Extravasation/Infiltration Management Chart - Johns Hopkins University

Extravasation/Infiltration Management Chart

JHH Extravasation/Infiltration Policy:



Administration procedures for compresses/antidotes:

Medication

Acyclovir*

Cold

Compresses

(**should not be

used in neonates)

(**should not be

used in neonates)

X

Amphotericin B

Arsenic Trioxide

X

X

Bleomycin

Busulfan

Calcium Chloride*

Calcium Gluconate*

X

X

X

CARBOplatin

Carmustine

CISplatin*

Cladribine

X

Cyclophosphamide

Cytarabine

X

Dacarbazine

Dactinomycin*

DAUNorubicin*

Dextrose >10%*

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

X

X

X

X

X

X

X

X

X

X

X

? Cool to touch

Gemtuzumab

? Skin blanched

X

X

X

X

X

X

X

X

procedure by clicking link at top of page)

Irinotecan

Lorazepam

Magnesium Sulfate

Mechlorethamine*

Metoprolol

X

X

Mitomycin

Mitoxantrone

Nafcillin*

Paclitaxel*

X

X

Potassium Chl. (>40 meq/L)*

Promethazine*

Sodium Benzoate/ Phenylacetate

(Ammunol?)*

Sodium Bicarbonate*

X

X

X

X

X

X

X

X

X

X

X

X

X

X

Teniposide

X

X

X

X

X

X

Vasopressin*

VinBLAStine*

VinCRIStine*

Vinorelbine*

X

X

X

? Pain at access site with erythema +/- edema

4

X

Vancomycin

? Erythema at access site +/- pain

2

? Streak formation

? Palpable venous cord

Sodium Chloride, Hypertonic

Topotecan

? No symptoms

1

? Pain at access site with erythema +/- edema

X

X

X

X

0

3

X

Thiotepa

Phlebitis Grading Scale

Grade Clinical Criteria

X

X

X

X

? Deep pitting tissue edema

? Blood product, irritant, or vesicant infiltration

X

X

X

Piperacillin/Tazobactam

? Skin discolored, bruised, swollen

? Gross edema >6" in any direction

X

X

Phenylephrine*

Phenytoin

4

? Circulatory impairment

X

X

X

X

X

X

Penicillin G Potassium

Phenobarbital*

? Skin tight, leaking

X

X

OXALIplatin

Parental Nutrition (TPN)*

? Skin blanched, translucent

? Moderate to severe pain

Norepinephrine*

Pamidronate

? Possible numbness

X

X

? Gross edema >6" in any direction

? Cool to touch

X

X

X

X

X

X

X

X

X

X

X

? Cool to touch

? Mild to moderate pain

3

X

X

X

X

? With or without pain

? Skin blanched, translucent

X

X

Ifosfamide

Iohexol* (see contrast agent extravasation

Melphalan

2

? Edema 1-6" in any direction

X

Idarubicin*

Mannitol*

? Edema ................
................

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