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Open Access Research article

Neonatal extravasation injury: prevention and management in Australia and New Zealand-a survey of current practice

Matthew Restieaux1, Andrew Maw1, Roland Broadbent2, Pam Jackson2, David Barker2 and Ben Wheeler2*

Author Affiliations

1 Dunedin School of Medicine, University of Otago, Dunedin, New Zealand

2 Department of Women’s and Child Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand

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BMC Pediatrics 2013, 13:34  doi:10.1186/1471-2431-13-34

Published: 11 March 2013

Abstract

Background

Extravasation injury remains an important cause of iatrogenic injury in neonatal intensive care. This study aims to describe the current approach to extravasation injury (EI) prevention and management in Neonatal Intensive Care Units (NICUs) in Australia and New Zealand.

Methods

A literature review regarding extravasation injury in the newborn was carried out to inform questionnaire design. An internet-based survey was then conducted with the clinical directors of the 27 tertiary NICUs in Australia and New Zealand.

Results

The survey received a 96% response rate. Approximately two thirds of Australian and New Zealand NICUs have written protocols for prevention and management of extravasation injury. Considerable practice variation was seen for both prevention and treatment of EI. 92% of units had experienced cases of significant EI.

Conclusions

Australian and New Zealand tertiary neonatal units clearly recognise EI as an important cause of iatrogenic morbidity and mortality. Significant variation still exists among units with regards to guidelines for both prevention and management of EI. We recommend that neonatal staff should remain vigilant, ensuring that guidelines for the prevention and treatment of EI are available, and rigorously followed.

Keywords:
Neonate; Extravasation; Injury; Hyaluronidase; Intravenous