Vesicant extravasation part I: Mechanisms, pathogenesis, and nursing care to reduce risk.
OBJECTIVE
To review the literature regarding the incidence, current practice, guideline recommendations, nursing management, and knowledge gaps relevant to vesicant extravasation.


METHODS
Published research articles, books, case reports, and national guidelines.


RESULTS
Vesicant extravasation is a relatively rare but significant complication of chemotherapy administration. Extravasation may have a range of consequences that can cause serious physical and quality-of-life effects. Knowledge of risk factors and preventive measures can reduce patient risk. Data-based and empirical management strategies such as immediate local measures (agent withdrawal, comfort measures, and medical interventions) may minimize risk for extravasation, as well as lead to timely recognition and management and decreased morbidity should extravasation occur.


CONCLUSIONS
Vesicant extravasation and sequelae constitute a complex patient problem that clinicians should strive to prevent or to minimize injury should it occur. To this end, clinicians must demonstrate awareness of risks and use specialized knowledge while administering vesicant agents.


CONCLUSIONS
Only nurses knowledgeable about extravasation and skilled in associated techniques should assume responsibility for vesicant administration.
Sauerland
Carmel
C
Nursing Cancer Center, Westchester Medical Center, Valhalla, NY, USA. caragho2@aol.com
Engelking
Constance
C
Wickham
Rita
R
Corbi
Dominick
D
D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000453:epidemiology / Q000451:nursing* / Q000517:prevention & control; D006801:Humans; D007275:Injections, Intravenous / Q000451:nursing; D009369:Neoplasms / Q000188:drug therapy* / Q000451:nursing*; D009859:Oncology Nursing / Q000379:methods*; D017410:Practice Guidelines as Topic; D012307:Risk Factors
D000970:Antineoplastic Agents