I.V. ROUNDS: Preventing and managing peripheral extravasation
LYNN C. HADAWAY RN, C, CRNI, ME

$3.95 		Nursing2013
May 2004 
Volume 34  Number 5
Pages 66 - 67
 
  PDF Version Available!

ABSTRACT
Outline

  • Preventing extravasation

  • If extravasation occurs …

  • SELECTED REFERENCES

    EXTRAVASATION—the infiltration of a vesicant drug from an I.V. line into surrounding tissue—can occur with either a peripheral or a central venous catheter. In this article, I'll describe prevention and management of extravasation from a peripheral catheter. In my next article, I'll address the same issues with a central venous catheter.

    Extravasation occurs when a peripheral catheter erodes through the vessel wall at a second point, when increased venous pressure causes leakage around the original venipuncture site, or when a needle pulls out of the vein. Signs and symptoms of extravasation include edema and changes in the site's appearance and temperature, such as swelling, blanching, and coolness. The patient may complain of pain or a feeling of tightness around the site.

    Vesicant drugs or solutions (such as certain antineoplastic drugs, antibiotics, electrolytes, antiemetics such as promethazine, and vasopressors) cause severe tissue injury or destruction when they extravasate. Possible consequences include necrotic ulcers, infection, disfigurement, reflex sympathetic dystrophy syndrome, and loss of function.

    Preventing extravasation

    Although short and midline peripheral catheters aren't recommended for continuous infusion of vesicants, they may be appropriate for single injections. Adhere strictly to proper administration techniques and follow these guidelines:

    * Know your hospital's policy about the use of antidotes for vesicants. For example, is a kit packaged with all needed supplies available, or will you need to collect the individual items?

    * Make sure you know the antidote and other recommended treatment for the vesicant drug you're giving.

    * Ensure that the drug has been properly diluted before injection or infusion. Dilution ...

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