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nomobile noexcerpt noprint searchaux" style="display:none">Medical condition</div><style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox ib-medical-condition"><tbody><tr><th colspan="2" class="infobox-above" style="background:#ccc">Extravasation</th></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_specialty" title="Medical specialty">Specialty</a></th><td class="infobox-data"><a href="/wiki/Toxicology" title="Toxicology">Toxicology</a></td></tr></tbody></table> <p><b>Extravasation</b> is the leakage of <a href="/wiki/Intravenous" class="mw-redirect" title="Intravenous">intravenously</a> (IV) infused, and potentially damaging, medications into the extravascular tissue around the site of infusion. The leakage can occur through brittle <a href="/wiki/Vein" title="Vein">veins</a> in the elderly, through previous <a href="/wiki/Venipuncture" title="Venipuncture">venipuncture</a> access, or through direct leakage from wrongly positioned venous access devices. When the leakage is not of harmful consequence it is known as <a href="/wiki/Intravenous_therapy#Infiltration/extravasation" title="Intravenous therapy">infiltration</a>. Extravasation of medication during <a href="/wiki/Intravenous_therapy" title="Intravenous therapy">intravenous therapy</a> is an adverse event related to therapy that, depending on the medication, amount of exposure, and location, can potentially cause serious injury and permanent harm, such as tissue <a href="/wiki/Necrosis" title="Necrosis">necrosis</a>. Milder consequences of extravasation include irritation, characterized by symptoms of pain and <a href="/wiki/Inflammation" title="Inflammation">inflammation</a>, with the clinical signs of warmth, <a href="/wiki/Erythema" title="Erythema">erythema</a> (redness), or tenderness.<sup id="cite_ref-1" class="reference"><a href="#cite_note-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Medications">Medications</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Extravasation_(intravenous)&action=edit&section=1" title="Edit section: Medications"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Complications related to extravasation are possible with any medication. Since vesicants are blistering agents, extravasation may lead to irreversible tissue injury. </p><p>Extravasation is particularly serious during <a href="/wiki/Chemotherapy" title="Chemotherapy">chemotherapy</a>, since chemotherapy medications are highly toxic. </p> <div class="mw-heading mw-heading2"><h2 id="Treatment">Treatment</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Extravasation_(intravenous)&action=edit&section=2" title="Edit section: Treatment"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The best "treatment" of extravasation is <i>prevention</i>. Depending on the medication that has extravasated, there are potential management options and treatments that aim to minimize damage, although the effectiveness of many of these treatments has not been well studied.<sup id="cite_ref-treatment_2-0" class="reference"><a href="#cite_note-treatment-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> In cases of tissue necrosis, surgical debridement and reconstruction may be necessary. The following steps are typically involved in managing extravasation: </p> <ul><li>Stop infusion immediately. Put on sterile gloves.</li> <li>Replace infusion lead with a disposable syringe. While doing this, do not exert pressure on the extravasation area.</li> <li>Slowly aspirate back blood back from the arm, preferably with as much of the infusion solution as possible.</li> <li>Remove the original <a href="/wiki/Cannula" title="Cannula">cannula</a> or other IV access carefully from the arm (removal of the original cannula is not advised by all healthcare institutions, as access to the original cannula by surgeons can be used to help clean extravasated tissue).</li> <li>Elevate arm and rest in elevated position. If there are blisters on the arm, aspirate content of blisters with a new thin needle. Warm compresses should be placed initially on the site to help diffuse the contrast medium, and cold compresses are used later to help reduce the swelling.<sup id="cite_ref-3" class="reference"><a href="#cite_note-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup></li> <li>If, for the extravasated medication, substance-specific measures apply, carry them out (e.g. topical cooling, <a href="/wiki/Dimethyl_sulfoxide" title="Dimethyl sulfoxide">DMSO</a>, hyaluronidase or <a href="/wiki/Dexrazoxane" title="Dexrazoxane">dexrazoxane</a> may be appropriate).<sup id="cite_ref-treatment_2-1" class="reference"><a href="#cite_note-treatment-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-4" class="reference"><a href="#cite_note-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup></li> <li>Recent clinical trials have shown that Totect (USA) or Savene (Europe) (<a href="/wiki/Dexrazoxane" title="Dexrazoxane">dexrazoxane</a> for extravasation) is effective in preventing the progression of anthracycline extravasation into progressive tissue necrosis. In two open-label, single arm, phase II multicenter clinical trials, necrosis was prevented in 98% of the patients. Dexrazoxane for extravasation is the only registered antidote for extravasation of anthracyclines (daunorubicin, doxorubicin, epirubicin, idarubicin, etc.).<sup id="cite_ref-5" class="reference"><a href="#cite_note-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup></li> <li>The only FDA approved treatment for vasopressor extravasation is <a href="/wiki/Phentolamine" title="Phentolamine">phentolamine</a><sup id="cite_ref-6" class="reference"><a href="#cite_note-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup></li></ul> <div class="mw-heading mw-heading3"><h3 id="Pain_management_and_other_measures">Pain management and other measures</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Extravasation_(intravenous)&action=edit&section=3" title="Edit section: Pain management and other measures"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li>Pain management and local supportive care is important, as it can help to minimize the additional risk of <a href="/wiki/Infection" title="Infection">infection</a> and <a href="/wiki/Superinfection" title="Superinfection">superinfection</a>.</li></ul> <div class="mw-heading mw-heading2"><h2 id="Prevention">Prevention</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Extravasation_(intravenous)&action=edit&section=4" title="Edit section: Prevention"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li>Only qualified, chemotherapy-certified nurses who have been trained in venipuncture and administration of medications with vesicant and irritant potential should be allowed to administer vesicants.<sup id="cite_ref-7" class="reference"><a href="#cite_note-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup></li> <li>Choose a large, intact vein with good blood flow for the venipuncture and placement of the cannula. Do not choose inadvertently "dislodgeable" veins (e.g. dorsum of hand or vicinity of joints) if an alternative vein is available.</li> <li>The digits, hands, and wrists should be avoided as intravenous sites for vesicant administration because of the close network of tendons and nerves that would be destroyed if an extravasation occurred.</li> <li>Place the smallest gauge and shortest length catheter to accommodate the infusion.</li> <li>Monitor the venipuncture site closely for evidence of infiltration and instructing patients to report any pain, discomfort, or tightness at the site.</li> <li>The IV infusion should be freely flowing. The arm with the infusion should not begin to swell (<a href="/wiki/Oedema" class="mw-redirect" title="Oedema">oedema</a>), "get red" (<a href="/wiki/Erythema" title="Erythema">erythema</a>), "get hot" (local temperature increase), and the patient should not notice any irritation or pain on the arm. If this occurs, extravasation management should be initiated.</li> <li>The infusion should consist of a suitable carrier solution with an appropriately diluted medicinal/chemotherapy drug inside.</li> <li>After the IV infusion has finished, flush the cannula with the appropriate fluid.</li> <li>Finally, depending on clinical circumstances, <a href="/wiki/Central_venous_catheter" title="Central venous catheter">central line access</a> may be most appropriate for patients who require repeated administrations of vesicants and irritants.</li></ul> <div class="mw-heading mw-heading2"><h2 id="Examples_of_vesicant_medicinal_drugs">Examples of vesicant medicinal drugs</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Extravasation_(intravenous)&action=edit&section=5" title="Edit section: Examples of vesicant medicinal drugs"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>List of vesicant and irritant medications:<sup id="cite_ref-treatment_2-2" class="reference"><a href="#cite_note-treatment-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Cytotoxic_drugs">Cytotoxic drugs</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Extravasation_(intravenous)&action=edit&section=6" title="Edit section: Cytotoxic drugs"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1184024115">.mw-parser-output .div-col{margin-top:0.3em;column-width:30em}.mw-parser-output .div-col-small{font-size:90%}.mw-parser-output .div-col-rules{column-rule:1px solid #aaa}.mw-parser-output .div-col dl,.mw-parser-output .div-col ol,.mw-parser-output .div-col ul{margin-top:0}.mw-parser-output .div-col li,.mw-parser-output .div-col dd{page-break-inside:avoid;break-inside:avoid-column}</style><div class="div-col" style="column-width: 22em;"> <ul><li><a href="/wiki/Amsacrine" title="Amsacrine">Amsacrine</a></li> <li><a href="/wiki/Cisplatin" title="Cisplatin">Cisplatin</a></li> <li><a href="/wiki/Dactinomycin" title="Dactinomycin">Dactinomycin</a></li> <li><a href="/wiki/Daunorubicin" title="Daunorubicin">Daunorubicin</a></li> <li><a href="/wiki/Docetaxel" title="Docetaxel">Docetaxel</a></li> <li><a href="/wiki/Doxorubicin" title="Doxorubicin">Doxorubicin</a></li> <li><a href="/wiki/Epirubicin" title="Epirubicin">Epirubicin</a></li> <li><a href="/wiki/Idarubicin" title="Idarubicin">Idarubicin</a></li> <li><a href="/wiki/Mechlorethamine" class="mw-redirect" title="Mechlorethamine">Mechlorethamine</a></li> <li><a href="/wiki/Mitomycin_C" title="Mitomycin C">Mitomycin C</a></li> <li><a href="/wiki/Mitoxantrone" title="Mitoxantrone">Mitoxantrone</a></li> <li><a href="/wiki/Oxaliplatin" title="Oxaliplatin">Oxaliplatin</a></li> <li><a href="/wiki/Paclitaxel" title="Paclitaxel">Paclitaxel</a></li> <li><a href="/wiki/Vinblastine" title="Vinblastine">Vinblastine</a></li> <li><a href="/wiki/Vincristine" title="Vincristine">Vincristine</a></li> <li><a href="/wiki/Vindesine" title="Vindesine">Vindesine</a></li> <li><a href="/wiki/Vinorelbine" title="Vinorelbine">Vinorelbine</a></li></ul> </div> <div class="mw-heading mw-heading3"><h3 id="Non-cytotoxic_drugs">Non-cytotoxic drugs</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Extravasation_(intravenous)&action=edit&section=7" title="Edit section: Non-cytotoxic drugs"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1184024115"><div class="div-col" style="column-width: 22em;"> <ul><li><a href="/wiki/Acyclovir" class="mw-redirect" title="Acyclovir">Acyclovir</a><sup id="cite_ref-Le_and_Patel_Rev_8-0" class="reference"><a href="#cite_note-Le_and_Patel_Rev-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Adrenergic_agonists" class="mw-redirect" title="Adrenergic agonists">Adrenergic agonists</a> (e.g. <a href="/wiki/Dobutamine" title="Dobutamine">dobutamine</a>, <a href="/wiki/Adrenaline" title="Adrenaline">adrenaline</a>)<sup id="cite_ref-Le_and_Patel_Rev_8-1" class="reference"><a href="#cite_note-Le_and_Patel_Rev-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Alcohol_(drug)" title="Alcohol (drug)">Alcohol</a></li> <li><a href="/wiki/Aminophylline" title="Aminophylline">Aminophyllines</a></li> <li><a href="/wiki/Amiodarone" title="Amiodarone">Amiodarone</a><sup id="cite_ref-Le_and_Patel_Rev_8-2" class="reference"><a href="#cite_note-Le_and_Patel_Rev-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Amphotericin" class="mw-redirect" title="Amphotericin">Amphotericin</a><sup id="cite_ref-Le_and_Patel_Rev_8-3" class="reference"><a href="#cite_note-Le_and_Patel_Rev-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Arginine" title="Arginine">Arginine</a><sup id="cite_ref-Le_and_Patel_Rev_8-4" class="reference"><a href="#cite_note-Le_and_Patel_Rev-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Chlordiazepoxide" title="Chlordiazepoxide">Chlordiazepoxide</a></li> <li>Calcium solutions (e.g. <a href="/wiki/Calcium_gluconate" title="Calcium gluconate">calcium gluconate</a>)<sup id="cite_ref-Le_and_Patel_Rev_8-5" class="reference"><a href="#cite_note-Le_and_Patel_Rev-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Diazepam" title="Diazepam">Diazepam</a></li> <li><a href="/wiki/Digoxin" title="Digoxin">Digoxin</a></li> <li><a href="/wiki/Mannitol" title="Mannitol">Mannitol</a><sup id="cite_ref-Le_and_Patel_Rev_8-6" class="reference"><a href="#cite_note-Le_and_Patel_Rev-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Metronidazole" title="Metronidazole">Metronidazole</a><sup id="cite_ref-Le_and_Patel_Rev_8-7" class="reference"><a href="#cite_note-Le_and_Patel_Rev-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Nafcillin" title="Nafcillin">Nafcillin</a><sup id="cite_ref-Le_and_Patel_Rev_8-8" class="reference"><a href="#cite_note-Le_and_Patel_Rev-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Nitroglycerine" class="mw-redirect" title="Nitroglycerine">Nitroglycerine</a></li> <li><a href="/wiki/Oxacillin" title="Oxacillin">Oxacillin</a><sup id="cite_ref-Le_and_Patel_Rev_8-9" class="reference"><a href="#cite_note-Le_and_Patel_Rev-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Phenytoin" title="Phenytoin">Phenytoin</a><sup id="cite_ref-Le_and_Patel_Rev_8-10" class="reference"><a href="#cite_note-Le_and_Patel_Rev-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Promethazine" title="Promethazine">Promethazine</a><sup id="cite_ref-Le_and_Patel_Rev_8-11" class="reference"><a href="#cite_note-Le_and_Patel_Rev-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Propylene_glycol" title="Propylene glycol">Propylene glycol</a></li> <li><a href="/wiki/Sodium_thiopental" title="Sodium thiopental">Sodium thiopental</a><sup id="cite_ref-Le_and_Patel_Rev_8-12" class="reference"><a href="#cite_note-Le_and_Patel_Rev-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Tetracyclines" class="mw-redirect" title="Tetracyclines">Tetracyclines</a></li> <li><a href="/wiki/Total_parenteral_nutrition" class="mw-redirect" title="Total parenteral nutrition">Total parenteral nutrition</a><sup id="cite_ref-Le_and_Patel_Rev_8-13" class="reference"><a href="#cite_note-Le_and_Patel_Rev-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Valproate" title="Valproate">Valproate</a><sup id="cite_ref-Le_and_Patel_Rev_8-14" class="reference"><a href="#cite_note-Le_and_Patel_Rev-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Vancomycin" title="Vancomycin">Vancomycin</a><sup id="cite_ref-Le_and_Patel_Rev_8-15" class="reference"><a href="#cite_note-Le_and_Patel_Rev-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Vasopressin" title="Vasopressin">Vasopressin</a><sup id="cite_ref-Le_and_Patel_Rev_8-16" class="reference"><a href="#cite_note-Le_and_Patel_Rev-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup></li></ul> </div> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Extravasation_(intravenous)&action=edit&section=8" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap"><ol class="references"> <li id="cite_note-1"><span class="mw-cite-backlink"><b><a href="#cite_ref-1">^</a></b></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite id="CITEREFRothrock2015" class="citation book cs1">Rothrock, Jane C. (2015). <i>Alexander's care of the patient in surgery</i> (15th ed.). Elsevier/Mosby. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/9780323089425" title="Special:BookSources/9780323089425"><bdi>9780323089425</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Alexander%27s+care+of+the+patient+in+surgery.&rft.edition=15th&rft.pub=Elsevier%2FMosby&rft.date=2015&rft.isbn=9780323089425&rft.aulast=Rothrock&rft.aufirst=Jane+C.&rfr_id=info%3Asid%2Fen.wikipedia.org%3AExtravasation+%28intravenous%29" class="Z3988"></span></span> </li> <li id="cite_note-treatment-2"><span class="mw-cite-backlink">^ <a href="#cite_ref-treatment_2-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-treatment_2-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-treatment_2-2"><sup><i><b>c</b></i></sup></a></span> <span class="reference-text"><a rel="nofollow" class="external text" href="http://hemonc.org/wiki/Vesicant_%26_irritant_chemotherapy">Chemotherapy vesicants, irritants, and treatment for extravasation</a></span> </li> <li id="cite_note-3"><span class="mw-cite-backlink"><b><a href="#cite_ref-3">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFShaqdan_K2014" class="citation journal cs1">Shaqdan K; et al. (2014). "Incidence of contrast medium extravasation for CT and MRI in a large academic medical centre: A report on 502, 391 injections". <i>Clinical Radiology</i>. <b>69</b> (12): 1264–1272. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.crad.2014.08.004">10.1016/j.crad.2014.08.004</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/25248291">25248291</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Clinical+Radiology&rft.atitle=Incidence+of+contrast+medium+extravasation+for+CT+and+MRI+in+a+large+academic+medical+centre%3A+A+report+on+502%2C+391+injections&rft.volume=69&rft.issue=12&rft.pages=1264-1272&rft.date=2014&rft_id=info%3Adoi%2F10.1016%2Fj.crad.2014.08.004&rft_id=info%3Apmid%2F25248291&rft.au=Shaqdan+K&rfr_id=info%3Asid%2Fen.wikipedia.org%3AExtravasation+%28intravenous%29" class="Z3988"></span></span> </li> <li id="cite_note-4"><span class="mw-cite-backlink"><b><a href="#cite_ref-4">^</a></b></span> <span class="reference-text">For more information on substance-specific measures, see, for example, the textbook "Extravasation of cytotoxic agents" (Authors: I Mader <i>et al.</i>, Springer Publishing House)</span> </li> <li id="cite_note-5"><span class="mw-cite-backlink"><b><a href="#cite_ref-5">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFMouridsenLangerButerEidtmann2007" class="citation journal cs1">Mouridsen HT, Langer SW, Buter J, Eidtmann H, Rosti G, de Wit M, Knoblauch P, Rasmussen A, Dahlstrom K, Jensen PB, Giaccone G (Mar 2007). <a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Fannonc%2Fmdl413">"Treatment of anthracycline extravasation with Savene (dexrazoxane): results from two prospective clinical multicentre studies"</a>. <i>Ann Oncol</i>. <b>18</b> (3): 546–50. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Fannonc%2Fmdl413">10.1093/annonc/mdl413</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/17185744">17185744</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Ann+Oncol&rft.atitle=Treatment+of+anthracycline+extravasation+with+Savene+%28dexrazoxane%29%3A+results+from+two+prospective+clinical+multicentre+studies&rft.volume=18&rft.issue=3&rft.pages=546-50&rft.date=2007-03&rft_id=info%3Adoi%2F10.1093%2Fannonc%2Fmdl413&rft_id=info%3Apmid%2F17185744&rft.aulast=Mouridsen&rft.aufirst=HT&rft.au=Langer%2C+SW&rft.au=Buter%2C+J&rft.au=Eidtmann%2C+H&rft.au=Rosti%2C+G&rft.au=de+Wit%2C+M&rft.au=Knoblauch%2C+P&rft.au=Rasmussen%2C+A&rft.au=Dahlstrom%2C+K&rft.au=Jensen%2C+PB&rft.au=Giaccone%2C+G&rft_id=https%3A%2F%2Fdoi.org%2F10.1093%252Fannonc%252Fmdl413&rfr_id=info%3Asid%2Fen.wikipedia.org%3AExtravasation+%28intravenous%29" class="Z3988"></span></span> </li> <li id="cite_note-6"><span class="mw-cite-backlink"><b><a href="#cite_ref-6">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFPlum2017" class="citation journal cs1">Plum, Michelle (2017). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5565133">"Alternative Pharmacological Management of Vasopressor Extravasation in the Absence of Phentolamine"</a>. <i>P&T</i>. <b>42</b> (9): 581–585. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5565133">5565133</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/28890646">28890646</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=P%26T&rft.atitle=Alternative+Pharmacological+Management+of+Vasopressor+Extravasation+in+the+Absence+of+Phentolamine&rft.volume=42&rft.issue=9&rft.pages=581-585&rft.date=2017&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC5565133%23id-name%3DPMC&rft_id=info%3Apmid%2F28890646&rft.aulast=Plum&rft.aufirst=Michelle&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC5565133&rfr_id=info%3Asid%2Fen.wikipedia.org%3AExtravasation+%28intravenous%29" class="Z3988"></span></span> </li> <li id="cite_note-7"><span class="mw-cite-backlink"><b><a href="#cite_ref-7">^</a></b></span> <span class="reference-text">Infusion Nurses Society, Infusion Nursing 3rd ed 2010</span> </li> <li id="cite_note-Le_and_Patel_Rev-8"><span class="mw-cite-backlink">^ <a href="#cite_ref-Le_and_Patel_Rev_8-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Le_and_Patel_Rev_8-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-Le_and_Patel_Rev_8-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-Le_and_Patel_Rev_8-3"><sup><i><b>d</b></i></sup></a> <a href="#cite_ref-Le_and_Patel_Rev_8-4"><sup><i><b>e</b></i></sup></a> <a href="#cite_ref-Le_and_Patel_Rev_8-5"><sup><i><b>f</b></i></sup></a> <a href="#cite_ref-Le_and_Patel_Rev_8-6"><sup><i><b>g</b></i></sup></a> <a href="#cite_ref-Le_and_Patel_Rev_8-7"><sup><i><b>h</b></i></sup></a> <a href="#cite_ref-Le_and_Patel_Rev_8-8"><sup><i><b>i</b></i></sup></a> <a href="#cite_ref-Le_and_Patel_Rev_8-9"><sup><i><b>j</b></i></sup></a> <a href="#cite_ref-Le_and_Patel_Rev_8-10"><sup><i><b>k</b></i></sup></a> <a href="#cite_ref-Le_and_Patel_Rev_8-11"><sup><i><b>l</b></i></sup></a> <a href="#cite_ref-Le_and_Patel_Rev_8-12"><sup><i><b>m</b></i></sup></a> <a href="#cite_ref-Le_and_Patel_Rev_8-13"><sup><i><b>n</b></i></sup></a> <a href="#cite_ref-Le_and_Patel_Rev_8-14"><sup><i><b>o</b></i></sup></a> <a href="#cite_ref-Le_and_Patel_Rev_8-15"><sup><i><b>p</b></i></sup></a> <a href="#cite_ref-Le_and_Patel_Rev_8-16"><sup><i><b>q</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFLePatel2014" class="citation journal cs1">Le, A; Patel, S (July 2014). "Extravasation of Noncytotoxic Drugs: A Review of the Literature". <i>The Annals of Pharmacotherapy</i>. <b>48</b> (7): 870–886. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1177%2F1060028014527820">10.1177/1060028014527820</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/24714850">24714850</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:31699023">31699023</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=The+Annals+of+Pharmacotherapy&rft.atitle=Extravasation+of+Noncytotoxic+Drugs%3A+A+Review+of+the+Literature.&rft.volume=48&rft.issue=7&rft.pages=870-886&rft.date=2014-07&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A31699023%23id-name%3DS2CID&rft_id=info%3Apmid%2F24714850&rft_id=info%3Adoi%2F10.1177%2F1060028014527820&rft.aulast=Le&rft.aufirst=A&rft.au=Patel%2C+S&rfr_id=info%3Asid%2Fen.wikipedia.org%3AExtravasation+%28intravenous%29" class="Z3988"></span></span> </li> </ol></div></div> <div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Extravasation_(intravenous)&action=edit&section=9" title="Edit section: External links"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="navbox-styles"><style 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style="position:relative; float:right; font-size:0.8em;"><a href="https://www.wikidata.org/wiki/Q2051919" class="extiw" title="d:Q2051919">D</a></div><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a></b>: <a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=D005119">D005119</a></li></ul></div></div></td></tr></tbody></table></div> <ul><li><a rel="nofollow" class="external text" href="http://hemonc.org/wiki/Vesicant_%26_irritant_chemotherapy">Table of chemotherapy vesicants, irritants, and treatments for extravasation</a></li> <li><a rel="nofollow" class="external text" href="https://archive.today/20150421094514/http://annonc.oxfordjournals.org/content/23/suppl_7/vii167.long">Management of chemotherapy extravasation: ESMO–EONS Clinical Practice Guidelines</a></li> <li><a rel="nofollow" class="external text" href="http://www.extravasation.org.uk/">UK National Extravasation Information Service</a></li> <li><a rel="nofollow" class="external text" href="http://www.iv-therapy.net/node/435">Iv-therapy.net</a> — links to useful websites about extravasation</li> <li><a rel="nofollow" class="external text" href="http://www.Savene.com/">Savene website</a></li></ul>    </div><noscript><img src="https://login.wikimedia.org/wiki/Special:CentralAutoLogin/start?type=1x1&useformat=desktop" alt="" width="1" height="1" style="border: none; position: absolute;"></noscript> <div class="printfooter" data-nosnippet="">Retrieved from "<a dir="ltr" href="https://en.wikipedia.org/w/index.php?title=Extravasation_(intravenous)&oldid=1237723235">https://en.wikipedia.org/w/index.php?title=Extravasation_(intravenous)&oldid=1237723235</a>"</div></div> <div id="catlinks" class="catlinks" data-mw="interface"><div id="mw-normal-catlinks" class="mw-normal-catlinks"><a href="/wiki/Help:Category" title="Help:Category">Categories</a>: <ul><li><a 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