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Chemo vesicant "extravasation kit"

I posted this question once before, but in the wrong place...so here I go again.

Our oncology unit does not have an extravasation kit.  When I ask them what they do if they have an extravasation occur, they say "call pharmacy"..  The oncology Clinical Educator recently sent me an article from Clinical Journal of Oncology Nursing about "Totect:  A New Agent for Treating Anthracycline Extravasation"  Have any of you used this?

My main question is what are nurses in the various areas and states using in an extravasation Kit?

Thanks for your input.

lynncrni
Totect was approved by the

Totect was approved by the FDA to treat anthracycline extravasation on Sept 7, 2007. So it is very new to the US. It has been used in the UK under the name of Savene with good results. It is a 3 day infusion to treat these extravasations and it cost about $15,000. But the benefit is to avoid the necrotic ulcer and surgery and skin grafting after the injury. So the cost is worth it.

I would encourage you to create a protocol for treating an infiltration and extravasation. You can not rely upon the physician or the pharmacists to immediately recall the most appropriate method of treatment based on the fluid or drug in the subq tissue. This protocol needs to address all the items listed in my recent article:

1.    Hadaway L. Emergency: Infiltration and Extravasation - Preventing a complication of IV catheterization. American Journal of Nursing. 2007;107(8):64-72.

There really are no standard contents of a "kit". Most drugs and fluids should be treated with cold but a few require heat. The antidote, if your facility chooses to use them, are different and depends upon the drug that escaped. Gloves and syringes and small gauge needles would be the only standard contents. Lynn 

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

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T. Nauman RN, CRNI  IV

T. Nauman RN, CRNI  IV Educator SHMC Eugene, OR

Thanks so much, Lynn, for your reply.  I was just reading your article and will share it and your post with out oncology Clinical Educator.  She and I are working together to develop a protocol for chemo extravasation.

T. Nauman RN, CRNI

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