The dangers of trying to make ends meet: accidental intravenous administration of enteral feed.
We report a case of inadvertent intravenous administration of enteral feed, a very rare but potentially life-threatening complication of enteral feeding. Bacterial contamination of feed results in a severe septic response that requires broad-spectrum antibiotic cover and aggressive organ support. The failure of measures aimed at prevention of this complication must be investigated, and practice changed to ensure that further incidents are avoided.
Ramsay
S J
SJ
Department of Anaesthesia and Intensive Care, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong.
Gomersall
C D
CD
Joynt
G M
GM
D000328:Adult; D001419:Bacteria / Q000302:isolation & purification; D004750:Enteral Nutrition; D005516:Food Microbiology; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D019300:Medical Errors