• Lisa DoughertyEmail author


Extravasation of vesicant drugs from a port is a real risk caused by catheter damage, incomplete insertion or dislodgement of the needle from the port or fibrin sheath. The focus must be on safe techniques of administration, early detection by close monitoring of the patient and the port and immediate and appropriate management. Accurate and contemporaneous documentation is vital along with education of the patient following extravasation.


Extravasation Vesicants Cytotoxic Chemotherapy Implanted ports Central venous access devices 


  1. 1.
    Polovich M, White JM, Kelleher L (2009) Chemotherapy and biotherapy guidelines and recommendations for practice, 3rd edn. Oncology Nursing Press, Pittsburgh, PAGoogle Scholar
  2. 2.
    Schulmeister L (2009) Antineoplastic therapy. In: Alexander M, Corrigan A, Gorski L et al (eds) Infusion therapy: an evidence based approach. Saunders Elsevier, Philadelphia,  chapter 18, pp 366–367Google Scholar
  3. 3.
    Hyde, L, Dougherty, L, Schorstein R (2011) Safe handling of cytotoxic drugs. In: Dougherty L, Lister S (eds) The Royal Marsden NHS Foundation Trust manual of clinical nursing procedures, 8th edn. Wiley Blackwell Publishing, OxfordGoogle Scholar
  4. 4.
    Hayden BK, Goodman M (2005) Chemotherapy: principles of administration. In: Henke Yarbro C, Wujcik D, Holmes Gobel B (eds) Cancer nursing-principles and practice, 6th edn. Jones and Bartlett, Boston, MA, pp 351–411Google Scholar
  5. 5.
    Khan MS, Holmes JD (2002) Reducing morbidity from extravasation injuries. Ann Plast Surg 48:628–632PubMedCrossRefGoogle Scholar
  6. 6.
    Lawson T (2003) A legal perspective on CVC-related extravasation. J Vasc Access Devices 8:25–27CrossRefGoogle Scholar
  7. 7.
    Masoorli S (2003) Extravasation injuries associated with the use of central vascular access devices. JVAD 8:21–23Google Scholar
  8. 8.
    Goolsby TV, Lombardo FA (2006) Extravasation of chemo-therapeutic agents: prevention and treatment. Semin Oncol 33:139–143PubMedCrossRefGoogle Scholar
  9. 9.
    Dougherty L (2008) Intravenous therapy: recognising the differences between infiltration and extravasation. J British Nurs 17:896–901Google Scholar
  10. 10.
    EONS (2007) Extravasation guidelines European Oncology Nursing SocietyGoogle Scholar
  11. 11.
    Schulmeister L (1989) Needle dislodgement from implanted venous access devices-inpatients and outpatient experiences. J Intraven Nurs 12:90–92PubMedGoogle Scholar
  12. 12.
    Mayo DJ (1998) Fibrin sheath formation and chemotherapy extravasation: a case report. Supp Care Cancer 6:51–56CrossRefGoogle Scholar
  13. 13.
    Weinstein S (2007) Antineoplastic therapy. In: Plumer’s principles and practices of intravenous therapy, 8th edn. Lippincott, Williams & Wilkins, Philadelphia, pp. 486–573Google Scholar
  14. 14.
    Rudolph R, Larson DL (1987) Etiology and treatment of chemotherapeutic agent extravasation injuries: a review. J Clin Oncol 5:1116–1126PubMedGoogle Scholar
  15. 15.
    Bertolli G (1995) Prevention and management of extravasation of cytotoxic drugs. Drug Saf 12:245–255CrossRefGoogle Scholar
  16. 16.
    CP Pharmaceuticals (1999) How quickly could you act? CP Pharmaceuticals, WrexhamGoogle Scholar
  17. 17.
    Few BJ (1987) Hyaluronidase for treating intravenous extravasations. MCN Pharmacopoeia 12:23Google Scholar
  18. 18.
    Doellmann D, Hadaway L, Bowes-Geddes LA et al (2009) Infiltration and extravasation: update on prevention and management. J Infusion Nurs 32:203–211CrossRefGoogle Scholar
  19. 19.
    Gault D, Challands J (1997) Extravasation of drugs. Anaesth Rev 13:223–241Google Scholar
  20. 20.
    Wickham R, Engelking C, Sauerland C, Corbi D (2006) Vesicant extravasation part II: evidence based management and continuing controversies. ONF 33:1143–1150CrossRefGoogle Scholar
  21. 21.
    Langer SW, Sehested M, Buhl Jensen P (2000) Treatment of antracycline extravasation dexrazoxane. Clin Cancer Res 6:3680–3686PubMedGoogle Scholar
  22. 22.
    Mouridsen HT, Langer SW, Butter J et al (2007) Treatment of anthracycline extravasation with Savene (dexrazoxane): results from two prospective multicentre studies. Ann Oncol 18:546–550PubMedCrossRefGoogle Scholar
  23. 23.
    Schulmeister L (2007) Totect. A new agent for treating anthracycline extravasation. Clin J Oncol Nurs 11:387–395PubMedCrossRefGoogle Scholar
  24. 24.
    RCN (2010) Standards for infusion therapy. Royal College of Nursing, LondonGoogle Scholar
  25. 25.
    Dougherty L (2003) An expert witness working within the legal system in the United Kingdom. J Vas Ass Net 8:29–37Google Scholar

Copyright information

© Springer-Verlag Italia 2012

Authors and Affiliations

  1. 1.Nurse Consultant IV TherapyThe Royal Marsden NHS Foundation TrustSurreyUK

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