Recommendations for Management of Noncytotoxic Vesicant Extravasations

J Infus Nurs. 2020 Nov/Dec;43(6):319-343. doi: 10.1097/NAN.0000000000000392.


To prepare clinicians to treat extravasation of noncytotoxic vesicants with antidotes and thermal compresses, a literature review was performed to identify noncytotoxic vesicants and to create evidence and consensus-based recommendations. The stage of injury and vesicant's mechanism of tissue injury dictate treatment. For a vasopressor extravasation, warm compresses and administration of a vasodilator are recommended. For osmolarity, pH, absorption refractory, and cytotoxic concentration-dependent vesicants, warm compresses and administration of hyaluronidase are recommended. Compared with potentially catastrophic costs of undertreatment, the cost of overtreatment is minimal.

Publication types

  • Review

MeSH terms

  • Antidotes / administration & dosage*
  • Antineoplastic Agents / administration & dosage*
  • Extravasation of Diagnostic and Therapeutic Materials*
  • Humans
  • Irritants / therapeutic use*


  • Antidotes
  • Antineoplastic Agents
  • Irritants