Extravasation is the accidental leakage from the vein into the surrounding tissue. Severe necrosis can be the result. Therefore, nurses and doctors have to protect their patients while administering intravenous medication.
Types of Extravasation
The types of extravasation are classified according to the reaction that is caused. Intravenous drugs are normally grouped into 3 categories: non-vesicants, irritants, and vesicants. Each produces known reactions when extravasated.
Non-vesicants ay cause some inflammation associated with an extravasation but there should be no tissue damage.
Irritants have the potential to cause tissue damage, but only when large amounts are extravasated. In most cases, irritants will cause an inflammatory response without necrosis.
Vesicants will cause blistering and tissue damage when left untreated. These drugs can cause serious tissue damage that can lead to severe nerve injury and loss of limb.
There are a number of steps that must be taken to reduce the risk of extravasation. These include: (1) educating the patient; (2) assessing the patient; (3) IV device selection and insertion, dressing; and, (4) obtaining a blood return.
Healthcare professionals have to educate their patients before IV administration. This should include a detailed discussion of the risks, signs and symptoms of extravasation.
When properly done, extravasation will not normally occur. However, when corners are cut, there is obviosely a greater risk that extravasation will occur.
Management of Extravasation
Once recognized, a quick response is necessary to prevent further damage.
- Stop the infusion immediately.
- Disconnect the infusion.
- Aspirate as much of the drug as possible.
- Mark the affected areas and take digital images of the site.
- Remove the cannula or needle.
- Treat the injured tissue.
- In case of a vesicant, surgery and debridement may be necessary.
Extravasation injuries can have dire consequences.
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