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POGO Satellite Manual

3.3.3 Sample Extravasation Documenting Tool

3.3.4 References

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This guidance document was developed by Ms. Julie Dowler, Ms. Denise Reniers and Ms. Anne Chambers, Children’s Hospital, London Health Sciences Centre, London. Reviewed in consultation with Ms. Lisa Honeyford, The Hospital for Sick Children, Ms. Kirsty Morelli, Scarborough Health Network, Centenary Hospital and Ms. Mary Jo De Courcy, Children’s Hospital, London Health Sciences Centre, based on the sources below.

References

  1. B.C. Cancer Agency Policy III-20, Extravasation of Chemotherapy, Prevention and Management of, Revised January 2016, Approved by Provincial Systemic Program Committee.
  2. Cancer Care Ontario, Safe Administration of Systemic Cancer Therapy Part 2: Administration of Systemic Treatment and Management of Preventable Adverse Events (November 2018, version 2). Retrieved December 2020, https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/1201
  3. Fabian, B. Intravenous complications: Infiltration. Journal of Intravenous Nursing 2000; 23(4):229-31.
  4. Froland, K. Extravasation injuries. J WOCN 2007; 34 (3): 299-302.
  5. Hooke MC. Clinical nurse specialist and evidence-based practice: Managing anthracycline extravasation. Journal of Pediatric Oncology  Nursing 2005; 22(5): 261-4.
  6. Kassner E. (2000). Evaluation and treatment of chemotherapy extravasation injuries. Journal of Pediatric Oncology Nursing 2000 Jul; 17(3):135-48.
  7. Langer SW, Sehested M, Jensen PB. Treatment of anthracycline extravasation with dexrazoxane. Clin Cancer Res; 2000; 6: 3680-86.
  8. Llinares ME, Bermudez M, Fuster JLet al. Toxicity to topical dimethyl sulfoxide in a pediatric patient with anthracycline extravasation. Pediatric Hematology and Oncology 2005;22(1):49-52.
  9. London Health Sciences Centre Formulary, Chemotherapy Extravasation Management Protocol. London, ON, Canada, Revised May 2011, Approved by Drugs and Therapeutics Committee.
  10. Mader I, Furst-Weger PR, Mader R, et al. Amsacrine. In: Mader I, ed. Extravasation of cytotoxic agents: Compendium for prevention and management. Vienna, Austria: Springer; 2003. p.59-60.
  11. Medication Extravasation, Treatment of, Clinical Standards Manual, Children’s Hospitals and Clinics, Minneapolis/St. Paul, Minnesota, Feb 11, 2005, page: E-105.1-105.6.
  12. Mouridsen HT, Langer SW, Buter J, et al. Treatment of anthracycline extravasation with Savene (dexrazoxane): results from two prospective clinical multicentre studies. Ann Oncol 2007; 18(3): 546-50.
  13. Olver IN, Aisner J, Hament A. et al. A prospective study of topical dimethyl sulfoxide for treating anthracycline extravasation. J Clin Oncol 1988; 6(11):1732-35.
  14. Perez Fidalgo JA, Garcia Fabregat L, Cervantes A, et al. Management of chemotherapy extravasation: ESMO-EONS Clinical Practice Guidelines. Ann Oncol 2012; 23(Suppl 7): vii167-73.
  15. Pizzo PA, Poplack DG (eds). Local treatment for chemotherapy extravasation. In: Principles and Practice of Pediatric Oncology, Table 44-7.  Lippincott Williams & Wilkins, United States 2002.
  16. Polovich M, Whitford JM, Olsen M, eds  Chemotherapy and Biotherapy Guidelines and Recommendations for Practice.,3rd ed.  Pittsburg, PA: Oncology Nursing Society; 2009. p. 105-10.
  17. Sauerland, C, Engelking, C, Wickham, R, et al. Vesicant Extravasation Part 1: Mechanisms, Pathogenesis and Nursing Care to Reduce Risk. Oncol Nurs Forum 2006; 336(6) 1134-41.
  18. Schulmeister, L. Preventing and managing vesicant chemotherapy extravasations. J Support Oncol 2010; 8(5): 212-15.
  19. Schulmeister, L and Camp-Sorell, D: Chemotherapy extravasation from implanted ports. Oncol Nurs Forum 2000; 27: 531-38.
Disclaimer: Source Accuracy

You are welcome to download and save a local copy of this document in the Word and/or PDF formats provided. As the POGO Satellite Manual is subject to ongoing revisions and updates by POGO, we recommend you regularly check the online version posted at https://www.pogo.ca/satellite-manual/ to ensure you have the most up-to-date content. In the event of any inconsistency between the content of a local copy and the online version of the POGO Satellite Manual, the content of the online version shall be considered correct. Please see also the POGO Satellite Manual Disclaimer.

Record of Updates
Version NumberDate of EffectSummary of Revisions
16/28/2021Original version posted.
3.4 Injecting SC Medication Via an Insuflon
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In this Section

  • 1.1 History and Overview
  • 1.2 Acknowledgements
  • 1.3 Committees and Working Groups
  • 1.4 POGO Satellite Manual Disclaimer
  • 2.1 Principles of Satellite Care
  • 2.2 Eligible Patients
    • 2.2.1 Children Eligible for Chemotherapy Administration in a Satellite Centre
    • 2.2.2 Children Not Eligible for Chemotherapy Administration in a Satellite Centre
    • 2.2.3 Children Eligible for the Management of Complications on a Satellite Centre
    • 2.2.4 Eligibility of Children Requiring Supportive Care
  • 2.3 Scope of Satellite Practice
    • 2.3.1 Implementation of Psychosocial Treatment Plan (Process for Communication)
    • 2.3.2 Limitations on Satellite Practice
  • 2.4 Advanced Satellite Practice
  • 3.1 Safe Handling, Administration and Disposal of Chemotherapy Agents
    • 3.1.1 Personal Protective Equipment
    • 3.1.2 Preparation, Transport and Storage
    • 3.1.3 Administration of IV Hazardous Drugs
    • 3.1.4 Administration of Oral Hazardous Drugs
    • 3.1.5 Disposal of Equipment/Personal Protective Equipment used to Administer Hazardous Drugs
    • 3.1.6 Safe Handling for Pharmacy
    • 3.1.7 References
  • 3.2 Accidental Exposure/Spills
  • 3.3 Extravasation Management
    • 3.3.1 Sample Extravasation Documenting Tool
    • 3.3.2 Antidotes and Treatments for Extravasation
    • 3.3.3 Sample Extravasation Documenting Tool
    • 3.3.4 References
  • 3.4 Injecting SC Medication Via an Insuflon
  • 3.5 Chemotherapy Administration Reference List
  • 3.6 Central Venous Catheter Care
  • 3.7 Chemotherapy Quick Reference
    • 3.7.1 Rapid Hydration Document
    • 3.7.2 Provider Guide: Prevention and Management or Irinotecan induced Diarrhea
    • 3.7.3 Parent Handout: Prevention and Management of Irinotean induced diarrhea
    • 3.7.4 Capizzi Methotrexate
    • 3.7.5 Erwinia L-Asparaginase
  • 4.1 Management of Fever and Neutropenia
    • 4.1.1 Routine Order Sample Sheet
    • 4.1.2 Sample Fever Cards
    • 4.1.3 Criteria for low-risk designation. Risk categorization refers to risk of bacteremia and serious complications, including mortality.
  • 4.2 Pentamidine Administration
    • 4.2.1 Inhaled Pentamidine
    • 4.2.2 Intravenous Pentamidine
  • 4.3 Antiemetics
  • 4.4 Treatment of Varicella-Zoster Infections
  • 4.5 Immunization of Children with Cancer
  • 4.6 Transfusion
  • 4.7 When to consult the Tertiary Centre
  • 5.1 Palliative Care Overview
  • 5.2 Communication
  • 5.3 Settings of Care
  • 5.4 Symptom Management
  • 5.5 End of Life
  • 5.6 When a Child Dies at the POGO Satellite Clinic
  • 5.7 Appendix: Sample Bereavement Materials
    • 5.7.1 Reconciling Your Grief
    • 5.7.2 Funeral Arrangement Checklist
    • 5.7.3 Helping Children Who Grieve
    • 5.7.4 Coping with the Holidays
    • 5.7.5 The Grief Experience
  • 5.8 References
  • 6.1 Goals and Objectives
  • 6.2 Participant Site Selection
    • 6.2.1 Tertiary Hospital Site Selection
    • 6.2.2 Community Hospital Site Selection
  • 6.3 POGO’s Roles
    • 6.3.1 PHIPA, Privacy and Research
  • 6.4 Funding
    • 6.4.1 Funding Support for Tertiary Hospital Activity
    • 6.4.2 Funding Support for Community Hospital Activity
  • 6.5 Infrastructure and Formal Requirements
    • 6.5.1 Specialized Childhood Cancer Program Partners’ Role in the POGO Satellite Program
    • 6.5.2 POGO Satellite Clinic Partners’ Role in the POGO Satellite Program
  • 7.1 Preamble
  • 7.2 Investigator responsibilities
  • 7.3 Training Requirements
    • 7.3.1 General Training for Conduct of Research
    • 7.3.2 Protocol Specific Training
  • 7.4 Research Activites that may be completed in satellite centres under supervision of DSI
  • 7.5 Research Activities to be completed in Tertiary Centres Only
  • 7.6 Recognition and Reporting of Adverse Events (AEs)
  • 7.7 Data Transfer
  • 7.8 Pharmacy Drug Accountibility
  • 7.9 Site Inspections and Quality Assurance
  • 8.1 Pediatric Oncology Shared Care Initial Data Transfer Sheet
  • 9.1 Satellite Readiness/ Preparedness Checklist
  • 9.2 Education Report for Tertiary Centres
  • 9.3 Vital Signs Report
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