Extravasation of cytotoxic chemotherapy from peripheral veins

The venodilation effects of tapping versus massaging for venipuncture

AIM

To compare the effectiveness of tapping and massaging venodilation techniques by evaluating venous cross-sectional area, venous depth, venous palpation score, and questionnaire responses of study participants.

METHODS

This study had a quasi-experimental design. Between August 2016 and October 2016, healthy adult volunteers (n = 30, mean ± standard deviation of age: 22.3 ± 2.2 years) were enrolled in this study. Three venodilation techniques were evaluated: the application of a tourniquet (Control Group), the application of a tourniquet and tapping of the participant's forearm (Tapping Group), and the application of a tourniquet and massaging of the participant's forearm (Massage Group).

RESULTS

In all three groups, venous cross-sectional areas increased significantly after the application of the venodilation technique. The change ratio of venous cross-sectional area was significantly larger in the Massage Group than in the Control Group. Additionally, 83.3% of the participants selected massaging as their preferred venodilation technique, stating the technique was comfortable and provided a feeling of relief.

CONCLUSIONS

No significant differences were observed between the degrees of venodilation that were achieved using the three investigated venodilation techniques. Nonetheless, massaging was deemed the most effective technique after considering the participants' subjective comments.

Standardization of the infusion sequence of antineoplastic drugs used in the treatment of breast and colorectal cancers

The definition of antineoplastic administration sequences can help planning of therapeutic regimens in a more rational way, and thus optimize chemotherapy effects on patients, increasing efficacy and reducing toxic effects. In this way, this study aimed to evaluate the infusion order of antineoplastic agents of the main therapeutic protocols used in the treatment of colorectal and breast cancer which are used in a tertiary hospital, identifying possible interactions dependent on the infusion sequence. For the definition of protocols adopted in the hospital, medical prescriptions were used in the period of January to March 2016 and a literature review was conducted to search for studies assessing the sequence of administering the selected regimens. The databases used were SciELO, LILACS and MEDLINE, in addition to Micromedex Solutions® and UpToDate®. A total of 19 protocols were identified for antineoplastic therapy, 11 for colorectal cancer and 8 for breast cancer. The selected articles provided evidence for administration order of 19 protocols, and three protocols did no report relevance of infusion sequence. Sequence-dependent interactions were mainly related to toxicity, pharmacokinetics and efficacy of the drug combination. The definition of the infusion sequence has a great impact on the optimization of therapy, increasing efficacy and safety of the protocols containing combined antineoplastic therapies.

Managing cytotoxic chemotherapy extravasation: use of saline washout

Florence Nightingale Foundation scholar Karen Harrold received funding to support her PhD exploring the patient experience of saline washout as a management strategy for chemotherapy extravasation. She discusses the focus of her thesis, the completion of phase one and looks ahead to phase two.

Extravasation of antineoplastic agents: prevention and treatments

The extravasation of antineoplastic agents is an unwanted and distressing situation that can easily occur. It may cause severe and irreversible local injuries. Left untreated, vesicant chemotherapy extravasation can potentially cause tissue necrosis, functional impairment and permanent disfigurement. This article provides a review of current literature regarding recommendations on the prevention and treatment of extravasation of antineoplastic agents.

Cytotoxic chemotherapy: what do community nurses need to know?

Among the range of increasingly complex care demands made of community nurses in the UK is the support of patients undergoing cytotoxic chemotherapy at home. The NHS Cancer Plan and associated standards (Department of Health, 2000a,b) have identified that community nurses need an increased awareness and knowledge of the procedures and drugs involved to ensure a quality service provision. This article, based on a validated education course commissioned for community nurses in East Berkshire, explores key areas that enable community staff to care for and support patients through the course of their treatment and allows them to begin identifying an operational structure that promotes a quality service. Health and safety (as part of risk management) routes of administration, recognizing neutropenic sepsis associated with chemotherapy, and communication and collaboration are presented as key points identified from the course.