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Published on: September 12, 2018
Describing Intravenous Extravasation in Children (DIVE Study).
Vanessa Paquette1, Rumi McGloin, Tracie Northway
1, BSc(Pharm), ACPR, is a Clinical Pharmacist, Neonatal Critical Care, in the Department of Pharmacy, Children's and Women's Health Centre of British Columbia, and a Clinical Instructor in the Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, British Columbia.
Pediatric extravasation incidence was low, with IV fluids and potassium chloride most commonly involved. Antidotes were safe but appropriately used in only 50% of cases, highlighting a need for improved management protocols.
Area of Science:
- Pediatric patient safety
- Intravenous therapy complications
- Pharmacovigilance in pediatrics
Background:
- Extravasation, or IV medication leakage, is a significant cause of iatrogenic patient injury.
- Reported incidence ranges from 0.1% to 6.5%, potentially higher in children due to anatomical and physiological risk factors.
Purpose of the Study:
- To determine the incidence of extravasation in a pediatric tertiary care hospital.
- To identify common causative agents and assess antidote use and adverse effects.
Main Methods:
- Retrospective analysis of medical records for pediatric extravasation cases from 2006-2008.
- Evaluation of antidote appropriateness based on institutional protocol.
Main Results:
- Overall incidence of 0.04% per patient-day; 42 cases documented.
- Most common agents: IV fluids (43%), potassium chloride (26%), antibiotics (19%).
- Antidotes were appropriately used in 50% of cases; no adverse drug effects reported.
Conclusions:
- The incidence of pediatric extravasation is low.
- Commonly implicated medications align with existing literature.
- While antidotes are safe, their appropriate use requires improvement, necessitating further research.
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