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)
