Extravasation in neonates


How are infiltrated or extravasations managed in your NICU? Documentation,photos,notification of neo or a practioner, wound care, who can treat, etc.


412 Posts

Different at different places I've worked. Infiltrated, I just take it out and monitor it. If I'm more concerned about it I show the doc. For a bad extravasation- document a detailed assessment of it, measurement of limb and area affected, photos, hyalurinadase (if indicated), wound care as needed and plastics referral.

BeccaznRN, RN

758 Posts

Specializes in NICU, High-Risk L&D, IBCLC. Has 16 years experience.

Our vascular access team is involved with all infiltrates and extravasations. They perform initial assessments, make recommendations for treatment, and follow until resolved.


412 Posts

Who injects the hyalurinadase?

The doctor

Specializes in NICU. Has 9 years experience.

We check our IV sites Q1h, if it looks infiltrated we stop the IV and get one of the IV nurses (usually charge or admits) to come look at it and restart if needed. If it's actually a case of extravasation, it depends on the case - if the med/fluid causes an IV burn then we usually give Hyaluronidase.

And who would be responsible for injecting the Hyaluronidase in your unit?

Specializes in NICU. Has 40 years experience.

we use hyalroudase immediatlt one ml in 5 spots divided 0.1 ml -0.2ml , works great.

Who decides if it needs treatment and who does those injections.

NICUmiiki, DNP, NP

1,774 Posts

Specializes in Neonatal Nurse Practitioner. Has 8 years experience.

In my unit: the physician or NNP decides whether hyaluronidase is warranted. The RN administers it

Specializes in NICU. Has 6 years experience.

At my facility, it's the RN taking care of the baby at the time that injects the hyaluronidase. I'll call the house officer for the baby & tell them first/ask for an order.

Specializes in NICU. Has 40 years experience.
Who decides if it needs treatment and who does those injections.

The nurse taking care of patient will inform the MD of the need and why,get an order if needed and administer it and reorder replacement hyalrounedase from pharmacy and restock it.If it is very bad ,broken skin etc-(get a laywer ) the MD assesses need for plastics consult.

I have seen vasoldilating cream used by some doctors.