In order to avoid problems of this kind, great care must be taken to assure that these agents are given into an intact vein with a good free flow of blood. Drug may leak from sites of previous recent punctures or from veins which are occluded from any cause such as tight clothing, obstructing masses or clotting. Therefore, the insertion site should not be distal to a recent venipuncture or in an arm with compromised circulation. A large vein in the mid-forearm would be ideal if available. The escape of a drug from a vessel into the tissues.
Precautions Select a large vein away from joints or tendons, if possible, e.g., in forearm.
Hand veins may be used and may be easier to observe in some patients, however extravasation in this area will cause severe damage. Make a clean venipuncture, preferably using an appropriate gauge intravenous catheter or butterfly. Leave the needle entry site visible so that it can be watched during injection. Have IV flowing freely at all times with saline or D5W. Inject into the medication injection port of IV tubing slowly enough that drip does not stop or reverse. Watch needle tip for evidence of extravasation and check for blood return every 2-3 mL during injection.