Patient Care and Monitoring Extravasation

1. Upon diagnosis, determine need for administration of chemotherapy with vesicant properties. Refer the patient for surgical placement of a central access device.

2. Insure proper training and certification of all personnel in institution who administer chemotherapeutic agents.

3. Educate the patient regarding signs and symptoms of extravasation and instruct to IMMEDIATELY relate to caregiver.

4. Educate the patient to promptly report increasing pain, spread of the lesion or ulceration.

5. Educate the patient regarding proper application of hot or cold packs as well as topical antidotes. Should the area be allowed to air dry or be covered?

6. Evaluate the patient for allergies and adverse effects of pharmacologic antidotes.

The antidote of choice for mechlorethamine extravasations is sodium thiosulfate. This agent binds alkylating agents resulting in neutralization to inactive compounds that are then excreted. Sodium thiosulfate may also be effective for high concentration cisplatin or dacarbazine extravasations.

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