Extravasation
Recognising and managing IV drug leakage — from irritants to vesicants
Extravasation occurs when an intravenous drug leaks out of the vein and into the surrounding tissue. It is a potentially serious complication of chemotherapy and other intravenous treatments, and requires immediate recognition and action to prevent lasting tissue damage.
What is Extravasation?
Extravasation happens when a drug given through a vein accidentally leaks into the tissues around the injection site. Symptoms include swelling, pain, burning, or redness at the cannula site during or after a drip. It is most serious with certain chemotherapy drugs that can cause tissue death if not treated quickly.
Why Does It Matter?
Some drugs — called vesicants — can destroy skin and underlying tissues if they leak, potentially causing permanent injury, nerve damage, or the need for surgery. Other drugs called irritants cause pain and inflammation but do not usually cause lasting harm. Identifying which type of drug has leaked determines how urgently and in what way treatment must begin.
What Happens When It Is Spotted?
The infusion must be stopped immediately and the healthcare team must act quickly to limit damage. Treatment depends on the drug involved — some need specific antidotes, others need cold or warm packs, and all need careful monitoring. Patients should tell their nurse or doctor straight away if they notice any pain, swelling, or leaking at their drip site.