Management of Extravasation of Cytotoxic Drugs in Children

Document Title
Management of Extravasation of Cytotoxic
Drugs in Children
Type of document
Corporate: Clinical
Brief summary of contents
Executive Director responsible for
Policy:
Directorate / Department responsible
(author/owner):
Guidance on the management of
extravasation in children
Director of Nursing, Midwifery and AHPs
Sabrina Tierney / Pharmacy
Contact details: 01872 252590
Date written: October 2011
Date revised:
This document replaces (exact title of
previous version):
Approval route (names of
committees)/consultation:
Divisional Manager confirming
approval processes
Name and Post Title of additional
signatories
Equality Impact Assessment appended
Approval must not be given if the EIS
is not attached
Signature of Executive Director giving
approval
Publication Location (refer to Policy
on Policies – Approvals and
Ratification):
Document Library Folder/Sub Folder
N/A
Management of Extravasation of Cytotoxic
Drugs
Child Health Directorate Guidelines
Committee
Medicines Practice Committee
Peter Trethewy, Director of Diagnostics
and Therapeutics
N/A
Yes
{Original Copy Signed}
Internet & Intranet Intranet Only
Clinical, RCHT, Chemotherapy
Date of final approval: 1 st February 2012
Date policy becomes live: 1 st February 2012
Date due for revision: 1 st December 2015
Links to key external standards

Related Documents: See Appendix 6
Suggested Keywords:
Training Need Identified
Extravasation, Chemotherapy
Yes - All nurses trained in initial
chemotherapy training, and to attend
oncology update day annually
This document is only valid on the day of printing
Controlled Document
This document has been created following the Royal Cornwall Hospitals NHS Trust
Policy on Document Production. It should not be altered in any way without the
express permission of the author or their Line Manager.
Policy Template

Management of Extravasation of Cytotoxic Drugs in
Children
V1.0
October 2011
Policy Template
Page 3 of 22

Version Control Table
Date
Version
No
Summary of Changes
Final amendments approved; EIA
20.12.07 V1.0 Completed; document published
Changes Made by
(Name and Job Title)
Jo Blogs
Manager
All or part of this document can be released under the Freedom of Information Act
2000
This document is to be retained for 10 years from the date of expiry.
Policy Template
Page 4 of 22

Table of Contents
1. Purpose and Scope ..................................................................................6
2. Definition...................................................................................................6
3. Ownership and Responsibilities................................................................7
4. Monitoring of the patient ...........................................................................7
5. Patient Education......................................................................................7
6. Signs and Symptoms................................................................................8
7. Treatment of Peripheral Line Extravasation..............................................9
8. Treatment of Extravasation from Central Venous Access Devices:
PICC’s, Hickman Lines & Portacaths.............................................................12
9. Mixed Extravasations..............................................................................13
10. Documentation ....................................................................................13
11. Monitoring compliance and effectiveness ...........................................14
12. Updating and Review ..........................................................................14
13. Equality and Diversity..........................................................................14
Appendix 1: Drugs commonly used in Paediatric oncology and their
classification ..................................................................................................15
Appendix 2: Non- Cytotoxic Extravasation....................................................16
Appendix 3 : Extravasation Kit Contents.......................................................17
Appendix 4 : Guidelines for Best Practice When Administering Intravenous
Infusions ........................................................................................................18
Appendix 5: Patient Information Sheet...........................................................19
Appendix 6 - References ...............................................................................20
Appendix 7.Initial Equality Impact Assessment Screening Form ...................21
Management of Extravasation of Cytotoxic Drugs in Children
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1. Purpose and Scope
1.1 This document outlines guidelines for the rapid treatment of extravasation injuries
in paediatric patients within Royal Cornwall Hospital Trust, excluding neonates,
for which there is a separate policy.
1.2 It provides a guideline to assist practitioners in the care of patients who may have
experienced an extravasation injury.
1.3 It will provide a basis for the nursing staff to recognise ways in which to help
prevent extravasation and how to recognise when an extravasation has occurred.
2. Definition
2.1 Extravasation is the leakage or accidental infiltration of intravenous drugs into the
surrounding tissues from the vein. This can lead to an immediate inflammatory
painful reaction and with some drugs may result in local tissue destruction
(necrosis) and other complications.
Neutrals do not cause ulceration and are unlikely to produce an acute
reaction or progress to necrosis.
Irritants are capable of causing inflammation and irritation. They rarely
proceed to the breakdown of tissues. They do have the potential to cause
ulceration, but only if a large amount has extravasated into the tissue.
Exfoliants are capable of causing inflammation and shedding of the skin, but
are less likely to cause tissue death. They can cause pain
Vesicants are drugs that have the potential to cause blistering and ulceration,
which when left untreated can lead to tissue damage and necrosis.
2.2 It is recognised that prevention of extravasation is of importance and particularly
when administering vesicants or irritants the precautions should be taken to
minimise the risk of extravasation, see appendix 4.
2.3 It is accepted that there are also other contributing factors that can affect each
individual patient’s risk of extravasation.
2.4 There are many different drugs that can equally be as destructive in the damage
that they can cause if extravasation occurs, the main bulk of this document
relates to cytotoxic chemotherapy, but the procedure outlined can be used for all
vesicant drugs. Please note that there is a separate guideline for the
extravasation of non-cytotoxic drugs in the neonate.
2.5 Cancer drugs have been grouped into 5 categories based on their potential to
cause tissue damage, see appendix 1.
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3. Ownership and Responsibilities
3.1 The Trust Lead for Cancer Chemotherapy is responsible for ensuring the
implementation and adherence to these guidelines. The Specialist
Clinical Pharmacists in Paediatrics will aid the Cancer Lead in this role.
3.2 The ward manager of Sennen ward is responsible for the education and
development of nursing staff in the handling, administration and disposal
of cytotoxic drugs.
3.3 It is the individual practitioner’s responsibility to ensure the training they
have received is appropriate, and remains updated.
3.4 Ward requirements:
3.4.1. Each clinical area where vesicant cytotoxic drugs are administered
must have a Paediatric Extravasation Kit available (i.e. Sennen ward and
Gwithian Unit)
3.4.2. Monthly checks of the Extravasation kit are the responsibility nurse
in charge. This requires a check of the contents and the expiry date, and
these checks should be recorded in the record book provided for this
prupose.
3.4.3. Replacement paediatric extravasation kits are available from
pharmacy
4. Monitoring of the patient
4.1 During administration of intravenous medication the injection site should be
clearly visible and monitored for redness and swelling regularly (see Appendix 4:
“Guidelines for best practice” for more detailed information on monitoring
requirements).
5. Patient Education
5.1 Patients/parents/guardians should be educated to the fact that extravasation is a
potential risk of receiving chemotherapy when consent is obtained.
5.2 Patient preference to cannulation site (if required) should be taken into account,
but education given as to why good placement and rotation of site is required.
5.3 Education should encourage patients to inform nursing staff if they have pain,
stinging, burning or a change in sensation at cannulation site from start of the
infusion.
5.4 In the advent of an extravasation patients should be provided with both verbal
and written information, see appendix 5
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6. Signs and Symptoms
An extravasation should be suspected if one or more of the following symptoms have
occurred:
6.1 The patient complains of burning, stinging, pain or any discomfort at the injection
site. This should be distinguished from a feeling of cold that may occur with some
drugs. The patient is often the first person to become aware that something is
wrong with the IV therapy, so instruct them at the beginning of treatment to inform
staff of any acute change during treatment.
6.2 Observation of swelling, redness, mottling or blistering at the injection site. This
should be distinguished from the ‘nettle rash’ or ‘flare’ effect seen with some
drugs.
6.3 Care should be taking when no ‘flash back’ or blood return is obtained on
aspiration. However, this is not a sign of extravasation if found in isolation and the
presence of blood does not exclude extravasation
6.4 There is increased resistance felt on the plunger of the syringe of a bolus drug
administration, this however, could be due to possible changes in the position of
the body.
6.5 There is absence of free flow or the rate of flow is remarkably reduced. This may
not be recognisable when using an infusion pump.
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7. Treatment of Peripheral Line Extravasation
Action
1 Stop the administration of the cytotoxic drug
immediately, leaving the cannula in place.
Rationale
To prevent further infiltration and to allow aspiration of
the drug to be attempted (see below)
2 Explain what has been suspected of
happening and next procedure to the
patient/parent/guardian.
To obtain patient’s and/or carer’s co-operation and
consent.
3 Disconnect any IV tubing from the
intravenous cannula, do not remove the
cannula. Attempt to aspirate as much drug
as possible with a new syringe.
To prevent further infusion through the line.
To remove any residual drug.
4 Contact a senior member of nursing and
inform medical staff.
Obtain the experience of other colleagues
Obtain Paediatric Extravasation Kit
5 Mark the area with a pen and take digital
pictures if possible (after patient consent)
To enable the size of the area to be evaluated and
recalled at first presentation.
7 Remove the cannula
Administer pain relief as required
8 Use flow sheet below and/or table
(Appendix 1) to identify agent and
determine action to be taken
Ensure patient comfort
To identify specific relevant instructions
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Peripheral extravasation identified
Stop infusion, Leave cannula in place, Aspirate as much of the drug as possible using a new 10mL syringe, contact senior
member of staff/medical staff, Mark area with pen, Remove cannula, Treat as follows:
Group 1 Drugs
Non-vesicants/neutrals
Asparaginase, Bleomycin, Cladribine,
Cyclophosphamide, Cytarabine, Fludarabine,
Ifosfamide, Melphalan, Rituximab
If large volume seek advice from St. Chad’s
If possible recannulate
in opposite
arm and recommence
chemotherapy
Group 2 & 3 Drugs
Inflammitants & Irritants
Carboplatin, Cisplatin,
Etoposide, Etoposide
Phosphate, Irinotecan,
Methotrexate, Topotecan
Draw up 100mg hydrocortisone and
administer S/C in a clockwise direction
around circumference of the extravasation
site followed by a thin layer of topical
hydrocortisone 1% cream
Use the relevant heat/cold pack to apply warm/cold compression
Apply heat/ cold pack for one hour post incident and then for 20 min four times a day
for 48hrs.
Group 4 & 5
Exfoliants and
Vesicants
Amsacrine,
Carmustine
Dactinomycin
Daunorubicin*
Doxorubicin*,
Epirubicin,
Idarubicin
Mitomycin
Mitoxantrone
Apply topical DMSO every 2
hours at the extravasation
site (DO NOT apply to
healthy skin) followed by
topical hydrocortisone 1%
cream. See also note below.
* for Liposomal preparation
delay DMSO for 8–12 hours
Group 5
Vinca
Alkaloids
Vinblastine,
Vincristine,
Vindesine,
Vinorelbine
Dissolve 1500 units
Hyaluronidase in 1mL water for
injection. Administer
Hyaluronidase 0.1-0.2mL S/C in a
clockwise direction around
circumference of the
extravasation site. Gently
massage area to facilitate
dispersal of drug.
Elevate limb for up to 48 hrs. Give prescribed analgesia & PO chlorphenamine prn for
comfort. If any concerns contact St. Chads, Birmingham for advice (0121 5543801)
Complete necessary documentation (medical notes, DATIX and green card). Ensure
patient has appropriate follow up arrangements.
Drugs requiring heat pack in red, those for
cold pack in blue
Apply heat pack for 1 hour
post & then for 20min every
4hrs for 48hrs. Apply a thin
layer of Hydrocortisone 1%
cream and cover with 2
squares of gauze and
bandage into position
Management of Extravasation of Cytotoxic Drugs in Children
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DMSO (Dimethyl Sulphoxide):
DMSO is stored in the chemotherapy cupboard on Sennen ward. When used or
going out of date, please ensure the ward pharmacist is made aware so replacement
supplies can be arranged.
DMSO is an unlicensed medication, and as such records of its use need to be kept.
When using DMSO please ensure that the record form is completed and returned to
the ward pharmacist.
DMSO should be prescribed by the medical team before giving, and is for
EXTERNAL use only
Gloves must be worn when applying DMSO – it may harm healthy skin.
After the first 24 hours treatment, for the next 7-14 days apply a thin layer of DSMO
every 6 hours using a cotton bud, alternating with topical hydrocortisone cream every
6 hours (a preparation applied every 3 hours on an alternate basis), checking the
area for erythema regularly. If blistering occurs, stop treatment with DMSO and
seek advice from St. Chad’s
For liposomal preparations at 8-12 hours post incidence apply DSMO 2-hourly for the
next 24 hours, and then 4 times a day for a further 10-14 days.
Do not use an occlusive cover. If required cover once the area is dry.
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8. Treatment of Extravasation from Central Venous
Access Devices: PICC’s, Hickman Lines & Portacaths
8.1 Although less likely to occur an extravasation occurring from an indwelling
central line can be particularly problematic because of the depth of the line and
the potential of slower development of signs and symptoms.
8.2 Extravasation can either occur in the tunnelled section or in the deep section of
the implanted line:
8.3 Extravasation can occur due to fracture of the catheter, perforation of the
superior vena cava, formation of a fibrin sheath on catheter or incomplete
placement or dislodgement of the needle.
8.4 Patients should be educated to the possibility of this happening and that burning
or pain on administration is not normal and should be reported immediately.
8.5 Follow steps as above, leaving the central line in place. The line should be x-ray
and removed as soon as clinically appropriate.
8.6 Referral to plastic surgeon should be made
Immediate Action
1 Stop the administration of the cytotoxic drug
immediately, leaving the central line in place.
Rationale
To prevent further infiltration.
Prompt action to minimise damage is important.
2 Explain what has been suspected of happening
and next procedure to the
patient/parent/guardian.
To obtain patient’s and/or carer’s co-operation and
consent.
3 Attempt to aspirate as much drug as possible
with a new syringe.
To remove any residual drug.
4 Mark the area with a pen and take digital pictures
if possible
To enable the size of the area to be evaluated and
recalled at first presentation.
5 Immediately refer to a senior member of medical
staff
The potential for damage is much greater than with
a peripheral line.
6 Refer to plastic surgeon For specialist input
7 Complete all documentation. Green Card
(available in the extravasation kit), DATIX,
medical and nursing notes
Record all actions taken (see below)
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9. Mixed Extravasations
In the event of an extravasation where different agents may have been given the
following applies.
9.1 The order of priority is vesicant, exfoliant, irritant.
9.2 For drugs of different classifications apply the temperature compress of the drug
that takes priority.
9.3 For drugs of the same classification a cold compress takes priority over a hot
compress.
10. Documentation
Each incident of extravasation must be carefully recorded, with an accurate account
of the event and signed by the reporting nurse.
10.1 Demographic:
Patient demographic details (name, address, and hospital number).
Date and time of incident.
Clinical area
Chemotherapy protocol and drug sequence.
Patient’s symptoms and appearance of site.
10.2 Description of IV access
Needle size and type
Insertion site and number of attempts,
Flash back present.
Drug administration technique i.e. ‘bolus or infusion’.
10.3 Extravasation area
Approximate amount of drug extravasated.
Appearance of area
Diameter, length and width of area effected
Photograph, if taken.
10.4 Step by step of action taken
Amount aspirated
Cold/hot applied
Antidote given
Nursing team and medical person notified.
Patient’s comments, complaints and statements.
Referrals made
Patient information sheet given and follow up arranged
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10.5 National Database
• A national database of extravasation incidents is being compiled by
Andrew Stanley, St. Chad’s unit, Dudley road, Birmingham. Reporting
cards should be sent following any extravasation and are available
inside the extravasation kit. www.extravasation.org.uk
11. Monitoring compliance and effectiveness
All Extravasations will be recorded and DATIX as pre policy. An audit of these will
be completed once a year and presented at the Paediatric Chemotherapy Multi
Disciplinary team meetings, by the author (overseen by the Trust Lead for
Cancer Chemotherapy).
Element to be
monitored
Lead
Tool
Frequency
Reporting
arrangements
Acting on
recommendations
and Lead(s)
Change in
practice and
lessons to be
shared
All chemotherapy extravasations with the child health
directorate
Sabrina Tierney, Specialist Clinical Pharmacist
(paediatrics)
Audit observing type of drug that extravasated, cannula
position, length of time cannula in, antidote
Audit completed yearly
Presented to Paediatric Multi-Displinary Team
Paediatric Chemotherapy MDT lead – Nicki Gilbertson,
Paediatric Consultant
Extravasations education to be provided and staff to be kept
up to date with new developments in this area.
All nursing staff to maintain training, including annual update
day.
12. Updating and Review
12.1. This policy will be reviewed every 3 years by the Paediatric Guidelines
Committee
13. Equality and Diversity
13.1. This document complies with the Royal Cornwall Hospitals NHS Trust
service Equality and Diversity statement.
13.2. The Initial Equality Impact Assessment Screening Form is at Appendix 1.
Management of Extravasation of Cytotoxic Drugs in Children
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Appendix 1: Drugs commonly used in Paediatric oncology
and their classification
(Taken from www.extravasation.org.uk)
Chemotherapy agent
Amsacrine
Asparaginase
Bleomycin
Campath (Alemtuzumab)
Carboplatin
Carmustine
Cisplatin
Cladribine
Cyclophosphamide
Cytarabine
Dactinomycin/actinomycin D
Daunorubicin
Doxorubicin
Epirubicin
Etoposide
Etoposide Phosphate
Fludarabine
Gemcitabine
Idarubicin
Ifosfamide
Irinotecan
Liposomal Daunorubicin
Liposomal Doxorubicin
Melphalan
Methotrexate
Mitomycin C
Mitozantrone
Rituximab
Thiotepa
Topotecan
Vinblastine
Vincristine
Vindesine
Vinorelbine
Broad category
Vesicant
Neutral
Non-vesicant/neutral
Non-vesicant/neutral
Irritants/inflammatants
Vesicant
Exfoliant. Treat as Irritants/inflammatants
Non-vesicant/neutral
Non-vesicant/neutral
Non-vesicant/neutral
Vesicant
Vesicant
Vesicant
Vesicant
Irritants/inflammatants
Irritants/inflammatants
Non-vesicant/neutral
Non-vesicant/neutral
Vesicant
Non-vesicant/neutral
Irritants/inflammatants
Exfoliants/irritants/inflammatants. Treat as
vesicant
Exfoliants/irritants/inflammatants. Treat as
vesicant
Non-vesicant/neutral
Irritants/inflammatants
Vesicant
Exfoliants/irritants/inflammatants. Treat as
vesicant
Non-vesicant/neutral
Non-vesicant/neutral
Exfoliants
Vinca-alkaloids
Vinca-alkaloids
Vinca-alkaloids
Vinca-alkaloids
Management of Extravasation of Cytotoxic Drugs in Children
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Appendix 2: Non- Cytotoxic Extravasation
Determine which type of drug has extravasated, then using the table; follow the
treatment procedure for that class of extravasated drug.
IRRITANTS
Adrenaline
(H)
Amiodarone
(C)
Clarithromycin
(C)
Diazemuls
(C)
Dobutamine
(H)
Dopamine
(H)
Erythromycin
(C)
Foscarnet
(C)
Noradrenaline
(H)
Phenobarbitone
(C)
Promethazine
(C)
Vancomycin
(C)
VESICANTS
Aciclovir
(C)
Aminophylline
(H)
Amphotericin
(C)
Calcium Chloride
(H)
Calcium Gluconate
(H)
Cefotaxime
(C)
Diazepam
(C)
Digoxin
(C)
Fluorescein
(C)
Ganciclovir
(C)
Hypertonic NaCl sol n > 5% (H)
Phentolamine
(C)
Parentral Nutrition
(H)
Phenytoin
(H)
Potassium Chloride
(>40mmols/l) (H)
Sodium Bicarbonate
(H)
Venofer
(C)
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Appendix 3 : Extravasation Kit Contents
An Extravasation Kit is to be stored in all areas where the administration of
cytotoxic drugs occurs. The kit contains all the drugs and equipment that
maybe needed in the event of an extravasation. The kit should be checked
regularly and re-supplied from pharmacy as required.
Hyaluronidase 1500 units injection.
Chlorphenamine 4mg tablets
Hydrocortisone Sodium Phosphate injection 100mg x 2
Hydrocortisone 1% cream.
Water for injection (5ml).
Heat Pad - instant
Cold Pad (in freezer on ward)
2mL Syringes x 2
19G needles x 2 (for drawing up)
25G needles x 4 (for injection)
Alcohol swabs
10mL syringe x 1
Indelible pen
Extravasation policy
Extravasation Report Card (Green Card)
Patient information leaflet
DMSO is not contained in the kit but is available on Sennen ward, in the
chemotherapy cupboard
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Appendix 4 : Guidelines for Best Practice When Administering Intravenous Infusions
Preventing
Extravasation
in Infants and
Children .
Guidelines
for best
practice.
Assess the
Risk
Check the
Site
•Extravasation injures are more common and severe in Children and Neonates.
•Infants may not be able to localise or report pain.
•Confused and sedated patients are more at risk.
•Does the patient have reduced sensation I.e. peripheral neuropathy.
•Repeated intravenous infusions and injections increases the risk. I.e. Ex premature
babies who have had repeat cannulations.
•Cover cannula site with designated transparent IV dressing.
•Select age appropriate dressing. Splint / Tubigrip / Bandage. Do not apply too tightly.
•Ensure insertion site can be easily observed.
•Check site hourly whilst infusion is running for:
•Redness, Swelling, Leaking, Tracking, Loss of colour to limb, Pain at site,
Stinging, Absent or sluggish blood return.
•Verify patency of the site prior to the infusion and hourly throughout. If there are any
doubts STOP and INVESTIGATE. Resite the cannula if the patency of the cannulation
is still not entirely satisfactory. NOTE: If extravasation suspected cannula should
remain in situe follow extravasation policy
•Record location, condition of the site, verification of patency and patient responses.
Report if necessary.
•Parents should be asked if there are any new signs of irritability in their child during
infusion.
Check
the
Device
•Check the device hourly and record: Prescribed rate, actual hourly rate, total volume infused, pressure
and alarm limits.
•Check clamps, giving set and attachment to cannula are secure and correctly loaded into the device.
•Always check the site as well as the pump pressures. This should be done hourly. High pump
pressures alone are not a reliable indication of extravasation.
Management of Extravasation of Cytotoxic Drugs in Children
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•Pump pressures should be set at minimum. Any changes should be documented and rational given.
•Sign/Initial fluid chart to demonstrate checks carried out.
18

Appendix 5: Patient Information Sheet
UWhat is Extravasation
Extravasation is the leakage (or accidental infiltration) of drugs outside of the vein and into the
surrounding tissues. With some drugs, this may lead to an immediate painful reaction, and result in
local tissue damage.
You may have noticed pain; stinging, swelling or other changes to the skin at the site of drug
administration, or the nurse may have noticed that the drug was not flowing in easily.
UWhy did this happen
Extrava sation is a rare but known complication of intravenous chemotherapy. It is impossible to
prevent this even though we take all possible precautions. The important thing is that it has been
detected and treated.
UWhy is extravasation a problem
It can potentially lead to pain, stiffness and tissue damage.
UWhat treatment have I received to prevent tissue damage
The nurse has given you the recommended treatment for the extravasation that you have
experienced.
You will have been instructed to apply either a cold or warm pack to the area for 20 minutes, four
times a day for two days.
It is also advised to keep your arm elevated as much as possible.
Although this will help to minimise the chance of developing further problems, you will need to keep
checking the area every day.
UChecking the area
Once a day, check the area for the following:
• Has the area changed colour or increased in redness
• Is the area blistering, peeling or flaking
• Is the area more uncomfortable
• Is the pain making it difficult for you to exercise the arm or hand
What else do I need to do
• Gently exercise the affected arm or hand.
• Take mild painkillers if required.
• Do not apply any other lotions, creams or ointments unless you have been instructed to do so by
a doctor or nurse.
• Do not expose the area to strong sunlight.
• Avoid wearing tight clothing around the affected area.
• Protect the affected area when bathing (or having a shower) so that it does not get wet.
When should I contact you
If you answered YES to any of the questions in the checklist above, or if you have any other
concerns, then you should contact Sennen ward (01872 252069)
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Appendix 6 - References
The National Extravasation Information Service. Protocol for Management of
Chemotherapy Extravasation. www.extravasation.org.uk
Wendy Saegenschnitter, Vanessa McLelland (Bristol Children’s Hospital). Prescribing,
Handling and Administration of Cytotoxic Drugs for Stem Cell Transplant and Paediatric
Haematology & Oncology Patients. July 2010
NOTE: This guideline is an adaption of the Royal Cornwall Hospitals Trust document
“Management of Extravasation of Cytotoxic Drugs in Adults” produced by Lisa Nicholls,
Clinical Nurse Specialist in Cancer care,
Management of Extravasation of Cytotoxic Drugs in Children
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Appendix 7.Initial Equality Impact Assessment Screening Form
Name of service, strategy, policy or project (hereafter referred to as policy) to be
assessed: Management of Extravasation of Cytotoxic Drugs in Children
Directorate and service area:
Child Health
Name of individual completing
assessment: Sabrina Tierney
Is this a new or existing Procedure
Existing
Telephone: 01872 252590
1. Procedure Aim* To provide clinical staff with clear guidelines on the care of
patients who have experienced an extravasation
2. Procedure Objectives* To provide a basis for the nursing care that is required for
patients that have experienced an extravasation
3. Procedure – intended
Outcomes*
Extravasation is treated in a safe manner
4. How will you measure
the outcome
5. Who is intended to
benefit from the
Procedure
6a. Is consultation
required with the
workforce, equality
groups etc. around this
procedure
b. If yes, have these
groups been consulted
c. Please list any groups
who have been consulted
about this procedure.
All staff involved in the giving of chemotherapy
Yes
Yes
Paediatric Oncology MDT
Paediatric Guidelines Committee
*Please see Glossary
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7. The Impact
Please complete the following table using ticks. You should refer to the EIA guidance
notes for areas of possible impact and also the Glossary if needed.
Where you think that the policy could have a positive impact on any of the equality
group(s) like promoting equality and equal opportunities or improving relations
within equality groups, tick the ‘Positive impact’ box.
Where you think that the policy could have a negative impact on any of the equality
group(s) i.e. it could disadvantage them, tick the ‘Negative impact’ box.
Where you think that the policy has no impact on any of the equality group(s) listed
below i.e. it has no effect currently on equality groups, tick the ‘No impact’ box.
Equality
Group
Age
Disability
Faith and
Belief
Gender
Race
Sexual
Orientation
Positive
Impact
Negative
Impact
No
Impact
Reasons for decision
Procedure available to all patients
who require treatment.
Procedure available to all patients
who require treatment.
Procedure available to all patients
who require treatment.
Procedure available to all patients
who require treatment.
Procedure available to all patients
who require treatment.
Procedure available to all patients
who require treatment.
You will need to continue to a full Equality Impact Assessment if the following have
been highlighted:
A negative impact and
No consultation (this excludes any policies which have been identified as not
requiring consultation).
8. If there is no evidence that
the policy promotes equality,
equal opportunities or improved
relations - could it be adapted
so that it does How
Full statement of commitment to policy of
equal opportunities is included in the policy
Please sign and date this form.
Keep one copy and send a copy to the Human Resources Team, c/o
Royal Cornwall Hospitals NHS Trust, Human Resources Department, Lamorna House,
Penventinnie Lane, Truro, Cornwall, TR1 3LJ
They will
arrange for a summary of the results to be published on the Trust’s web site.
Signed ________________________________________
Date _________________________________________
Management of Extravasation of Cytotoxic Drugs in Children
Ratified: Review: 22