3.3.1 Sample Extravasation Documenting Tool

Extravasation of infusing chemotherapy is a rare but potentially debilitating adverse event of cancer therapy.  This printable tool can used to both document and grade the issue and allow for concise review of the incident. 

Click here to print the Same Extravasation Documenting Tool.

Primary author Ms. Julie Dowler, Children’s Hospital, London Health Sciences Centre, London with input from Ms. Denise Reniers, Children’s Hospital, London Health Sciences Centre Ms. Mary Jo Decourcy, Children’s Hospital, London Health Sciences Centre, and Ms. Anne Chambers,  Children’s Hospital, London Health Sciences Centre, London.  Reviewed by POGO Satellite Manual Review Nursing Group, 2016 and the POGO Satellite Manual Review Pharmacy Working Group, 2016.