Management of Vasoactive Drug Extravasation
Nov 25, 2025
Source: Cainiu Health
Dr. Wang Lei
Introduction
In case of extravasation of vasoactive drugs, infusion must be stopped immediately, contact with the drug discontinued, local treatment initiated, injury assessed, and symptomatic interventions provided. Timely and proper management can reduce tissue damage and prevent serious complications. If the area of extravasation expands, severe pain occurs, or signs of tissue necrosis appear, immediate medical attention is recommended. Quickly close the infusion clamp and avoid compressing the vessel when removing the needle to prevent further drug leakage.
Vasopressor drug extravasation requires immediate cessation of infusion, discontinuation of exposure, local management, injury assessment, and symptomatic interventions. Timely and standardized management can reduce tissue damage and prevent serious complications. If the area of extravasation expands, severe pain occurs, or signs of tissue necrosis appear, prompt medical attention is recommended.
1. Immediate cessation of infusion: Quickly close the infusion line and remove the needle without compressing the blood vessel to prevent further spread of the drug into surrounding tissues and minimize tissue injury caused by high local drug concentration.
2. Discontinuation of exposure: Gently wipe away any residual drug at the extravasation site using a sterile swab, avoiding vigorous rubbing. Then rinse the affected skin area with normal saline to reduce ongoing irritation from the drug.
3. Local management: Choose cold or warm compresses based on the drug’s properties. Apply warm compresses for vasoconstrictors to enhance circulation, and cold compresses for vasodilators to reduce swelling. Avoid inappropriate treatment that may worsen tissue injury.
4. Injury assessment: Observe changes in skin color, temperature, degree of swelling, and sensation at the extravasation site. Record the extent of extravasation along with the name and dose of the drug to provide accurate information for further management.
5. Symptomatic intervention: Apply antidotes or protective agents locally as prescribed. If blisters develop, manage them under sterile conditions, keep the wound clean to prevent infection, and elevate the affected limb to promote blood return.
During routine infusions, select large, straight veins and secure the catheter firmly. Increase monitoring of the infusion site and strictly control the infusion rate. After managing extravasation, continuously monitor skin condition, maintain cleanliness and dryness of the affected area, avoid pressure and friction, and support tissue recovery.
