

  • Luigi Pais dei Mori Infermiere legale. Fondatore dello studio di Infermieristica legale e forense LPdM di Belluno. Presidente dell’Ordine degli Infermieri della Provincia di Belluno http://orcid.org/0000-0002-3190-127X
Parole chiave: Infermieristica Legale, Medicina Legale, Neonatologia, Stravaso, Infiltrazione, Infusione, Piastrine

Abstract

[Nursing responsibility profiles in a case of forearm amputation by wrong infusion practice in a premature newborn]

This article refers to the case of a premature newborn twin (23 weeks of gestation + 6). Of the two brothers, only one survived, in a highly compromised state of health that led to a notable and dramatic series of clinical events: infectious complications, chronic renal failure, viscera herniation, intestinal perforation, and thrombocytopenia, treated with various infusions of platelet concentrates.

During an infusion of platelet concentrate, an extravasation occurred with important tissue infarction. The lesion created, secondary to ischemic necrosis, evolves into dry necrosis, from the hand to the whole forearm, and leads to the amputation of the right forearm, despite the various attempts, pharmacological and surgical, experienced to avoid the extrema ratio.

The purpose of this article is to analyze what happened considering scientific clinical evidence and the profile of responsibilities related to nursing practice.

Biografia autore

Luigi Pais dei Mori, Infermiere legale. Fondatore dello studio di Infermieristica legale e forense LPdM di Belluno. Presidente dell’Ordine degli Infermieri della Provincia di Belluno
Founder of the legal and forensic nursing study LPdM in Belluno (IT)

Riferimenti bibliografici

Decreto del Ministero della Sanità del 14 settembre 1994, n. 739. «Regolamento concernente l’individuazione della figura e del relativo profilo professionale dell’infermiere». Gazzetta Ufficiale Serie Generale n. 6 del 9 gennaio 1995

Legge 26 febbraio 1999, n. 42. «Disposizioni in materia di professioni sanitarie». Gazzetta Ufficiale n. 50 del 2 marzo 1999

Legge 10 agosto 2000, n. 251. «Disciplina delle professioni sanitarie infermieristiche, tecniche, della riabilitazione, della prevenzione nonché' della professione ostetrica». Gazzetta Ufficiale n. 208 del 6 settembre 2000

Corbett M, Marshall D, Harden M, et al. Treatment of extravasation injuries in infants and young children: a scoping review and survey. Health Technol Assess 2018; 22: 1-112; https://doi.org/10.3310/hta22460

Webster J, Osborne S, Rickard CM, et al. Clinically-indicated replacement versus routine replacement of peripheral venous catheters. Cochrane Database of Systematic Reviews 2015; 8: CD007798; https://doi.org/10.1002/14651858.CD007798.pub4

Garofoli B, De Nisco G. Gestione degli accessi venosi. Linee guida GA.VE.CE.LT. 2013, p. 118-122

Infusion Nurses Society. Infusion nursing standards of practice. Section Seven: Vascular Access Device (VAD)-Related Complications . J Infus Nurs 2016; 39 (1S): S95

Buonocore AM, Richman S. Phlebitis IV-related. Nursing Practice Counsil. CINAHL Information Systems, October 2010

O’Grady NP, Alexander M, Burns LA, et al. Guidelines for the prevention of intravascular catheter-related infections. Clin Infect Dis 2011; 52: e162-93; https://doi.org/10.1093/cid/cir257

Ponzio C, Da Ros L. Gestione del catetere venoso periferico. Dossier InFad 2007; 2 (15)

Gorski LA. Speaking of Standards...Standard 54: Infiltration. J Infus Nurs 2007; 30: 330- 331

Simona R. A pediatric peripheral intravenous infiltration assessment tool. J Infus Nurs 2012; 35: 243-8; https://doi.org/10.1097/NAN.0b013e31825af323

Infusion Nurses Society. Infusion nursing standards of practice. Section Seven: Vascular Access Device (VAD)-Related Complications . Infiltration and extravasation. J Infus Nurs 2016; 39 (1S): S98

Doellman D, Hadaway L, Bowe-Geddes, et al. Infiltration and extravasation. Update on prevention and management. J Infus Nurs 2009; 32: 203-11; https://doi.org/10.1097/NAN.0b013e3181aac042

Infusion Nurses Society. Infusion nursing standards of practice. J Infus Nurs 2016; 39 (1S): S98-9

Stanley A. Managing complications of chemotherapy administration. In: Allwood M, Stanley A, Wright P. The cytotoxics handbook (4th edition). Oxford: Radcliffe Medical Press, 2002, p. 119-194

Hayden BK, Goodmann M. Chemotherapy: principles of administration. In: Yarbro CH, Frogge MH, Goodmann M (eds). Cancer nursing (6th edition). Sudbury, MA: Jones and Bartlett Publishers, 2005

Weinstein SM. Plumer’s principles and practice of intravenous therapy (8th edition). Philadelphia: Lippincott Williams & Wilkins, 2007

Hide L, Dougherty L. Drug administration: cytoxic drugs. In: The Royal Marsden Hospital manual of clinical nursing procedures (7th edition). Hoboken, New Jersey: Wiley-Blackwell, 2008

Pubblicato
2018-10-31
Come citare
Pais dei Mori, L. (2018). Profili di responsabilità infermieristica in un caso di amputazione dell’avambraccio da errata pratica infusionale in neonato prematuro. Pratica Medica & Aspetti Legali, 12(1). https://doi.org/10.7175/pmeal.v12i1.1375
Sezione
Caso medico-legale commentato
Statistiche
Abstract: 146 visualizzazioni
HTML: 80 visualizzazioni
PDF: 7 visualizzazioni