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CSIT SIDE EFFECTS & COMPLICATIONS (IMMEDIATE! (Vasovagal syncope…
CSIT
SIDE EFFECTS
& COMPLICATIONS
IMMEDIATE!
Vasovagal
syncope faint
lie flat
monitor
Overdose
eg LA
check MSD for patient
Allergy
anaphylaxis
adrenaline
CPR
help!
Bleeding
pressure, elevation
Technique
pain
intravascular injection
needle breakage
poor aseptic technique
lipo-atrophy
nerve trauma
INTERMEDIATE
Painful flare
(26%)
ice 20mins
NSAIDs
Paracetamol
increased risk
depot injection
crystals form?
upto 5-7 days,
Allergy
facial flushing (5%), 1:20
f>m,
Infection
(<1%)
1:50,000c
septic arthritis
strict
aseptic technique
Antibiotics
ASAP
CARE!
Diabetes
others
TB
viral infections
skin infections
RA
immunosuppressed
patients
LONGER TERM
Skin
depigmentation
(1% 1:100)
Increased
Risk with
Triamcinolone
Kenalog
high doses
bony prominences
white lines = lymph vessels
Atrophy
of
tendon
ligament
fascia
articular cartilage
(degeneration)
fat pad
care!
heel pad
irreversible
muscle breakdown
increased risk
with repeat injections
eg
Mortons
neuroma
RISKS!
Diabetes mellitus
if
HbA1c - >8
no injection
Bld glucose <10
Neuropathy
Arthropathy
Risk!
Charcot!
access risk
Increased risk of
Bld glucose
hyperglycaemia
Infection
Immunosuppressed
latent
infections
e.g. viral, TB
PREVENTION
RISKS
undesirable effects
= side effects
= adverse effects
fails
to relieve
symptoms
incorrect
diagnosis
review
differential
diagnosis
other
treatment options
site
poor technique
use imaging
think carefully
before repeating
BENEFITS
desirable effects
= resolution of symptoms
may still have
side effects
Good
medical history
drug history
allergy history
Right
training
staff
equipment