Skip to main content
Top
Published in: BMC Pediatrics 1/2013

Open Access 01-12-2013 | Research article

Neonatal extravasation injury: prevention and management in Australia and New Zealand-a survey of current practice

Authors: Matthew Restieaux, Andrew Maw, Roland Broadbent, Pam Jackson, David Barker, Ben Wheeler

Published in: BMC Pediatrics | Issue 1/2013

Login to get access

Abstract

Background

Extravasation injury remains an important cause of iatrogenic injury in neonatal intensive care. This study aims to describe the current approach to extravasation injury (EI) prevention and management in Neonatal Intensive Care Units (NICUs) in Australia and New Zealand.

Methods

A literature review regarding extravasation injury in the newborn was carried out to inform questionnaire design. An internet-based survey was then conducted with the clinical directors of the 27 tertiary NICUs in Australia and New Zealand.

Results

The survey received a 96% response rate. Approximately two thirds of Australian and New Zealand NICUs have written protocols for prevention and management of extravasation injury. Considerable practice variation was seen for both prevention and treatment of EI. 92% of units had experienced cases of significant EI.

Conclusions

Australian and New Zealand tertiary neonatal units clearly recognise EI as an important cause of iatrogenic morbidity and mortality. Significant variation still exists among units with regards to guidelines for both prevention and management of EI. We recommend that neonatal staff should remain vigilant, ensuring that guidelines for the prevention and treatment of EI are available, and rigorously followed.
Appendix
Available only for authorised users
Literature
1.
go back to reference Ramasethu J: Pharmacology Review Prevention and Management of Extravasation Injuries in Neonates. NeoReviews. 2004, 5 (11): e491-e497. 10.1542/neo.5-11-e491.CrossRef Ramasethu J: Pharmacology Review Prevention and Management of Extravasation Injuries in Neonates. NeoReviews. 2004, 5 (11): e491-e497. 10.1542/neo.5-11-e491.CrossRef
2.
go back to reference Gault DT: Extravasation injuries. Br J Plast Surg. 1993, 46 (2): 91-96. 10.1016/0007-1226(93)90137-Z.CrossRefPubMed Gault DT: Extravasation injuries. Br J Plast Surg. 1993, 46 (2): 91-96. 10.1016/0007-1226(93)90137-Z.CrossRefPubMed
3.
go back to reference Phillips RA: Deep dopamine extravasation injury: a case report. J Plast Reconstr Aesthet Surg. 2009, 62 (7): e222-e224. 10.1016/j.bjps.2008.11.064.CrossRefPubMed Phillips RA: Deep dopamine extravasation injury: a case report. J Plast Reconstr Aesthet Surg. 2009, 62 (7): e222-e224. 10.1016/j.bjps.2008.11.064.CrossRefPubMed
4.
go back to reference Cartlidge P, Fox P, Rutter N: The scars of newborn intensive care. Early Hum Dev. 1990, 21 (1): 1-10. 10.1016/0378-3782(90)90105-R.CrossRefPubMed Cartlidge P, Fox P, Rutter N: The scars of newborn intensive care. Early Hum Dev. 1990, 21 (1): 1-10. 10.1016/0378-3782(90)90105-R.CrossRefPubMed
5.
go back to reference Wilkins C, Emmerson A: Extravasation injuries on regional neonatal units. Arch Dis Child Fetal Neonatal Ed. 2004, 89 (3): F274-F275. 10.1136/adc.2003.028241.CrossRefPubMedPubMedCentral Wilkins C, Emmerson A: Extravasation injuries on regional neonatal units. Arch Dis Child Fetal Neonatal Ed. 2004, 89 (3): F274-F275. 10.1136/adc.2003.028241.CrossRefPubMedPubMedCentral
6.
go back to reference Davies J, Gault D, Buchdahl R: Preventing the scars of neonatal intensive care. Arch Dis Child Fetal Neonatal Ed. 1994, 70 (1): F50-F51. 10.1136/fn.70.1.F50.CrossRefPubMedPubMedCentral Davies J, Gault D, Buchdahl R: Preventing the scars of neonatal intensive care. Arch Dis Child Fetal Neonatal Ed. 1994, 70 (1): F50-F51. 10.1136/fn.70.1.F50.CrossRefPubMedPubMedCentral
7.
go back to reference Chowdhury M, Wong LH, Horn V, Eaton S, Pierro A: Extravasation injury in surgical neonates and children. Proceedings of the Nutrition Society. 2004, 63 (Suppl(1)): 23A- Chowdhury M, Wong LH, Horn V, Eaton S, Pierro A: Extravasation injury in surgical neonates and children. Proceedings of the Nutrition Society. 2004, 63 (Suppl(1)): 23A-
8.
go back to reference Harris PA, Bradley S, Moss ALH: Limiting the damage of iatrogenic extravasation injury in neonates. Plast Reconstr Surg. 2001, 107 (3): 893-10.1097/00006534-200103000-00054.CrossRefPubMed Harris PA, Bradley S, Moss ALH: Limiting the damage of iatrogenic extravasation injury in neonates. Plast Reconstr Surg. 2001, 107 (3): 893-10.1097/00006534-200103000-00054.CrossRefPubMed
9.
go back to reference Dugger B: Peripheral Dopamine Infusions: Are They Worth the Risk of Infiltration?. J Infus Nurs. 1997, 20 (2): 95- Dugger B: Peripheral Dopamine Infusions: Are They Worth the Risk of Infiltration?. J Infus Nurs. 1997, 20 (2): 95-
10.
go back to reference Millan D: Managing complications of IV therapy. Nursing. 1988, 18 (3): 34-43.CrossRef Millan D: Managing complications of IV therapy. Nursing. 1988, 18 (3): 34-43.CrossRef
12.
go back to reference Cartwright D: Central venous lines in neonates: a study of 2186 catheters. Arch Dis Child Fetal Neonatal Ed. 2004, 89 (6): F504-F508. 10.1136/adc.2004.049189.CrossRefPubMedPubMedCentral Cartwright D: Central venous lines in neonates: a study of 2186 catheters. Arch Dis Child Fetal Neonatal Ed. 2004, 89 (6): F504-F508. 10.1136/adc.2004.049189.CrossRefPubMedPubMedCentral
13.
go back to reference Laurie S: Intravenous extravasation injuries: the effectiveness of hyaluronidase in their treatment. Ann Plast Surg. 1984, 13 (3): 191-10.1097/00000637-198409000-00003.CrossRefPubMed Laurie S: Intravenous extravasation injuries: the effectiveness of hyaluronidase in their treatment. Ann Plast Surg. 1984, 13 (3): 191-10.1097/00000637-198409000-00003.CrossRefPubMed
14.
go back to reference Raszka W: The use of hyaluronidase in the treatment of intravenous extravasation injuries. J Perinatol. 1990, 10 (2): 146-PubMed Raszka W: The use of hyaluronidase in the treatment of intravenous extravasation injuries. J Perinatol. 1990, 10 (2): 146-PubMed
15.
go back to reference Zenk KE, Dungy CI, Greene GR: Nafcillin extravasation injury: use of hyaluronidase as an antidote. Arch Pediatr Adolesc Med. 1981, 135 (12): 1113-10.1001/archpedi.1981.02130360021008. Zenk KE, Dungy CI, Greene GR: Nafcillin extravasation injury: use of hyaluronidase as an antidote. Arch Pediatr Adolesc Med. 1981, 135 (12): 1113-10.1001/archpedi.1981.02130360021008.
16.
go back to reference Young T, Mangum BN, Neofax A: The Manual of Drugs used in Neonatal Care. 1996 Young T, Mangum BN, Neofax A: The Manual of Drugs used in Neonatal Care. 1996
17.
go back to reference Casanova D, Bardot J, Magalon G: Emergency treatment of accidental infusion leakage in the newborn: report of 14 cases. Br J Plast Surg. 2001, 54 (5): 396-399. 10.1054/bjps.2001.3593.CrossRefPubMed Casanova D, Bardot J, Magalon G: Emergency treatment of accidental infusion leakage in the newborn: report of 14 cases. Br J Plast Surg. 2001, 54 (5): 396-399. 10.1054/bjps.2001.3593.CrossRefPubMed
18.
go back to reference Gopalakrishnan P, Goel N, Banerjee S: The Cochrane Library. Saline irrigation for the management of skin extravasation injury in neonates. 2012CrossRef Gopalakrishnan P, Goel N, Banerjee S: The Cochrane Library. Saline irrigation for the management of skin extravasation injury in neonates. 2012CrossRef
19.
go back to reference Hoffman BB, Lefkowitz RJ: Alpha-adrenergic receptor subtypes. N Eng J Med. 1980, 302 (25): 1390-1396. 10.1056/NEJM198006193022504.CrossRef Hoffman BB, Lefkowitz RJ: Alpha-adrenergic receptor subtypes. N Eng J Med. 1980, 302 (25): 1390-1396. 10.1056/NEJM198006193022504.CrossRef
21.
go back to reference Denkler KA, Cohen BE: Reversal of dopamine extravasation injury with topical nitroglycerin ointment. Plast Reconstr Surg. 1989, 84 (5): 811-10.1097/00006534-198911000-00017.CrossRefPubMed Denkler KA, Cohen BE: Reversal of dopamine extravasation injury with topical nitroglycerin ointment. Plast Reconstr Surg. 1989, 84 (5): 811-10.1097/00006534-198911000-00017.CrossRefPubMed
22.
go back to reference Wong AF, McCulloch LM, Sola A: Treatment of peripheral tissue ischemia with topical nitroglycerin ointment in neonates. J Pediatr. 1992, 121 (6): 980-983. 10.1016/S0022-3476(05)80356-7.CrossRefPubMed Wong AF, McCulloch LM, Sola A: Treatment of peripheral tissue ischemia with topical nitroglycerin ointment in neonates. J Pediatr. 1992, 121 (6): 980-983. 10.1016/S0022-3476(05)80356-7.CrossRefPubMed
Metadata
Title
Neonatal extravasation injury: prevention and management in Australia and New Zealand-a survey of current practice
Authors
Matthew Restieaux
Andrew Maw
Roland Broadbent
Pam Jackson
David Barker
Ben Wheeler
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2013
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/1471-2431-13-34

Other articles of this Issue 1/2013

BMC Pediatrics 1/2013 Go to the issue