Extravasation management: clinical update.
OBJECTIVE
To present a clinical update on the prevention, detection, and evidence-based management of vesicant chemotherapy extravasations.


METHODS
Journal articles, published and unpublished case reports, personal experience.


CONCLUSIONS
In the 4 years that have elapsed since the publication of the original article, much more is known about vesicant chemotherapy extravasation, and effective evidence-based treatments now are available. The antidotes sodium thiosulfate for mechlorethamine extravasations and hyaluronidase for plant alkaloid extravasations are recommended by the manufacturers of these vesicants and cited in nursing guidelines. The anthracycline extravasation treatment dexrazoxane for injection, the first and only extravasation treatment with proven effectiveness, is now available as Totect (dexrazoxane; TopoTarget USA, Rockaway, NJ, USA) in the US and Savene (SpePharm, Amsterdam, The Netherlands) in Europe.


CONCLUSIONS
Nurses who administer vesicant chemotherapy agents need to be aware of the most current evidence (or lack of evidence) for various types of extravasation treatment. Well-informed nurses are patient advocates and instrumental in detecting, managing, and documenting extravasations. Most importantly, nurses play a key role in preventing vesicant chemotherapy extravasations.
LisaSchulmeister@hotmail.com
Lisa
L
Schulmeister
D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000451:nursing / Q000628:therapy*; D005260:Female; D005544:Forecasting; D006801:Humans; D007262:Infusions, Intravenous / Q000009:adverse effects; D008297:Male; D009859:Oncology Nursing / Q000379:methods* / Q000639:trends; D017410:Practice Guidelines as Topic
D000970:Antineoplastic Agents