Extravasation/Infiltration Management Chart

1 JHH Extravasation/Infiltration Policy: procedures for compresses/antidotes: Compresses (**should not be used in neonates)Cold Compresses (**should not be used in neonates)HyaluronidasePhentolamineDexraz oxaneSodium ThiosulfateAcyclovir*XX * Vesicants are highlighted in this colorAllopurinolXAminophylline*XXAmiodar oneXAmphotericin BXArginine HCLXXA rsenic TrioxideXXBleomycinX Infiltration Grading ScaleBusulfanXXGradeClinical CriteriaCalcium Chloride*XX0 No symptomsCalcium Gluconate*XX1 Skin blanchedCARBO platinX With or without painCarmustineX Cool to touchCISplatin*XX Edema <1" in any directionCladribineXX Skin blanchedCyclophosphamideXX With or without

2 PainCytarabineXX Cool to touchDacarbazineX Edema 1-6" in any directionDactinomycin*X Skin blanched, translucentDAUN orubicin*XX Mild to moderate painDextrose >10%*XX Gross edema >6" in any directionDiazepamX Cool to touchDigoxinXXX Possible numbnessDOBUT amineX Skin blanched, translucentDocetaxelX Moderate to severe painDOPamine*X Skin tight, leakingDOXorubicinXX Skin discolored, bruised, swollenDoxycycline*XX Deep pitting tissue edemaEpinephrine*X Gross edema >6" in any directionErythromycinX Circulatory impairmentEsmololXX Blood product, irritant.

3 Or vesicant infiltrationEtomidateXXXE toposideXXPhlebitis Grading ScaleFluorouracilXXGradeClinical CriteriaGemcitabineXX0 No symptomsGemtuzumabXX1 Erythema at access site +/- painIdarubicin*XX2 Pain at access site with erythema +/- edemaIfosfamideX Pain at access site with erythema +/- edemaIohexol* (see contrast agent extravasation procedure by clicking link at top of page)X Streak formationIrinotecanX Palpable venous cordLorazepamX Pain at access site with erythema +/-edemaMagnesium SulfateX Streak formation, Palpable venous cord >1" Mannitol*XXMechlorethamine*XXMelphalanXX MetoprololXXMitomycinXMitoxantroneXNafci llin*XXNorepinephrine*XOXALI platinXPaclitaxel*XPamidronateXXParental Nutrition (TPN)*XXPenicillin G Potassium XXPhenobarbital*XXPhenylephrine*XPhenyto inXXPiperacillin/TazobactamXPotassium Chl.

4 (>40 meq/L)*XXPromethazine*XXSodium Benzoate/ Phenylacetate (Ammunol )*XXSodium Bicarbonate*XXSodium Chloride, HypertonicXXTeniposideXXThiotepaXXTopote canXXVancomycinXXVasopressin*XVinBLAS tine*XXVinCRIS tine*XXVinorelbine*XX34234 Extravasation/Infiltration Management ChartKeyX =X in both warm and cold compresses columns means that either compress can be used for these agents and should be guided by patient comfort