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Infiltration and Extravasation: Update on Prevention and Management

Doellman, Darcy BSN, RN, CRNI®; Hadaway, Lynn MEd, RN, BC, CRNI®; Bowe-Geddes, Leigh Ann BS, RN, CRNI®; Franklin, Michelle BSN, RN, MBA, CRNI®; LeDonne, Jack MD; Papke-O'Donnell, Lorelei MSN, RN, CRNI®; Pettit, Janet MSN, RNC, NNP, CNS; Schulmeister, Lisa MN, RN, APRN-BC, OCN®, FAAN; Stranz, Marc PharmD

Journal of Infusion Nursing:
doi: 10.1097/NAN.0b013e3181aac042
Feature
Abstract

Infiltration and extravasation are risks of intravenous administration therapy involving unintended leakage of solution into the surrounding tissue. Consequences range from local irritation to amputation. While immediate action using appropriate measures (ie, dilution, extraction, antidotes, and supportive treatments) can decrease the need for surgical intervention, many injuries may be prevented by following established policy and procedures. However, timely surgical intervention, when necessary, can prevent more serious adverse outcomes. Clinicians should be prepared to act promptly when an event occurs. Thorough incident documentation helps determine whether infusion care meets the standard of practice and is a keystone to medicolegal defense.

In Brief

Infiltration and extravasation are risks of intravenous administration therapy involving unintended leakage of solution into the surrounding tissue. Consequences range from local irritation to amputation. While immediate action using appropriate measures (ie, dilution, extraction, antidotes, and supportive treatments) can decrease the need for surgical intervention, many injuries may be prevented by following established policy and procedures. However, timely surgical intervention, when necessary, can prevent more serious adverse outcomes. Clinicians should be prepared to act promptly when an event occurs. Thorough incident documentation helps determine whether infusion care meets the standard of practice and is a keystone to medicolegal defense.

Author Information

Vascular Access Specialist and Neonatal/Pediatric PICC Nurse, Cincinnati Children's Hospital, Cincinnati, Ohio (Ms Doellman); President, Lynn Hadaway Associates, Inc, Milner, Georgia (Ms Hadaway); Vascular Access Specialist, University of Louisville Hospital, Louisville, Kentucky (Ms Bowe-Geddes); CPHQ Director, Clinical Services Group, Hospital Corporation of America, Nashville, Tennessee (Ms Franklin); General Surgeon, Greater Baltimore Medical Center, Baltimore, Maryland (Dr LeDonne); Clinical Nurse Manager, Vascular Access Service, University of Michigan Health Systems, Ann Arbor (Ms Papke-O'Donnell); Vascular Access Specialist, Neonatal Nurse Practitioner, Doctors Medical Center, Modesto, California (Ms Pettit); Oncology Consultant, River Ridge, Louisiana (Ms Schulmeister); and Vice President, Operations East, Critical Homecare Solutions, Conshohocken, Pennsylvania (Dr Stranz).

Corresponding Author: Darcy Doellman, BSN, RN, CRNI®, Cincinnati Children's Hospital, 3333 Burnet Ave, Cincinnati, OH 45229 (darcy.doellman@cchmc.org).

Editorial support was provided by Barbara Joan Goldman, RPh, of Advogent, and funded by Baxter Healthcare Corporation.

© Copyright 2009 by the Infusion Nurses Society