Extravasation: there could be more than meets the eye!

Intravenous catheter insertion is one of the commonest procedures in hospitals. It may sound like a simple intervention, but it is certainly critical in resuscitation and the administration of infusion and medications. However, the insertion of peripheral venous catheters or intravenous plugs can be associated with complications such as pain, bleeding, thrombophlebitis, failure of proper cannulation thus leading to extravasation and infection. The incidence of extravasation is increased in the population prone to complications, e.g. extremes of age groups, intravenous drug users, diabetics. In published reports, the mechanism of damage is postulated to be due to factors such as direct cellular toxicity, vasoconstriction leading to ischaemia, osmotic damage or even extrinsic mechanical compression of large volumes of extravasation. The morbidity can be reduced with early detection and vigilance. Of course, prevention is better than cure.