A retrospective chart review of risk factors for extravasation among neonates receiving peripheral intravascular fluids.

PURPOSE

To identify variables associated with extravasation and resulting tissue damage in neonates with peripheral intravascular therapy.

DESIGN

A retrospective chart review was completed.

SETTING AND SUBJECTS

Randomly selected medical records of 25 neonates admitted to a neonatal intensive care unit from January 2003 through April 2004 and who experienced peripheral intravascular infiltration were examined.

INSTRUMENTS

The Neonatal Tissue Extravasation Tool was created to reflect common descriptive variables of the neonatal population and infused solutions used in their care. Tissue damage was classified with the scale from the Task Force of Pediatric Nursing Research Committee, 1994.

RESULTS

Charts of 15 female and 10 male infants 24 to 39.6 weeks old were reviewed. Extravasation was not significantly related to age, weight, or sex. The most common intravenous medications were total parenteral nutrition (n = 19) and calcium (n = 18). Peripheral intravenous sites were secured with tape. The sites of the infiltrate were the arm (n = 16), foot/leg (n = 5), and scalp (n = 3) (one not recorded). Stages 0 (absence of redness, pain, swelling; flushes with ease) (n = 11) and 4 (severe swelling; blanching, pain, skin breakdown, etc.) (n = 6) were the most common stages. The site of the infiltrate was measured and care described in only 9 neonates.

CONCLUSIONS

The intravascular solutions causing the most extensive damage from extravasation were similar to those reported in other studies. No other potential risk factors were identified, but poor documentation about the extravasation site and management of skin damage hampered data collection via retrospective chart review.