Vesicant extravasation part II: Evidence-based management and continuing controversies.
OBJECTIVE
To review the literature, synthesize current recommendations, and discuss remaining controversies regarding vesicant extravasation management.


METHODS
Published evidence-based reports, clinical articles, and anecdotal case reports about antineoplastic and nonantineoplastic vesicant agent management.


RESULTS
Prevention of vesicant extravasation sequelae requires knowledge about vesicant extravasation manifestations and differentiation of vesicant extravasation from other local IV site reactions. When evidence is weak or missing, logical application of data-based or empirical management strategies is critical. Actions may include timely administration of subcutaneous or topical antidotes, comfort measures, and surgical interventions to minimize the extent of tissue damage and morbidity should extravasation occur.


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


CONCLUSIONS
Nurses who administer vesicant agents should understand the nursing and collaborative actions that should be taken to minimize patient morbidity, pain, and disability.
Wickham
Rita
R
College of Nursing, Rush University, Chicago, IL, USA. ritawickham@comcast.net
Engelking
Constance
C
Sauerland
Carmel
C
Corbi
Dominick
D
D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D019317:Evidence-Based Medicine; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000451:nursing* / Q000517:prevention & control / Q000628:therapy; D006801:Humans; D007275:Injections, Intravenous / Q000451:nursing; D009369:Neoplasms / Q000188:drug therapy* / Q000451:nursing*; D009859:Oncology Nursing / Q000379:methods*
D000970:Antineoplastic Agents