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J Educ Eval Health Prof > Volume 17; 2020 > Article
J Educ Eval Health Prof. 2020; 17: 21.
Published online July 16, 2020.
DOI: https://doi.org/10.3352/jeehp.2020.17.21
Guidelines for the management of extravasation
Jung Tae Kim1  , Jeong Yun Park2  , Hyun Jung Lee1  , Young Ju Cheon1 
1Department of Pharmacy, Kyung Hee University Hospital at Gangdong, Seoul, Korea
2Department of Clinical Nursing, University of Ulsan, Seoul, Korea
Correspondence  Jung Tae Kim ,Email: jtkim@khnmc.or.kr
Editor:  Sun Huh, Hallym University, Korea
Submitted: July 16, 2020  Accepted after revision: July 16, 2020
Abstract
The purpose of these practice guidelines is to offer and share strategies for preventing extravasation and measures for handling drugs known to cause tissue necrosis, which may occur even with the most skilled experts at intravenous (IV) injection. Herein, general knowledge about extravasation is first described, including 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, nursing intervention with following steps is recommended: stop administration of IV fluids immediately, disconnect the IV tube from the cannula, aspirate any remaining drug from the cannula, administer 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, theoretically limiting the drug dispersion. Although clear benefit has not been demonstrated with thermal applications, it remains a 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 prevention of extravasation, health professionals 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 on extravasation is essential. With the practical use of these guidelines, it is expected to reduce the occurrence rate of extravasation and contribute to patient care improvement.
Keywords: Extravasation; Antidotes; Intravenous injections; Patient care; Risk factors
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