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Leakage of a vesicant infusion into subcutaneous tissue can cause progressive necrosis despite initially modest pain or swelling.
Recognise stinging, blanching, swelling, erythema, resistance to infusion or a leaking cannula. Identify the exact infusate, especially cytotoxics, vasopressors or concentrated electrolytes.
Stop the infusion immediately and summon the trust extravasation team or senior nurse/pharmacist. Leave cannula in place initially for assessment and possible aspiration according to the agent-specific protocol.
Record the medicine, concentration, time, estimated volume, symptoms and injury outline; monitor limb perfusion, pain and skin progression. Specialist advice determines antidote, compress choice and whether to remove the cannula.
Do not arbitrarily choose warm versus cold compresses or remove a vesicant line before appropriate advice. Time-sensitive escalation is more important than an initial benign appearance.
UK reference: University Hospitals Sussex extravasation guidance. Focused editorial source check, 7 November 2026; this is not independent clinical or pharmacy sign-off. Verify current local policy, BNF/BNFC and specialist advice before treatment. Not a prescribing protocol.
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