How can extravasation be recognised?

Extravasation may be suspected if the patient complains of the following symptoms or signs at/or surrounding the injection site:

  • Burning or stinging sensation
  • Swelling
  • Pain or acute change in the area of the IV administration

A clinical examination of the injection site will show the following:

  • Erythema (redness caused by increased blood flow)
  • Mottling/darkening of skin
  • Swelling of the area compared with the other side
  • Tenderness on pressure
  • Local blistering (symptomatic of a partial thickness skin injury)
  • White appearance with non‑blanching skin (no filling of the capillaries, symptomatic of full-thickness skin damage)
  • Reduced flow rate in the cannula/infusion pump
  • Lack of blood return from the cannula. Be aware that:
  • Drawing back to test for blood return can re-position the cannula in the vein which now has a hole in its wall.
  • When administration recommences, a larger and more significant extravasation injury can ensue.
  • Firm induration
  • Ulceration (evident 1-2 weeks after injury)