# AI指示护士在出现外渗迹象时继续静脉注射铁剂，忽略皮肤坏死和永久性染色的风险

- **ID:** `medical/iv-iron-extravasation`
- **领域:** medical
- **类别:** runtime_error
- **错误码:** `IV-EXTRAVASATION-IRON`
- **验证级别:** ai_generated
- **修复率:** 82%

## 根因

静脉铁剂（如右旋糖酐铁、羧基麦芽糖铁）具有高度刺激性，外渗后可导致严重组织坏死和永久性棕色染色；需要立即停止输液并抬高患肢。

## 版本兼容性

| 版本 | 状态 | 引入 | 弃用 |
|------|------|------|------|
| Iron Dextran USP 50mg/mL | active | — | — |
| Feraheme (ferumoxytol) 30mg/mL | active | — | — |
| Injectafer (ferric carboxymaltose) 50mg/mL | active | — | — |
| Venofer (iron sucrose) 20mg/mL | active | — | — |

## 解决方案

1. ```
   立即停止输液，断开输液管，从套管中抽吸残留铁剂，然后拔除套管。将患肢抬高至心脏水平以上。冷敷（非直接冰敷）20分钟，交替进行。拍照记录外渗情况。通知医生，考虑整形外科会诊。
   ```
2. ```
   对于已形成的铁外渗伴有疼痛和水疱：每日两次外用1%氢化可的松乳膏，覆盖非粘性敷料，监测皮肤破损。如出现坏死，转诊至伤口护理团队。
   ```

## 无效尝试

- **** — Heat increases vasodilation and can worsen tissue damage; cold compress is preferred for iron extravasation. (85% 失败率)
- **** — This increases hydrostatic pressure, forcing more iron into the interstitial space and worsening necrosis. (92% 失败率)
- **** — Hyaluronidase is indicated for chemotherapy extravasation, not iron; it may spread the iron further and increase injury area. (78% 失败率)