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This booklet has been produced to provide information to patients receiving intravenous chemotherapy. It is not meant to substitute the discussion between you and the nursing team treating you but helps to clarify what is discussed.
What is Extravasation?
Extravasation is the leakage (or accidental infiltration) of drugs outside of the vein and into surrounding tissues. With some drugs, this may lead to an immediate painful reaction and result in local tissue and vein damage. You may notice pain; stinging, swelling or other changes to the skin at the site of drug administration, or the nurse may have noticed that the drug was not flowing in easily.
Why did this happen?
Extravasation is a rare but known complication of intravenous chemotherapy. It may be difficult to prevent even though we take all possible precautions. The important thing is that it had been detected and treated.
Why is extravasation a problem?
The problems vary with different drugs but can include pain, stiffness and ulcers. The treatment you were given when the leakage was found should prevent some of the damage. We will continue to treat any damage until it has healed. Very occasionally patients will require plastic surgery to repair the damage caused by the extravasation. If necessary your doctor will discuss this with you.
What treatment have I received to prevent tissue damage?
The nurse/doctor has given you the recommended treatment for the extravasation. Although this will help to minimise the chance of developing further problems, you will need to keep checking the area every day. You may require further advice and treatment with dermatology or plastic surgeons. The team will keep you up to date if this is necessary.
Checking the area
Once a day, check the area for the following:
• Has the area changed colour or increased in redness?
• Is the area blistering, peeling or flaking?
• Is the area hot?
• Is the area more uncomfortable?
• Is the pain making it difficult for you to exercise your arm or hand?
If you have answered YES to any of the questions in the checklist on page 2 or if you have any other concerns then you should contact either Oncology Suite or Macmillan Unit.
Macmillan Unit Telephone number is 01908 996351
Oncology Suite telephone number is 01908 996431
Out of hours number is 01908 660033 and ask to bleep 1090.
What else do I need to do?
• Gently exercise the affected arm or hand
• Raise the hand or arm on a pillow to reduce any swelling
• Take mild painkillers as required
• Do not apply any other lotions, creams or ointments unless you have been instructed to do so by the doctor or nurse
• Do not expose the area to strong sunlight
• Avoid wearing tight clothing around the affected area
• Protect the affected area when bathing (or having a shower) so that it does not get wet.
Information regarding additional treatment recommended by the hospital
You will be informed of when you need to come back into the hospital to review the affected area
Glossary of medical terms
Intravenous chemotherapy: Chemotherapy given into a vein
Extravasation – leakage (or accidental infiltration) of drugs outside of the vein and into surrounding tissues
This information was utilised from Pan Birmingham Cancer Network via http://www.birminghamcancer.nhd.uk