How to prevent drug extravasation

Causes of drug extravasation

1. 1 drug itself

It is mainly related to drug pH, osmotic pressure, drug concentration, drug toxicity and type I allergic reaction. It is reported that the incidence of extravasation of corrosive chemotherapeutic drugs is about 0.1%-6% [1].

1.2 Mechanical injury

In the process of drug infusion, the needle pierces the blood vessel, and when the vein is compressed, the pressure is too high, which leads to the increase of blood vessel permeability. Unskilled puncture technique, improper selection of blood vessels, unstable needle fixation, incorrect pressing technique after needle extraction, repeated puncture of blood vessels and local diseases may all lead to extravasation.

1.3 vascular status

In patients with superior vena cava compression syndrome, the arm vein of breast cancer is compressed, the blood flow is blocked, local vasospasm is caused by infusion, the nutritional status of patients with digestive tract tumor is poor, the blood vessels are hardened and the elasticity is poor, and multi-course chemotherapy increases the risk of extravasation.

2 to prevent extravasation

2. 1 hot compress

Local hot compress with drugs can dilate blood vessels, increase blood flow and speed up liquid flow, which is the simplest method often used in clinic.

2.2 Strengthen training

Nurses engaged in chemotherapy should receive professional training, understand the pharmacological effects and side effects of drugs, correctly master the administration method, concentration and input speed, protect blood vessels, and prevent venous inflammation and drug extravasation.

2.3 Establish a systematic intravenous use plan.

Choose blood vessels reasonably, master the puncture technique skillfully, avoid repeated puncture, repeated infusion or long-term infusion of the same vein, establish venous access with scalp needle, establish venous access with 0.9/NS for the first time, confirm that the venous return is good and there is no exudation, check whether there is redness and pain at the injection site, and connect diluted chemotherapy drugs after ensuring that the vein is unobstructed.

2.4 early prevention, early detection and early treatment, pay attention to identify atypical extravasation.

2.4. 1 early prevention to master the patient's vascular condition, so as to achieve a clear idea, take preventive measures as soon as possible, and achieve predictive nursing.

2.4.2 Early detection can improve the understanding of nurses and ensure the continuity of detection.

2.4.3 Early treatment will regularize the above measures, and whoever finds them will deal with them, and strengthen the health education for patients so that they can report in time, so that we can deal with them at the first time and avoid serious consequences.

2.5 Correct and timely treatment of drug extravasation

Explain the precautions of drug infusion to patients in detail in order to obtain the cooperation of patients and their families. In the process of infusion, we should observe carefully, find problems and deal with them correctly in time. If drug extravasation is found, the following treatment should be carried out: pull out the needle immediately and stop using the drug; Under strict aseptic operation, 0.5% procaine can be used for cold compress or ice compress after circulation sealing, and it is not suitable for immediate hot compress to avoid tissue necrosis.

2.6 Correct needle drawing method

Intravenous infusion of chemotherapy drugs, rinse the catheter with a small amount of 0.9%Ns before needle withdrawal to prevent the chemotherapy solution from leaking out of the blood vessel with the needle during needle withdrawal, and press the skin blood vessel puncture point 1 ~ 2 minutes with your fingertips.

2.7 Strengthen the sense of responsibility of nurses.

Nurses should raise their awareness, strengthen their responsibilities, closely observe the infusion situation, find problems in time, and deal with them in time to prevent extravasation injury.

I hope my answer is helpful to you!