Canberra Hospital and Health Services
Guideline
IV Extravasation Management Practice Guideline(infants, children and adolescents)
Purpose
The Intravenous (IV) Extravasation Management Practice Guideline has been developed to provide direction to clinicians and is aimed at achieving the best possible paediatric care through timely recognition and appropriate management following the extravasation of a vascular device. The practice guideline was prepared for the Sydney Children’s Hospital Network(SCHN) by expert clinical reference groups
It should be noted that this document reflects what is currently regarded as a safe and appropriate approach to care. However, as in any clinical situation there may be factors which cannot be covered by a single set of guidelines. This document should be used as a guide, and does not replace the need for the application of clinical judgment to each individual presentation.
This document provides guidance on staging of extravasation injuries (appendix 1 of hyperlinked document) and guideline for management of extravasation injury for specific drugs (appendix 3 and 4 of hyperlinked document).
Alert:
Any SCHN-specific information/policies, including Sydney Children’s Hospital (SCH) and Children’s Hospital Westmead (CHW), is not relevant to the care of infants, children and paediatric adolescent patients at CHHS. The only exception is the EviQ resources, which are endorsed for use at CHHS.
Specific information for CHHS includes:
- Escalation of care in the event of extravasation:
- Stage 1 and 2: Consider referral to the Tissue Viability Nurse (TVN) for advice or if you are concerned.
- Stage 3 and 4: must refer to the TVN and to the Plastics or Paediatric Surgical teams
- Stage 4: A local emergency response (i.e. urgent Paediatric medical review)
- A RiskMan incident report (referred to as IiMs in SCHN policy) must be submitted for all intravenous extravasations.
- For an additional review and management plan for extravasation sites, consider referral to the TVN.
- For further drug information contact the Pharmacy Department drug information pharmacist or pharmacist on call.
- Intravenous solutions in CHHS Paediatric Department are administered as per the ‘Paediatric Injectable Guidelines’ (Royal Children’s Hospital Melbourne, 5th Edition, 2016).
- IV Extravasation kits can be found in all Paediatric Medication Rooms.
Scope
The guideline is applicable to clinicians caring for paediatric patients in the Paediatric Department, Emergency Department, Post Anaesthetic Care Unit and Intensive Care Unit of Canberra Hospital and Health Services.
This document relates to the assessment and management of paediatric patients (infant, children and adolescents)who require assessment and management following the extravasation of a vascular device.
Which area in ACT Health can I contact for more information?
Chelsey Helliwell – Paediatric Clinical Support Nurse
Phone: 61747492 or 61426210
Email:
How can I access the document?
Sydney Children’s Hospital Network guideline number 1/C/16:9057-01:00
Search Terms
Extravasation, Intravenous, EviQ, Cannula, IVC
Disclaimer: This document has been developed by ACT Health, Canberra Hospital and Health Services specifically for its own use. Use of this document and any reliance on the information contained therein by any third party is at his or her own risk and Health Directorate assumes no responsibility whatsoever.
Policy Team ONLY to complete the following:
Date Amended / Section Amended / Divisional Approval / Final Approval1/12/17 / New Document / Karen Faichney, DON, WY&C / CHHS Policy Committee
This document supersedes the following:
Document Number / Document NameDoc Number / Version / Issued / Review Date / Area Responsible / Page
CHHS17/295 / 1 / 07/12/2017 / 01/12/2020 / WY&C – Paediatrics / 1 of 3
Do not refer to a paper based copy of this policy document. The most current version can be found on the ACT Health Policy Register