Extravasation is the inappropriate or accidental infiltration of SACT into the subcutaneous or subdermal tissues surrounding the administration site. The injuries range from less significant erythematous reactions to skin sloughing and necrosis. Whilst extravasation is possible with any intravenous injection it is only considered to be problematic with compounds knowns to have irritant or vesicant properties (see WOSCAN guidance – section 8). The onset of symptoms may occur immediately or several days to weeks after administration. If left undiagnosed or inappropriately treated, necrosis and functional loss of tissue and limb concerned may ensue.
As noted above, although it can occur with other drugs, this policy only covers cytotoxic drugs and the aim of this SOP is to provide guidance on how to access the policy, the procedure and the documentation in the event of suspected cytotoxic extravasation.
All personnel responsible for the administration of SACT must be appropriately trained and immediately access this SOP and the equipment listed in Section 4 on first suspicion of SACT extravasation and follow the pathway listed in Section 6. The process should be followed for any suspected extravasation. If, when reviewed by plastic surgery it is not defined as a true extravasation this should then be documented to complete the incident.
SUSPECTED EXTRAVASATION SHOULD BE TREATED AS A MEDICAL EMERGENCY