Infiltration and Extravasation: A toolkit to improve practice (NIVAS, 20 February 2024)

Summary

Intravenous therapy is an essential aspect of modern healthcare. While the benefits of using intravenous therapy usually outweigh the risks, occasionally the administration of IV therapies can go wrong. Infiltration and extravasation is a complication whereby the drug or IV therapy leaks into the tissues surrounding the vascular access device. This toolkit, developed by the National Infusion and Vascular Access Society (NIVAS), is intended to enable local services and healthcare organisations to implement polices, protocols and guidelines that will increase awareness about non-chemotherapy extravasations.

Content

This toolkit outlines what is meant by infiltration and extravasation and the scale and impact of these injuries within the NHS. It provides information and further resources shaped around a five-stage approach:

1. Prevention – Safe IV therapy administration and vascular access practice.
2. Recognition – Recognise the early stages of extravasation.
3. Treatment – Early intervention and treatment to reduce or stop tissue damage.
4. Follow up – Ensure the patient is followed up and supported.
5. Reporting – Standardised incident reporting of infiltration and extravasation.

To support the implementation of this approach, NIVAS recommends that:

• All NHS hospitals should have an extravasation lead for non–chemotherapy and chemotherapy practice.
• All NHS hospitals should improve awareness of non–chemotherapy and chemotherapy extravasation and have guidelines in place.
• All NHS hospitals should standardise reporting of infiltration and extravasation incidents.
• National infiltration and extravasation guidelines for chemotherapy and non-chemotherapy practice.
• Support the creation of a vascular access service team in all NHS Hospitals.

Related reading

• National campaign aims to reduce patient harm from infiltration and extravasation (March 2023)
• NHS Resolution presentation: Learning from extravasation claims (6 October 2023)