title: Extravasation management.
abstract: OBJECTIVE
  To describe the mechanisms of injury associated with DNA binding and DNA non-binding vesicants. To review various procedures used in clinical practice to manage vesicant extravasations.
  
  
  METHODS
  Journal articles, published case reports, personal experience.
  
  
  CONCLUSIONS
  There is a lack of evidenced-based information and consensus about vesicant extravasation management. The antidotes sodium thiosulfate for mechlorethamine extravasations and hyaluronidase for plant alkaloid extravasations are recommended by the manufacturers of these vesicants. Data suggest that administration of IV dexrazoxane is effective in preventing tissue necrosis following anthracycline extravasation. Dimethyl sulfoxide also may have a role in treating anthracycline extravasations, but further research is needed.
  
  
  CONCLUSIONS
  Nurses who administer vesicant chemotherapy agents must be aware of the most current (or lack of) evidence for extravasation treatment. Well-informed nurses can serve as patient advocates and may be instrumental in detecting, managing, and documenting these injuries. Most importantly, nurses play a key role in preventing vesicant extravasation injuries.
authors: FAAN, 282 Orchard Road, River Ridge, LA 70123-2648, USA. LisaSchulmeister@hotmail.com
authors: Lisa
authors: L
authors: Schulmeister
mesh_terms: D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D019793:Fluorescein; D006801:Humans; D013396:Suction
chemical_list: D019793:Fluorescein