Brought to operating room for heart transplant, induced, intubated.The 9f double lumen cordis placed in right femoral vein.Betadine prep used as patient reported rash/swelling with chlorhexidine in past.After placement, hemodynamically unstable, hypotension, tachycardia.Treated for anaphylaxis, cpr initiated.Rash noted on chest.Team located alternative central line, and placed it, removing offending catheter.(i had to look outside the operating room for a non-chg coated catheter).Case cancelled.Tryptase positive.Eventually was transplanted successfully.Pre-existing allergies: ceftriaxone (anaphylaxis) and chlorhexidine (rash and swelling) with lvad placement at outside hospital.Came for allergy testing six weeks after event and had diffuse urticaria.Unable to patch test at that time.Re-transplanted soon afterward, successfully, avoiding chg products.
|