Collaborative Intravenous Nursing Service (CINS) Guidelines

70EXTRAVASATION/INFILTRATION AT VASCULAR ACCESS DEVICE SITESigns & Symptoms• Burning sensation or swelling in subcutaneoustissue• Blanching• Burning or discomfort at IV site• Cool skin around IV site• Slow or continuing flow rate even when vein isoccluded• Swelling at and above the IV site• Tight feeling at the IV site• Neck swellingActions• Stop the infusion immediately• Elevate limb to reduce oedema (if peripheral line)• Remove VAD and apply pressure• Re-site VAD above affected site• Seek medical help if evidence of infiltration• Advise patient to seek medical help if they experienceburning, stinging or sensation of sudden heat• Observe site daily• See extravasation policyResolvedUnresolvedCONTINUE TREATMENT USING NEWLY SITED VADMONITORING CONTINUALLY FOR SIGNS OFEXTRAVASATIONIF SYMPTOMS PERSISTS FOLLOWING REMOVAL OFCANNULA, SEEK MEDICAL HELP OR URGENT ADVICEFROM IV NURSE SPEVIALIST.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