Upper-Extremity Extravasation: Evaluation, Management, and Prevention
Extravasation events are injuries common in the medical field, given the vast variety of therapeutic agents that are regularly delivered parenterally. Reports exist of an incidence of up to 10% in neonates receiving parental nutrition and 0.14% in adult patients receiving contrast agent for imaging 1,2 . The agents that infiltrate can be categorized as irritants and vesicants. Irritants typically cause mild symptoms such as localized pain, edema, and erythema due to localized inflammatory reaction 3 . However, vesicants are inherently cytotoxic and can cause blistering, induration, skin necrosis, and deep-tissue damage 3-5 . If the fluid that enters the subcutaneous tissue accidentally is a nonvesicant, it is said that the fluid infiltrated. If the fluid is more harmful and is considered a vesicant, it is said that the fluid extravasated into the surrounding tissues.