Collaborative Intravenous Nursing Service (CINS) Guidelines

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scheme is co-ordinated through the St.Chad’s Unit, City Hospital, Birmingham. Green cardscan be filled in online14The aims of the Green Card are:• to obtain accurate statistical information on the number of incidents categorised byextravasating drug and type of treatment• to collect data on treatment methods and antidotes being used for extravasationincidents• to obtain accurate information on the outcome of incidents• to feedback information on the treatment and its effectivenessGreen Cards ask for the following information:• the drug or drugs involved• how was it detected• the extent of the problem• drugs used in the treatment of the extravasation• the procedure for treatment• type of cannula used for the administration of the chemotherapy• location and extent of the extravasation• outcomeThese reporting cards are user friendly. The information given can remain anonymous for thereporter, the patient and the Centre involved.Reporting can be done online athttp://www.extravasation.org.uk/Greenmenu.htmGreen cards should be available alongside the extravasation kit and can be obtained fromhttp://www.extravasation.org.uk/Greenmenu.htm or by post from Extravasation Co-ordinator,c/o St Chad’s Unit, City Hospital, Dudley Road, Birmingham B1 8 7QHIf reporting online please print a copy of the form before submitting and send to the networkpharmacist. If using a green card please make a copy and send to your trust pharmacist whowill send it to the network pharmacist.12 References and suggested further reading1 Mallet and Dougherty (2004) The Royal Marsden Manual Handbook2 How, C and Brown J. (1998) Extravasation of cytotoxic chemotherapy from peripheral veinsEuropean Journal of Oncology Nursing 2 (1) 51-583Hadaway L.C. (2001) Vesicant Extravasation. Nursing 31(8) 884National Extravasation Information Service (2004)www.extravasation.org.uk accessed 19/04/20065UKCCSG extravasation policy (2005)The CINs group hereby assert their moral rights tothe works herein in accordance with the Data Protection Act 1988.Policy review date 01/10/10
15Appendix 1CLASSIFICATION OF CYTOTOXIC DRUGS ACCORDING TO THEIR POTENTIAL TO CAUSE SEVERENECROSIS WHEN EXTRAVASATEDVesicants:Group 1Exfoliants:Group 2Irritants:Group 3Inflammitants:Group 4Amsacrine Aclarubicin Carboplatin EtoposideCarmustine Cisplatin (concDacarbazine>0.5mg/ml)DaunorubicinLiposomalPhosphateNeutrals:Group 5(unlikely tocause problemsif extravasated)AsparaginaseEtoposide Fluorouracil BleomycinIrinotecan Methotrexate CladribineDactinomycin Docetaxel Teniposide Raltitrexed CyclophosphamiDaunorubicinDoxorubicinLiposomaldeCytarabineDoxorubicin Floxuridine bortezomibEpirubicin Oxaliplatin FludarabineIdarubicin Topotecan GemcitabineMitomycinMitoxantroneMustinePaclitaxelPlicamycinIfosfamideMelphalanPentostatinRituximabThiotepaBeta-InterferonsStreptozocin Aldesleukin (IL-TreosulfanVinblastineVincristineVindesineVinorelbine2)TrastuzumabcisplatinalemtuzumabNb this list may not be exhaustive. It is the practitioners responsibility to know the vesicant potential of any drugnot on this list Appendix 2The CINs group hereby assert their moral rights tothe works herein in accordance with the Data Protection Act 1988.Policy review date 01/10/10
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Intravenous Access Care and Mainten
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4Cheshire and Merseyside NHS North
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Open sterile pack, allowing inner p
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Ensure all equipment is gathered be
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Skin Tunnelled Catheters - Blood Sa
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catheter.• Ensure that the cathet
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• Open sterile pack allowing inne
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Algorithm persistent withdrawal occ
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The CINs group hereby assert their
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Care and Maintenance of a non tunne
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Central Non-Tunnelled Catheters - S
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Central Non-Tunnelled Catheters - B
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Central Venous Non-Tunnelled Cathet
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Algorithm persistent withdrawal occ
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31References.1. Department of Healt
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• Open sterile pack, allowing inn
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• Open out sterile pack to create
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37Peripherally Inserted Central Cat
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• Place 0.9% sodium chloride (sal
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References431. Department of Health
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Care and Maintenance of a Periphera
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Peripheral Midline - 0.9% Sodium Ch
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49Peripheral Midline -Administratio
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Page 56 and 57: Put on sterile glovesPlace sterile
Page 58 and 59: ampoule(s) near to the working area
Page 60 and 61: 59Totally Implanted Venous Access D
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Page 66 and 67: 65Care and Management of Peripheral
Page 68 and 69: 67Changing a Needle-free I/V access
Page 70 and 71: 69EXIT SITE INFLAMMATION/PHLEBITISP
Page 72 and 73: SYSTEMIC INFECTION71Signs & Symptom
Page 74 and 75: FOR CARE OF PERIPHERAL VENOUS CANNU
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Page 78 and 79: 77Type of device Risks Actions Vari
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Page 88 and 89: 87EVALUATION RECORDDATE EVALUATION
Page 92 and 93: 91EVALUATION RECORDDATE EVALUATION
Page 94 and 95: 2List of contributors to the Venous
Page 96 and 97: 4PCTcoordinatorMalcolm Smith Mid Ch
Page 98 and 99: 6University Hospital Aintree NHS Fo
Page 100 and 101: 81. IntroductionThe purpose of this
Page 102 and 103: venous shock, flare or phlebitis. S
Page 104 and 105: 12Hyaluronidase: Dilute 1500 units
Page 108 and 109: 16Appendix 2Specific antidotes in t
Page 110 and 111: experience. Due to the volume of th
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Collaborative Intravenous Nursing Service (CINS) Guidelines

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