Information on Extravasation (Paediatrics)

What is an extravasation?

Extravasation refers to the accidental leakage of fluids from a vein into the surrounding tissue. It is a risk when thin tubes called central and peripheral lines or cannulas, are inserted into a vein to administer medicines or fluids. Some medicines can cause damage when they escape from the line or the vein. The symptoms can vary from blisters to severe tissue injury and in extreme cases can even cause the cells or tissue to die.

Extravasation can occur when for instance, there is an obstruction to the line administering the medicine, the drug being administered too quickly or the cannula is overused. Certain medicines are also more likely to cause extravasations than others.

What we do to prevent extravasation

All central and peripheral lines and cannulas will be secured with a clear dressing for easy visualisation of the insertion site. The infusion site is checked regularly; every time medications are given and on an hourly basis if continuous fluids are being administered. In some instances, the site may be checked more frequently than this. We are aware of the of the types of drugs which can increase the risk of extravasation. We record, monitor, and investigate all extravasation injuries that occur. This is so that we can put measures in place to try to prevent them happening in the future.

What are the signs of an extravasation?

All line sites will be observed for signs such as redness, swelling or leaking of the site where the tube enters the vein. Extravasation usually results in pain such as stinging and burning. We will regularly monitor and record the pressure shown on the machine, which regulates the infusion, which helps tell us if extravasation may be occurring. A rise in pressure could point to an issue with the line being used. Some medicines can feel uncomfortable when being administered but do not go on to cause extravasation.

If you notice any of these symptoms whilst your child is receiving intravenous fluids or medications, please inform a nurse immediately.

How will extravasation be treated?

Any infusions will be immediately stopped. The area will be checked and photographed. The medical team will be informed and an assessment made. The treatment required will depend on the degree of injury and the medicine that has leaked into the tissues. An on-call plastic surgeon may be contacted. The affected area may need to be washed out by the surgeon. The area affected is likely to be uncomfortable so your child will receive the appropriate pain relief to manage this. If your child still requires intravenous medications another line or cannula will be placed in an alternative site.

Long term effects of extravasation

The area may be sore but if the extravasation is recognised and treated early then there should not be any long-term effects. However, in cases where tissue damage is more extensive, further specialist treatment may be required, and healing times may be longer.

This leaflet only gives general information. You must always discuss the individual treatment of your child with the appropriate member of staff.