903 React! – An Aide Memoire to Guide Management of Extravasation Injuries

Abstract

Abstract Introduction Intravenous infusions are common practice but come with the risk of extravasation injury. Although overall incidence is low, in those undergoing chemotherapy and in children the risk is much greater (4.7% and 11-58% respectively). These injuries can have severe consequences ranging from skin necrosis to loss of function, some necessitating complex reconstruction. Prompt recognition and treatment reduces the chance of these outcomes. Whilst classically managed by plastic surgeons, many hospitals do not have such services locally. Time-delays introduced by remote referral or inadequate initial treatment result in poor outcomes. We describe a simple algorithm with accompanying video designed to enable confident immediate management. Method We devised a simple acronym describing the basic steps, based on the technique described by Gault. Accompanied by an instructional video demonstrating the technique they form a simple to follow guide. Results The initial treatment of an extravasation injury can be split into the following key steps: These steps, detailed in a simple poster, sit alongside a descriptive video which could be accessed through hospital intranets and video publishing platforms, such as Youtube and Vimeo, can allow potential users access on their portable devices. Conclusions The combination of the REACT! acronym and video provides an example of an easy-to-use teaching tool, when combined with local training, could improve the initial management of extravasation injuries in hospitals where plastic surgery input is not immediately available, reducing poor outcomes.