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Extravasation of neonates revisited | Signal

Reference number
1162 E
Issue date26 February 2010

This Signal returns to a risk highlighted in an earlier issue and provides good practice and guidance from local trusts to reduce risks of extravasation injury to neonates from intravenous fluid.


In the September issue of Signals, we highlighted risks of extravasation injury to neonates from intravenous fluids. Preterm infants often depend on intravenous infusion for their survival and are particularly vulnerable to extravasation and tissue damage because of the fragility of their vascular system and skin. Following a trigger incident, the National Reporting and Learning Service (NRLS) identified 184 relevant incidents in the Reporting and Learning System (RLS) database. As these were drawn from a sample, we estimate the total database contains around 1,400 neonatal extravasation injury reports.


Following this Signals item, three neonatal units have shared their neonatal extravasation guidelines with us including:


  • Winchester and Eastleigh Healthcare NHS Trust
  • Ashford and St. Peter’s Hospitals NHS Trust
  • Luton and Dunstable Hospital NHS Foundation Trust.


The focus of both Ashford and Winchester’s policies is the treatment of extravasation injuries with either hyaluronidase or glycerine trinitrate. Winchester also make use of a neonatal extravasation scoring system. For further information please contact Simon Struthers (Winchester) at simon.struthers@wehct.nhs.uk or Tracy Lawson (Ashford) at tracy.lawson@asph.nhs.uk.


Luton and Dunstable have developed a neonatal care bundle for intravenous cannula care as one of their high impact interventions which aims to reduce the incidence of peripheral intravenous cannula infections and extravasations. The care bundle consists of 10 elements including:

  • hand hygiene
  • insertion and site choice
  • dressing
  • use of appropriate infusion devices.

The care bundle also has an accompanying audit tool which can be used to audit compliance with the care bundle. For further information please contact Jacki Oughton at jacki.oughton@ldh.nhs.uk.


We thank these organisations for providing useful information for others to share. If you have any comments on these or want to send any further initiatives and local good practice, please contact us at rrr@npsa.nhs.uk




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