Upper-Extremity Extravasation: Evaluation, Management, and Prevention

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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.
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