Proposed Topic (Most preferred): :
Clinical Safety and Quality Service II (Projects aiming to enhance clinical safety and outcomes, clinical governance / risk management)
Authors (including presenting author) :
HN Siu(1), KM Poon(2), KF Sun(3), KL Tsui(3), WY Leung(3), MM Chan(2), KL Hung(1)
Affiliation :
(1) Accident & Emergency Department, Tuen Mun Hospital (2) Accident & Emergency Department, Tin Shui Wai Hospital (3) Accident & Emergency Department, Pok Oi Hospital
Introduction :
Intravenous iron therapy becomes one of the major treatment options for iron deficiency anemia. However, due to severe toxicity associated with its earliest formulations, some physicians may still have concerns over its safety. In fact, excellent safety profile has been shown for newer formulations like ferric gluconate (FG), iron sucrose (IS), LMWID, ferumoxytol, ferric carboxymaltose (FCM), and ferric derisomaltose (FDI) in recent research. Serious adverse events like anaphylaxis are exceedingly rare. While intravenous iron is now mostly given in ward setting, we propose a protocol for intravenous iron therapy for menorrhagia patients with iron deficiency anemia in the setting of Emergency Department.
Objectives :
To evaluate the safety of administration of intravenous iron therapy in the setting of Emergency Department
Methodology :
All hemodynamically stable adult patients, who have (1) clinical diagnosis of menorrhagia and (2) laboratory results showing iron deficiency anemia with hemoglobin level between 7 to 9 g/dL, were included. Recruited patients were administered with intravenous iron isomaltoside (Monofer) in the observation room of Emergency Department. At 15 minutes during infusion, completion of infusion and 30 minutes post-infusion, patients were monitored for adverse events including blurred vision, numbness, vomiting, flushing, itchiness, rash, dyspnea, fever, injection site complications, altered mental status, hypotension, palpitation or tachycardia.
Result & Outcome :
The total number of recruited patients is 85. 7 patients reported adverse events. The total number of adverse events is 13, including facial numbness (n=1), itchiness/flushing/rash (n=7), fever (n=1), palpitation (n=1), chest discomfort (n=1) and dizziness (n=2). Among 7 cases with adverse events, 2 of them were given intravenous hydrocortisone with subsequent improvement.
