Central venous access extravasations

Drugs which may cause extravasation injuries such as vesicant drugs or drugs with high osmolarities (≥600 mOsm/L or more) should be administered via a central line wherever possible.

Preventive strategies for extravasations with central venous access devices include the following:

  • Inspect for blood backflow prior to the administration of the drug solution to ensure that the catheter is correctly positioned in the vein.
  • Check with the patient for any local discomfort or swelling following running a saline solution through the catheter as patients are often the first to know that something is amiss with their IV therapy.

Ensure that patients are aware that they should report immediately any pain or burning at the site of injection.

Education and training of oncology teams is essential for the prevention and timely management of chemotherapy extravasation. Moreover, the use of new antidotes such as dexrazoxane when anthracyclines are infused is essential.

Care protocols in the event of extravasation and training of healthcare teams are vital to achieve the best prevention and management of extravasations.