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Amiodarone induced skin necrosis
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  • Published on:
    Are the risks of amiodarone exagerated?

    Dear Editor,

    The Committee for the Safety of Medicines has only two entries for amiodarone extravasation injury, yet almost every consultant seems to remember a patient who has had their arm amputated following extravasation of amiodarone. Surely this is a case of the dangers of peripheral amiodarone being exagerated? In periarrest / cardiac arrest situations amiodarone has been given as a peripheral bolus countl...

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    Conflict of Interest:
    None declared.
  • Published on:
    Weighing up the risks

    Dear Editor,

    Skin necrosis is a recognised complication of amiodarone infusion, but how does it compare with the risks of central venous cannnulation? The risks are considerable (and potentially fatal), especially if performed by inexperienced junior staff, or in units with no Sonosite or other ultrasound device.
    I think, for many patients, it is reasonable to deliver amiodarone via a large perip...

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    Conflict of Interest:
    None declared.
  • Published on:
    'Safe than sorry'

    Dear Editor,

    Amiodarone is frequently used in the intensive care units. Very often it is used to treat atrial fibrillation in septic patients. As Russel and Saltissi mentioned in the case report we also give first a bolus of amiodarone followed by an maintainance infusion over 23 hours. It is advised in the BNF that amiodaorne has to be given through the central line. In the intensive Care Unit we follow this stri...

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    Conflict of Interest:
    None declared.