In this section
Note: This guideline is currently under review.
Extravasation may occur due to either the cannula piercing the vessel wall or from distal venous occlusion causing backpressure within the vessel. Literature suggests up to 11% of infants and children admitted to hospital will experience extravasation of an intravenous infusion. A small but significant proportion of
these may develop long-term cosmetic or functional compromise as a result of the injury.
Peripheral and central venous catheters are both capable of causing extravasation. A Cochrane review comparing catheter types in neonates receiving TPN showed that centrally placed catheters may provide better nutritional input but did not significantly decrease the incidence of extravasation when compared
with peripherally placed catheters.
Intravenous pumps do not always alert staff to an extravasation injury in progress. Limiting the pump cycle to one hour may minimise the extent of tissue damage from extravasation providing the entry site is observed concurrently. Nursing vigilance is the key to avoiding or minimising injury.
Examples of commonly used solutions with the potential to cause skin necrosis
The patient's parents should be informed of an extravasation injury and management plan.
Procedure for the irrigation of neonatal extravasation injuries
This should be completed by the Doctor performing the irrigation procedure, printed and scanned into the patient's EMR.
The evidence table for this guideline can be found
Please remember to read the
development of this nursing guideline was coordinated by Trudy Holton, Clinical Nurse Educator, Butterfly,
and approved by the Nursing Clinical Effectiveness Committee. Updated May 2016.