By Ryan MacArthur |

Extravasations are a dangerous complication of IV failure that has the potential to cause serious harm to patients. An extravasation is the result of an accidental leaking of a vesicant or chemotherapy drug into the tissue surrounding the IV site. If either of these types of substances come into contact with tissue, they may cause blisters or even necrosis.

Types of Extravasation

When an extravasation occurs, there are two categories for the substances that may have leaked out of the IV catheter. Vesicants may cause severe tissue damage and result in painful blisters. Irritants can result in discomfort at the IV site or along the vein, and could lead to inflammation of the surrounding tissue.

Healthcare professionals classify medications like Dacarbazine, Etoposide, Bleomycin, and Cytarabine (all of which doctors commonly use to treat different types of cancers like leukemia and lymphoma) as irritants.

Examples of vesicant chemotherapy drugs include Aclacinomycin, Cisplatin, Docetaxel, Mitoxantrone, Paclitaxel, and Liposomal Doxorubicin.

In addition to chemotherapy, other treatments and substances that possess vesicant properties  are Vancomycin, Nafcillin, Calcium Chloride, Sodium Chloride, and Dopamine.

Signs and Symptoms

Patients should look for redness, tissue damage, pain, loss of mobility in the extremity and infection. The skin near the site may also darken or peel. Signs may not become apparent for several hours or even days after the leak happens.

Treatment & Prevention

When nurses detect an extravasation, they should stop treatment and try to extract the medication from the patient’s body. They’ll also apply a cold or warm compress, depending on the medication, and administer an antidote to minimize tissue damage.

Be sure to let your doctor or nurse know immediately if you start to feel itching, burning, or stinging around the IV. Learn more IV risks here.


References –

Extravasation Injuries in Adults –

Vesicants and Extravasations –

What is Extravasation? –

Know the Difference: Infiltration vs. Extravasation –

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