Extravasation of drugs

Meaning ?
 Extravasation
• Escape of drug into extravascular space
Which drug?
 Which drug?
• Cancer drugs
• Non cancer drugs
1. Acyclovir
2. Taxim
3. Doxycycline
4. Piptaz
5. Vancomycin
6. Dopamine/Dobutamine
7. Adrenaline/Noradrenalie/Vasopressin
8. Calcium injection/Potassium injection
9. 25% dextrose
10.Iv contrast
11.Phenytoin
Risk factors
 Risk factors
• Small veins
• Obesity
• Previous multiple vein punctures
• Patient movements(restless pt)
How to find out?
 Clinical features
Symptoms

1.Burning
2.Itching
3.Redness
4.Slowness of iv infusion rate
 Signs
Grades
1.Painless edema
2.Redness with edema/pain/swelling
3.Ulcer formation/Severe tissue damage
4.Life threatening consequence – sepsis
5.Death
Grade 1
Grade 2
Grade 3
How to prevent?
 Prevention
• Always new iv line - for these medicines
• Large vein with good blood return
• Check patency of iv line with flush every time
before injection
• Skin over the vein should be healthy
• Avoid areas of flexion
• Observe and palpate iv line site frequently –
each shift and before giving injection
Treatment
 Treatment
Don’ts
•Do not flush the line
•Do not apply pressure over the site
•Do not remove the line
Do’s
•Stop infusion
•Elevate
•Aspiration of iv line
•Apply cold packs
•Antidotes by doctor
•Surgery
Thank you