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Extravasation

Most chemotherapy drugs are given intravenously (IV.) To assure the proper administration of chemotherapy, the injection site has to be under constant monitoring by an Oncology nurse. Drugs should never leak from the injection site. Leakage of the drug into the tissues around the injection site is called "Extravasation ". The nurse has to be certain of the patency of the vein and the needle that is used. If there is any doubt, another vein should be used. If a leak or any swelling is seen at the injection site, the infusion of the chemotherapy drug has to be stopped right away. The site may need to be treated according to the kind of drug that was used. Certain drugs, if extravsate, can cause severe damage to the skin and the underlying tissues. Among them are:

• Adriamycin

• BiCNU

• Daunorubicin

• DTIC

• Mithramycin

• Mitomycin

• Mitoxantrone

• Nitrogen Mustard

• Velban

• Vincristine

• VP-16

• Carboplatinum

• Fludarabine

• Gemcitabine

• Idarubicin

• Irinotecan

• Navelbine

• Taxol

• Taxotere

• Topotecan

Treatment:

The infusion of chemotherapy drug has to be stopped right away. The arm has to be observed for swelling and change in color at the site of Extravasation. Warm compresses may be applied to enhance the absorption of the drug from the tissue and thereby reducing the damage. In case of adriamycin, local application of highly concentrated DMSO may help in prevention of severe skin damage.