Department of Haematology & Oncology. Managing extravasation. Drug group: patientinformation. Rotherham Hospital Your health, your choice, our passion

Transcription

1 Department of Haematology & Oncology Managing extravasation Drug group: patientinformation Rotherham Hospital Your health, your choice, our passion

2

3 What is extravasation? Chemotherapy is often given as fluid into a vein through a thin hollow tube called a cannula. Occasionally a cannula can become dislodged or blocked, causing the chemotherapy to go into the area around the vein. When this happens, it is called extravasation. What can happen as a result? The effect of extravasation depends on a number of factors. these include: l The type of chemotherapy drug that was given l The amount of chemotherapy that went into the area around the vein Some chemotherapy can cause irritation, pain and tissue damage that is temporary. This usually responds to simple treatments and will get better over a few weeks. Other chemotherapy can lead to a more severe reaction and can cause blistering and more permanent damage. This damage may not appear until a few days, or weeks later. Your nurse, or doctor, will tell you which of these types of chemotherapy you have been given. How will the extravasation be treated? The treatment you receive depends on the chemotherapy you were given, and the amount of the drug that went into the tissue. The treatment you will receive is described in this booklet. 3

4 What should I do? Please continue with the treatment your doctor or nurse has advised you to carry out. Have a look at the area regularly, at least twice a day, and let us know if you have any concerns or notice any of the following: l There are changes in the affected area. For example it seems redder, the affected area is getting bigger or you notice fluid leaking from the skin l The area feels more painful l There have been no improvements after 3 days Who should I contact if I have any concerns? If you have any concerns, you should contact the area where you had your treatment. If you were receiving your chemotherapy as a Haematology inpatient or outpatient, please contact Ward A7 on at any time. If you are a patient having chemotherapy for cancer treatment, under the care of Western Park Hospital, please contact the day case service on between 9.00am and 5.00pm. Outside these times please contact the nursing bleep holder through the hospital switchboard on

5 Management of extravasation Drug group A Your extravasation has happened with a type of chemotherapy that tends to cause temporary problems. However, the area around the vein does need to be looked after carefully so that any problems are reduced. Good care can also help your veins recover from any damage that may have occurred. Please follow the instructions you have been given by your nurse or doctor. In some cases you will just be asked to look at the skin where the extravasation occurred so you can contact us if you notice any problems. If you are experiencing symptoms such as pain you may be advised to apply a cold pad to the area for 20 minutes four times a day. This should be done for 2 days. A cold pad can be made from the following: l A cold pack (used to keep food cool in a picnic bag) l Ice pack l Towel soaked in cold water and rung out If you use a cold pack or ice pack make sure that it does not come into direct contact with the skin for example, put a towel between the cold pad and your skin. 5

6 You are also advised to elevate (raise) the arm that was involved in the extravasation. This can be done by resting your arm on 2 or 3 pillows or cushions when sitting or lying down. This should be done as much as possible for 2 days, but you should still use and move your arm. After 2 days you should use your arm as usual. The doctor may also have prescribed hydrocortisone cream. This is a mild steroid cream and can help if the area is sore, or inflamed. It should be put on thinly twice a day. It is very important for you to have a look at the skin where the extravasation happened a few times a day and let us know if you notice any problems. 6

7 Management of extravasation Drug group B Your extravasation has happened with a type of chemotherapy that can cause long term damage This damage may be noticeable straight away but can happen a few days or even weeks after the extravasation. However, any potential problems can be reduced by careful management and attention. Please apply a cold pad to the area for 20 minutes four times a day. This should be done for 2 days. A cold pad can be made from the following: l A cold pack (used to keep food cool in a picnic bag) l Ice pack l Towel soaked in cold water and rung out If you use a cold pack or ice pack make sure that it does not come into direct contact with the skin for example, put a towel between the cold pad and your skin. If your skin was intact (not blistered or broken) following the extravasation you may also have been given a cream called DMSO. This helps to remove the chemotherapy from the area around the vein. You should put a thin layer of this on the affected area four times a day. This should be done for 7 days. Occasionally this cream can cause blistering on the skin, headaches and drowsiness. If this happens to you stop using the cream and contact us for further advice. It can also make your breath taste/smell of garlic. 7

8 Management of extravasation Drug group C Your extravasation has happened with a type of chemotherapy that can cause long term damage However, this may be reduced by careful management of the problem. When your extravasation happened the doctor, or nurse, may have given you some small injections into the area around the vein. These were injections of a drug that helped remove the chemotherapy from the area around the vein. After this a warm pad may have been put on for one hour. You are now advised to elevate (raise) the arm that was involved in the extravasation. This can be done by resting your arm on 2 or 3 pillows or cushions when sitting or lying down. This should be done as much as possible for 2 days but you should still use and move your arm. After 2 days you should use your arm as usual. It is very important for you to have a look at the skin where the extravasation occurred a few times a day and let us know if you notice any problems. You will be asked to return to the hospital within the next 2 to 3 days so that the area can be examined. 8

9 Appointments You have an appointment to return to: Ward or department: Date: Time: 9

10 Useful contact numbers NHS Direct Telephone Patient Services Telephone Health Info Telephone Stop Smoking Service Telephone For GP out of hours, contact your surgery Useful websites If you require this document in another language, large print, braille or audio version, please contact Patient Information on or Produced by Michel Thompson, Matron. February Revised July 2009, April Revision due April Version: 3.0 The Rotherham NHS Foundation Trust All rights reserved. 10

11 How to find us Hospital site plan Woodlands P Two Way traffic One Way traffic Public Parking Leapfrog Day Nursery Child Development Centre Oakwood Hall Greenoaks P Oakwood Hall Annexe P Oldfield Centre Moorgate Wing OAKWOOD HALL DRIVE Day Surgery Centre Maternity Entrance Rotherham Hospital Main Entrance Accident & Emergency P PAY AND DISPLAY P PAY AND DISPLAY P PAY AND DISPLAY One Way Bus stop BAKER STREET MOORGATE One way Bus stop ROAD A618 Bus stop Security Centre TO WOODSIDE Rotherham main routes To Leeds Parkgate To Doncaster 35 Thorpe Hesley B6089 A633 M1 North 34 South 34 To Sheffield Kimberworth Park A629 Kimberworth A6109 A631 A630 A630 Woodside Brinsworth A A630 TOWN Clifton CENTRE A618 A631 East Dene Rotherham Hospital Moorgate A6123 Whiston Herringthorpe A631 M1 Wickersley Bramley 32 A631 To A1, M62 & Hull M18 1 To Sheffield Treeton A618 M1 To Nottingham and the South

12 LS /12 V3 WFO How to contact us Ward A7 Patients receiving chemotherapy as a Haematology inpatient or outpatient. Telephone Western Park Hospital day case service Patients receiving chemotherapy cancer treatment under the care of Western Park Hospital Telephone am to 5.00pm Outside these times please contact the nursing bleep holder Telephone Switchboard Telephone Rotherham Hospital Moorgate Road Oakwood Rotherham S60 2UD Telephone Sustainable Forests / Low chlorine