
Extravasations are a dangerous complication of IV failure that have the potential to cause serious harm to patients. Extravasation means “outside the vessel.” An extravasation is the result of an accidental leaking of a damaging drug or IV fluid into the tissue surrounding the IV site. The drug may be an irritant, causing pain and possibly inflammation. It may be a vesicant, potentially causing blistering and/or necrosis. Your healthcare professional may refer to all accidental leaks as infiltrations, even if it might officially be an extravasation.
Types of Extravasation
When an extravasation occurs, the damage can be severe, causing tissue damage, painful blisters, and/or severe swelling. It can also be mild, resulting in discomfort at the IV site or along the vein, inflammation of the surrounding tissue, and/or redness.
Healthcare professionals classify IV medications as irritants and vesicants. Each hospital develops a list of these “high risk” medications. If you are curious if you are receiving one of these high-risk infusions, ask your care provider.
Extravasation Signs and Symptoms
If a high-risk medication leaks during your IV procedure, you may feel discomfort and see some redness, swelling, or feel itchiness at the IV site. You may also notice blistering, peeling, and darkening of the skin over the site. Be sure to let your doctor or nurse know immediately if you start to feel itching, burning, swelling or stinging around the IV.
Some of the signs of trouble may not be visible until several hours or even days after the leak. Extravasations may not always show these symptoms, depending on how much of the vesicant infiltrates and how the patient responds to the antidote, if one is given.

Extravasation Treatment & Prevention
While the healthcare team will be highly trained in administering chemo drugs and other vesicants, accidents happen. The drug’s classification as an irritant or vesicant will help determine the possible reactions and the actions needed to control the damage.
If the drug is an irritant, the care team will stop the IV, start a new one, and give the rest of the medication through a fresh site. If it’s a vesicant, the team will stop the IV, apply warm or cold compresses, potentially give you an injection to minimize tissue damage, and administer the rest of your treatment through a fresh IV site.
Depending on the severity of the extravasation, your medical team may also try to remove as much of the vesicant as possible by making multiple injections around the insertion site and the area of the extravasation. If the tissue damage is extensive, you may need to see a surgeon.
Early Detection of Extravasations is Key
With infiltration and extravasation events, the earlier they are detected, the more patient harm can be reduced. Learn how ivWatch’s non-invasive technology continuously monitors a patient’s IV site and notifies clinicians of potential infiltration and extravasation events in real time.
Learn more about commonly asked IV questions or how to prepare and care for an IV.
References
Image: https://www.consultant360.com/articles/extravasation-intravenous-fluid-preterm-neonate
Extravasation Injuries in Adults – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3664495/
Vesicants and Extravasations – https://infusionnurse.org/2014/03/14/vesicants-and-extravasation/
What is Extravasation? – https://www.verywell.com/what-is-extravasation-2252331
Know the Difference: Infiltration vs. Extravasation – https://www.rn.com/nursing-news/know-the-difference-infiltration-vs-extravasation/
Extravasation Overview and Prevention – https://www.verywell.com/what-is-extravasation-2252331
Extravasation: Prevention Is the Best Treatment – https://www.nurse.com/blog/2008/04/07/extravasation-prevention-is-the-best-treatment/
Vesicants and Irritants — What Is the Difference? http://hadawayassociates.com/1/post/2014/10/vesicants-and-irritants-what-is-the-difference.html
Can you recognize the risk factors for vesicant extravasation? https://www.thefreelibrary.com/Can+you+recognize+the+risk+factors+for+vesicant+extravasation%3f-a0187772647
Central Venous Catheters – https://www.cancer.org/treatment/treatments-and-side-effects/central-venous-catheters.html
What is an Extravasation
Extravasations are a dangerous complication of IV failure that have the potential to cause serious harm to patients. Extravasation means “outside the vessel.” An extravasation is the result of an accidental leaking of a damaging drug or IV fluid into the tissue surrounding the IV site. The drug may be an irritant, causing pain and possibly inflammation. It may be a vesicant, potentially causing blistering and/or necrosis. Your healthcare professional may refer to all accidental leaks as infiltrations, even if it might officially be an extravasation.
Types of Extravasation
When an extravasation occurs, the damage can be severe, causing tissue damage, painful blisters, severe swelling. It can also be mild, resulting in discomfort at the IV site or along the vein, inflammation of the surrounding tissue, and/or redness.
Healthcare professionals classify IV medications as irritants and vesicants. Each hospital develops a list of these “high risk” medications. If you are curious if you are receiving one of these high-risk infusions, ask your care provider.
Extravasation Signs and Symptoms
If a high-risk medication leaks during your IV procedure, you may feel discomfort and see some redness, swelling, or feel itchiness at the IV site. You may also notice blistering, peeling, and darkening of the skin over the site. Be sure to let your doctor or nurse know immediately if you start to feel itching, burning, swelling or stinging around the IV.
Some of the signs of trouble may not be visible until several hours or even days after the leak. Extravasations may not always show these symptoms, depending on how much of the vesicant infiltrates and how the patient responds to the antidote, if one is given.
Extravasation Treatment & Prevention
While the healthcare team will be highly trained in administering chemo drugs and other vesicants, accidents happen. The drug’s classification as an irritant or vesicant will help determine the possible reactions and the actions needed to control the damage.
If the drug is an irritant, the care team will stop the IV, start a new one, and give the rest of the medication through a fresh site. If it’s a vesicant, the team will stop the IV, apply warm or cold compresses, potentially give you an injection to minimize tissue damage, and administer the rest of your treatment through a fresh IV site.
Depending on the severity of the extravasation, your medical team may also try to remove as much of the vesicant as possible by making multiple injections around the insertion site and the area of the extravasation. If the tissue damage is extensive, you may need to see a surgeon.
Early Detection of Extravasations is Key
With infiltration and extravasation events, the earlier they are detected, the more patient harm can be reduced. Learn how ivWatch’s non-invasive technology continuously monitors a patient’s IV site and notifies clinicians of potential infiltration and extravasation events in real time.
Learn more about commonly asked IV questions or how to prepare and care for an IV.
References
Image: https://www.consultant360.com/articles/extravasation-intravenous-fluid-preterm-neonate
Extravasation Injuries in Adults – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3664495/
Vesicants and Extravasations – https://infusionnurse.org/2014/03/14/vesicants-and-extravasation/
What is Extravasation? – https://www.verywell.com/what-is-extravasation-2252331
Know the Difference: Infiltration vs. Extravasation – https://www.rn.com/nursing-news/know-the-difference-infiltration-vs-extravasation/
Extravasation Overview and Prevention – https://www.verywell.com/what-is-extravasation-2252331
Extravasation: Prevention Is the Best Treatment – https://www.nurse.com/blog/2008/04/07/extravasation-prevention-is-the-best-treatment/
Vesicants and Irritants — What Is the Difference? http://hadawayassociates.com/1/post/2014/10/vesicants-and-irritants-what-is-the-difference.html
Can you recognize the risk factors for vesicant extravasation? https://www.thefreelibrary.com/Can+you+recognize+the+risk+factors+for+vesicant+extravasation%3f-a0187772647
Central Venous Catheters – https://www.cancer.org/treatment/treatments-and-side-effects/central-venous-catheters.html