How to Care for Suspected Chemotherapy Extravasation
Your treatment
The name of the chemotherapy drug which may have extravasated is:
…………………………………………………………………
Introduction
When you received your chemotherapy or other cancer treatment today, some of the drug may have leaked out of the vein and into the tissue surrounding your cannula. This is called extravasation. Extravasation is a rare complication of chemotherapy.
Why is extravasation important?
Some chemotherapy drugs can cause irritation, soreness and ulceration if they leak under the skin and surrounding tissue. It is important that you receive the appropriate treatment to minimise the discomfort, and tissue and skin damage that can be caused.
What causes extravasation?
Extravasation can occur because your veins may be irritated by the drugs. They may be thin or weak, or the cannula itself can become dislodged. The nurses that administer chemotherapy have received training in how to prevent and treat this potential complication.
What treatment do I need?
The treatment depends on the drug which is thought to have extravasated. Please follow the instructions marked in this leaflet for your own individual care.
Staff to delete from the following table, as appropriate in accordance with the Dorset County Hospital Extravasation Policy.
| Apply a cold compress to the cannula site 4 to 5 times a day for 15-20 minutes for the next 24-48 hours. Do not apply directly on the skin – lay a piece of gauze/cloth directly over the skin. |
| Apply a warm compress to the cannula site 4-5 times a day for 15-20 minutes for the next 24-48 hours. Do not apply directly on the skin – lay a piece of gauze/cloth directly over the skin. |
| Apply a thin layer of hydrocortisone cream (1%) 3 times a day for a week, stopping once redness has disappeared. Stop the cream if the area blisters and contact the 24-hour chemotherapy helpline. |
| Apply dimethyl sulfoxide (DMSO) 99% solution with a cotton bud to the area marked on your skin. Allow to air dry. Repeat every three hours during waking hours, for the next 24 hours and then six-hourly for the next seven days. Stop DMSO if the skin blisters and contact the 24-hour chemotherapy helpline. |
| You will require an intravenous infusion of a medicine called dexrazoxane for three consecutive days, which will be done in hospital. A cold compress may help to relieve pain; however, you should not use a cold compress for at least 15 minutes before and for three to four hours after your dexrazoxane infusion. |
General advice
- Only allow clean running water over the area eg a shower, and gently pat the area dry with a clean towel
- Do not rub the area
- Do not apply any lotion, creams or ointments to the affected area unless asked to do so by your doctor or nurse
- Do not expose the area to strong sunlight
- Avoid clothing that constricts the affected area
- If your hand has been affected, it may help to take rings off in case you experience any swelling
- Elevate the affected arm on a pillow wherever possible to reduce swelling, and keep moving the arm/hand gently
- Take pain relief as required – as discussed with your doctor or nurse.
Please contact the 24-hour chemotherapy helpline on 01305 255995 immediately if any increased discomfort, swelling, peeling or blistering of the skin occurs. Please immediately report any fever above 37.5 ˚ or below 35.5 ˚.
Please attend the Fortuneswell Unit for review on:
………………………………………………………………..
Useful numbers
24-hour chemotherapy helpline: 01305 255995
About this leaflet
Author: Abby Tindall, Macmillan Systemic Anti-Cancer Clinical Nurse Specialist
Written: November 2022
Approved: November 2022
Review date: November 2025
Edition: v2
If you have feedback regarding the accuracy of the information contained in this leaflet, or if you would like a list of references used to develop this leaflet, please email patientinformation.leaflets@dchft.nhs.uk
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