Nursing care for pediatric patients with extravasation: a case study

Authors

  • Vimonwan Varolarn School of Nursing, Rangsit University, Mueang Pathum Thani District, Pathum Thani 12000, Thailand

Keywords:

Extravasation, pediatric nursing care

Abstract

The most severe complication of peripheral intravenous in children was the fluid leakage from blood vessels into tissue injury or extravasation. Due to severe cases, it takes several months to heal or may be to the point of disability, affecting to quality of life of both pediatric patients and families. Nurses play important roles in caring during intravenous fluid therapy, including the ability to assess early warning signs as quickly as possible. Nursing care should be started before giving fluids, choosing the location of the blood vessel, selecting an equipment, type of fluid, and the duration fluid administration. The nurses should monitor every hour after fluid administration such as a site assessment when fluids or medications are running through the line, including assessing the initial symptoms and prevention of extravasation continuously. This article provides an example of a case study and nursing care for increasing the quality of nursing and safety of children treated with peripheral intravenous fluids

References

Pathomjaruwat T. Prevention and management of extravasation in infusion therapy. Songklanagarind J of Nurs. 2017;37(2):169-81. (in Thai).

Inderwati F, Mathew S, Munday J, Keogh S. Incidence of peripheral intravenous catheter failure and complications in pediatric patient: systematic review and meta-analysis. Int J Nurs Stud. 2020 Feb;102:103488. doi: 10.1016/j.ijnurstu.2019.103488. Epub 2019 Nov 26. PMID: 31862530.

Restieaux M, Maw A, Broadbent R, Jackson P, Barker D, Wheeler B. Neonatal extravasation injury: prevention and management in Australia and New Zealand-a survey of current practice. BMC Pediatr. 2013 Mar 11;13:34. doi: 10.1186/1471-2431-13-34. PMID: 23497004; PMCID: PMC3599986.

Oommen S, Shetty A. Does parental anxiety affect children's perception of pain during intravenous cannulation? Nurs Child Young People. 2020 May 6;32(3):21-24. doi: 10.7748/ncyp.2019.e1187. Epub 2019 Oct 28. PMID: 31657172.

Kaphan K, Auypornsakul S, Somno J, Wongwattananan W, Jamsittikul K, Baicha W, et al. The Prevalence and Associated Factors of Peripheral Intravenous Complications in a Thai Hospital. J Infus Nurs. 2024 Mar-Apr 01;47(2):120-131. doi: 10.1097/NAN.0000000000000538. PMID: 38422405; PMCID: PMC10916754.

Hackenberg RK, Kabir K, Müller A, Heydweiller A, Burger C, Welle K. Extravasation injuries of the limbs in neonates and children—development of a treatment algorithm. Dtsch Arztebl Int. 2021 Aug 23;118(33-34):547-54. doi: 10.3238/arztebl.m2021.0220. PMID: 34158148; PMCID: PMC8579427.

Gorski LA, Hadaway L, Hagle ME, McGoldrick M, Orr M, Dorcy D, et al. Infusion therapy standards of practice, 8th Edition. J Infus Nurs. 2021 Jan-Feb 01;44(1S Suppl 1):S1-S224. doi: 10.1097/NAN.0000000000000396. PMID: 33394637.

Perez Fidalgo JA, Fabregat G, Cervantes A, Margulies A, Vidall C, Roila F, et al. Management of chemotherapy extravasation: ESMO-EONS clinical practice guideline. Ann Oncol. 2012;23 (Supp7):167-3.vii167-73. doi: 10.1093/annonc/mds294.

Kostogloudis N, Demiri E, Tsimponis A, Dionyssiou D, Ioannidis S, Chatziioannidis I, et al. Severe extravasation injuries in neonates: a report of 34 cases. Pediatr Dermatol. 2015 Nov-Dec;32(6):830-5. doi: 10.1111/pde.12664. Epub 2015 Sep 4. PMID: 26337780.

Coyle CE, Griffie J, Czaplewski LM. Eliminating extravasation events: a multidisciplinary approach. J Infus Nurs. 2015 Nov-Dec;38 Suppl 6:S43-50. doi: 10.1097/NAN.0000000000000144. PMID: 26536412.

Pathomjaruwat T, Petpichetchian W, Pongcharoen P. A comparative study of accuracy and usability between two extravasation injuries assessment tools. Pacific Rim Int J Nurs Res. 2021;25(3):437-51.

Amjad I, Murphy T, Nylander-Housholder L, Ranft A. A new approach to management of intravenous infiltration in pediatric patients: pathophysiology, classification, and treatment. J Infus Nurs. 2011 Jul-Aug;34(4):242-9. doi: 10.1097/NAN.0b013e31821da1b3. PMID: 21734520.

Ghanem AM, Mansour A, Exton R, Powell J, Mashhadi S, Bulstrode N, et al. Childhood extravasation injuries: improved outcome following the introduction of hospital-wide guidelines. J Plast Reconstr Aesthet Surg. 2015 Apr;68(4):505-18. doi: 10.1016/j.bjps.2014.12.029. Epub 2015 Jan 8. PMID: 25618570.

Mas V, Simon AL, Presedo A, Mallet C, Ilharreborde B, Jehanno P. Upper limb extravasation of cytotoxic drugs: results of the saline washout technique in children. J Child Orthop. 2020 Jun 1;14(3):230-35. doi: 10.1302/1863-2548.14.200020. PMID: 32582391; PMCID: PMC7302410.

Park HJ, Kim KH, Lee HJ, Jeong EC, Kim KW, Suh DI. Compartment syndrome due to extravasation of peripheral parenteral nutrition: extravasation injury of parenteral nutrition. Korean J Pediatr. 2015 Nov;58(11):454-8. doi: 10.3345/kjp.2015.58.11.454. Epub 2015 Nov 22. PMID: 26692883; PMCID: PMC4675928.

Healthcare Accreditation Institute: HAI (Public Organization). Hospital and healthcare standards. [homepage on the Internet]. The Institute; 2009 [cited 2022 Jun 30]. Available from:

https://www.ha.or.th/TH/Contents/%E0%B8%A1%E0%B8%B2%E0%B8%95%E0%B8%A3% (in Thai).

Sung CY, Chung RK, Ra YS, Lee HS, Lee GY. Impending compartment syndrome of the forearm and hand after a pressurized infusion in a patient under general anesthesia-a case report-. Korean J Anesthesiol. 2011 Jan;60(1):60-3. doi: 10.4097/kjae.2011.60.1.60. Epub 2011 Jan 28. PMID: 21359085; PMCID: PMC3040436.

Gorski LA. The 2016 infusion therapy standards of practice. Home Healthc Now. 2017 ;35(1):10-8. doi: 10.1097/NHH.0000000000000481. PMID: 27922994.

Tofani BF, Rineair SA, Gosdin CH, Pilcher PM, McGee S, Varadarajan KR, et al. Quality improvement project to reduce infiltration and extravasation events in a pediatric hospital. J Pediatr Nurs. 2012 Dec;27(6):682-9. doi: 10.1016/j.pedn.2012.01.005. Epub 2012 Feb 16. PMID: 22342260.

Denton A, Bodenham A, Conquest A, Davies A, Davidson A, Portsmouth J, et al. Standard for infusion therapy. 4th edition. London: Royal College of Nursing; 2018.

Downloads

Published

2024-05-24

How to Cite

1.
Varolarn V. Nursing care for pediatric patients with extravasation: a case study. Thai J Cardio-Thorac Nurs. [Internet]. 2024 May 24 [cited 2024 Nov. 5];35(1):2-16. Available from: https://he02.tci-thaijo.org/index.php/journalthaicvtnurse/article/view/262312

Issue

Section

Academic Articles