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European Oncology Nursing Society extravasation guidelines
1University of Stirling, Department of Nursing and Midwifery, Cancer Care Research Centre, Scotland. Yvonne.wengstrom@ki.se
Summary
Vesicant chemotherapy extravasation can cause tissue damage. Current guidelines recommend topical cooling for anthracycline extravasations, with Savene (dexrazoxane) as the only registered treatment.
Area of Science:
- Oncology Nursing
- Chemotherapy Complications
- Extravasation Management
Background:
- Vesicant chemotherapy extravasation is an infrequent but serious complication.
- Extravasation can lead to blistering and ulceration of tissues.
- European Oncology Nursing Society (EONS) published guidelines in 2007 for management.
Purpose of the Study:
- To review current evidence-based guidelines for vesicant extravasation.
- To highlight the importance of early detection and management.
- To emphasize the need for nurses to be prepared for evidence-based treatment administration.
Main Methods:
- Review of existing literature and guidelines on extravasation management.
- Identification of recommended treatments based on vesicant type (e.g., plant alkaloids, anthracyclines).
- Evaluation of evidence supporting various antidote treatments.
Main Results:
- Topical cooling is recommended for anthracycline extravasations; topical heating for plant alkaloids.
- Topical DMSO, sodium thiosulfate, and hyaluronidase lack strong evidence for anthracycline extravasation.
- Savene (dexrazoxane) is the sole registered drug for anthracycline extravasation treatment.
Conclusions:
- Nurses must adhere to evidence-based guidelines for vesicant extravasation.
- Prompt and appropriate management is crucial to minimize tissue damage.
- Further research is needed for non-registered antidote efficacy.
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