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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