QWhat items should be included in an office vascular occlusion kit?
Preparation for a vascular occlusion and ischemic event is imperative when injectables are a part of your practice. An accessible occlusion protocol and the below items will ensure the safety of the patient and support an organized systematic approach to tackling this stressful situation.
- At least four vials of Hyaluronidase (Hylenex or Vitrase) refrigerated
- Lidocaine 2% (no epinephrine)
- Topical Nitroglycerin paste
- Bottle of Aspirin 325mg
- Medrol Dose Pack
- Hot gel snap packs
- Local Ophthalmologist contact information (for loss of vision)
- Stop injecting
- Massage the area
- Apply heat, continue to massage
- Option to apply Nitro paste to area (confirm cardiac contraindications) and massage
- Inject the occluded area with 150-750 units of hyaluronidase. Mix 1:1 with lidocaine (no epinephrine) or normal saline and massage
- Inject every 20 minutes until area is re-perfused
- Option to administer oral steroids