Czech Republic consensus on recommendations to prevent and manage extravasation (paravasation) of cytotoxic drugs

Extravasation (paravasation) of cytotoxic chemotherapy drugs represents a very important complication in oncology nursing. Prevention and proper care can reduce the risk of extravasation and its consequences. A consensus on chemotherapy extravasation management have been reached within twenty seven oncology and haemato-oncology centres in the Czech Republic. Ensuring reliable, safe venous access, choice of injection site, venous line control, and patient education are integral and very important parts of care. DMSO (99%) is recommended for topical application after extravasation of anthracyclines, mitomycin C and cisplatin. Dry cold should be applied in case of DMSO-treated cisplatin extravasation, anthracyclines, mitomycin C and in extravasations of all other cytotoxic drugs (except for those with recommended dry heat applications). Dry heat is to be applied in cases of extravasation of oxaliplatin, taxanes and vinca-alkaloids. Hyaluronidase applied subcutaneously around the extravasation is recommended in the case of extravasation of taxanes and vinca-alkaloids. Dexrazoxane i.v. can be used when dealing with extravasation of anthracyclines. Corticosteroids applied subcutaneously, moist heat or cooling, are not recommended.