Guidelines for the management of extravasation

The purpose of these practice guidelines is to offer and share strategies for preventing extravasation from occurring and measures for handling drugs known to cause tissue necrosis, which may occur even with the most skilled intravenous injection experts. At first, the general knowledge of extravasation was described for its definition, incidence, risk factors, diagnosis, differential diagnosis, and extravasation injuries. Management of extravasation includes nursing intervention and thermal application. At the first sign of extravasation, the following steps are recommended during the nursing intervention: stop administration of IV fluids immediately, disconnect the IV tubing from the cannula, attempt aspiration of the residual drug from the cannular, and administer the drug-specific antidote, and notify the physician. Local thermal treatments are used to decrease the site reaction and absorption of the infiltrate. Local cooling (ice packs) aids in vasoconstriction, thus theoretically limiting drug dispersion. Although clear benefit has not been demonstrated with thermal applications, it remains standard supportive care. The recommended application schedule for both warm and cold applications is 15 to 20 minutes, every 4 hours, for 24 to 48 hours. For the prevention of extravasation, health professions should be familiar with the extravasation management standard guidelines. They should regularly check the extravasation kit, assess patients' sensory changes, tingling or burning, and always pay attention to patients' words. The medical team's continuous education regarding extravasation is essential. With the practical use of these guidelines, it is expected to reduce the occurrence rate of extravasation within the hospital and contribute to patient care improvement.