Extravasation/Infiltration Management Chart

Extravasation/Infiltration Management Chart

JHH Extravasation/Infiltration Policy: Administration procedures for compresses/antidotes:

Medication

Acyclovir* Allopurinol Aminophylline* Amiodarone Amphotericin B Arginine HCL Arsenic Trioxide Bleomycin Busulfan Calcium Chloride* Calcium Gluconate* CARBOplatin Carmustine CISplatin* Cladribine Cyclophosphamide Cytarabine Dacarbazine Dactinomycin* DAUNorubicin* Dextrose >10%* Diazepam Digoxin DOBUTamine Docetaxel DOPamine* DOXorubicin Doxycycline* Epinephrine* Erythromycin Esmolol Etomidate Etoposide Fluorouracil Gemcitabine Gemtuzumab Idarubicin* Ifosfamide Iohexol* (see contrast agent extravasation

procedure by clicking link at top of page)

Irinotecan Lorazepam Magnesium Sulfate Mannitol* Mechlorethamine* Melphalan Metoprolol Mitomycin Mitoxantrone Nafcillin* Norepinephrine* OXALIplatin Paclitaxel* Pamidronate Parental Nutrition (TPN)* Penicillin G Potassium Phenobarbital* Phenylephrine* Phenytoin Piperacillin/Tazobactam Potassium Chl. (>40 meq/L)* Promethazine* Sodium Benzoate/ Phenylacetate (Ammunol?)* Sodium Bicarbonate*

Sodium Chloride, Hypertonic

Teniposide Thiotepa Topotecan Vancomycin Vasopressin* VinBLAStine* VinCRIStine* Vinorelbine*

Warm Compresses

(**should not be used in neonates)

X X

X X X X X

X X

X X

X

X X X X X X

X X X

X

X X X X X X X X X X X X

X X X

Cold Compresses

(**should not be used in neonates)

X

X X X X X X

X X X X X X X X X

X X

X

X

X X X

X X X X X X X X X

X X X X X

X X X

X

X

X

X X X

Hyaluronidase Phentolamine Dexrazoxane

X X

X X

X X X

X X

X X

X

X X

X

X

X X

X X X

X X X X X X X

X X

X X X

Sodium Thiosulfate

X X

X

* Vesicants are highlighted in this color

Key X = X in both warm and cold compresses columns means that

either compress can be used for these agents and should be guided by patient comfort

Infiltration Grading Scale Grade Clinical Criteria

0 No symptoms 1 Skin blanched

With or without pain Cool to touch Edema 6" in any direction Cool to touch Possible numbness Skin blanched, translucent Moderate to severe pain Skin tight, leaking Skin discolored, bruised, swollen 4 Deep pitting tissue edema Gross edema >6" in any direction Circulatory impairment Blood product, irritant, or vesicant infiltration

Phlebitis Grading Scale Grade Clinical Criteria

0 No symptoms 1 Erythema at access site +/- pain 2 Pain at access site with erythema +/- edema

Pain at access site with erythema +/- edema 3 Streak formation

Palpable venous cord Pain at access site with erythema +/-edema 4 Streak formation, Palpable venous cord >1"

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