Extravasation is the leakage of certain harmful medicines into the body from an IV drip or injection into and through a vein.

Some medicines will only cause slight damage and they are called irritants. Medicines that cause more serious damage are called vesicants.

Medicines such as chemotherapy and penicillin, can be dangerous when they escape from the drip or the vein. Extravasation can cause injuries ranging from blisters to cell or tissue death. Severe cases can require surgical reconstruction or lead to amputation.

What causes extravasation injuries?

The device that administers the medicine may not be secured properly, may be the incorrect size or may be placed on an area that moves a lot so it can become loose or dislodged. A needle may puncture the vein causing the medicine to go into the surrounding tissue. If the same vein is used multiple times, it can weaken. The same applies if multiple attempts are made to site the device in the same vein. Young patients are at risk because they have small veins. Older patients are at risk because their veins may be more fragile.

Signs and Symptoms

  • Symptoms of an extravasation injury can include:
  • Coolness or blanching at the medicine insertion site.
  • Swelling.
  • Tenderness/discomfort.
  • Taut or stretched skin.
  • Leakage of fluid at the insertion site.
  • Inability to obtain blood return (not always present).
  • Change in quality and flow of the infusion or injection.
  • Numbness, tingling or a pins and needles feeling.
  • Burning, stinging pain
  • Redness may occur followed by blistering, tissue necrosis and ulceration.
  • Treatment

Extravasation injuries are considered medical emergencies. It is important to diagnose extravasation early to avoid complications. Once extravasation has been considered one or more of the following should be carried out:

  • Stop the administration of the substance;
  • Obtain the assistance of someone with experience of extravasation injuries, including but not limited to a plastic surgeon;
  • Elevate the hand;
  • Attempt to aspirate the extravasated drug from the cannula;
  • Apply a hot or cold compress;
  • Wash out the area.

Thankfully extravasation injuries are uncommon, but if they do occur and have not been recognised and treated immediately the consequences can be very nasty and necessitate significant multiple surgeries.  Unfortunately, should this occur there is still likely to be a cosmetically noticeable disfigurement which will be life-long and result in hyper-sensitivity and pain.

If you have suffered an extravasation injury, please do not hesitate to give our clinical negligence solicitors a call to explore whether this was avoidable and for which damages should be sought.