Using sterile water as diluent
Started by Quito
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Or just inject it.
Or mix it with 1% lido.
Or mix it with 1% lido.
You're saying sterile water could be injected together with, for example, dexamethasone for a TFESI?
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Inadvertent sterile water injection in the epidural space: history revisited - PMC
www.ncbi.nlm.nih.gov
Don't inject it by itself. And don't be a resident accidentally injecting it as a 2cc bolus in Ob.
Is there a particular formula for mixing the sterile water with dex to make the mix isotonic, or does the mix not have to be isotonic?
Just use lido.
It has not been studied in TFESI that I can find. Recommend mixing it 50/50 with lido and try. If pain: Inject lido.
Lido won’t help with CESI. I refuse to consider adding lidocaine to CESI.
Any one use extra contrast to mix with steroid or injectate?
When we've run out of saline or want to use extra volume have used 0.3-0.5 mL (or whatever amount you desire) of left over contrast as a "chaser" to ensure no injectate left in tubing or needle.
When we've run out of saline or want to use extra volume have used 0.3-0.5 mL (or whatever amount you desire) of left over contrast as a "chaser" to ensure no injectate left in tubing or needle.
I don't think I'd use sterile water as a carrier. My group has been using sterile saline flushes if needed. You could always just use contrast or go low volume if you are local adverse.
Great ideas! Thanks everyone!
I just inject the steroid and flush it through with a little bit of air until the fluid clears the translucent hub of my needle but not enough that Im just inflating the epidural space. had to do this for a few weeks when we went through a saline shortage a few weeks ago. I havent noticed a change in those patients vs those who received diluted steroid.
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Remember with the sterile saline syringes the syringes themselves aren’t usually sterile
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