Name of the Condition

• Extravasation of Vesicant Antineoplastic Chemotherapy, Initial Encounter
• Also known as chemotherapy extravasation.

Summary

• This condition occurs when a vesicant chemotherapy drug leaks from a blood vessel into surrounding tissues. Vesicants are highly irritating drugs that can cause severe tissue damage when not administered properly.

Causes

• Most commonly caused during intravenous (IV) administration of highly concentrated chemotherapy drugs where the drug leaks out of the vein.

Risk Factors

• High-risk factors include small veins, fragile veins often found in elderly patients, repeated cannulations, prior damage to veins from previous treatments, and inexperienced healthcare personnel administering chemotherapy.

Symptoms

• Patients may experience pain, swelling, redness, or a burning sensation at the site of the IV injection. If severe, there might be tissue necrosis leading to ulceration.

Diagnosis

• Diagnosis is primarily based on clinical examination and patient history. Imaging tests such as ultrasound might be used to assess the extent of the leakage and damage.

Treatment Options

• Immediate cessation of the infusion of the drug.
• Application of ice or heat packs, depending on the protocol for the specific drug.
• Administration of antidotes or medications to neutralize the drug.
• Surgical interventions might be necessary in severe cases to remove dead tissue.

Prognosis and Follow-Up

• With prompt treatment, the prognosis is generally good, but late treatment may lead to long-term complications like scarring.
• Follow-up involves monitoring for any signs of infection or delayed healing.

Complications

• Potential complications include severe tissue necrosis, compartment syndrome, nerve damage, and chronic pain at the site of extravasation if not promptly treated.

Lifestyle & Prevention

• Preventive measures in hospital settings include careful administration techniques, using freshly skilled personnel to administer vesicants, and monitoring of infusion sites.
• Patients and caregivers should be educated to report any discomfort immediately during chemotherapy infusions.

When to Seek Professional Help

• Immediate attention is needed if you experience severe pain, swelling, blistering, or discoloration around the IV site during or after chemotherapy administration.

Additional Resources

• American Cancer Society: www.cancer.org
• Oncology Nursing Society: www.ons.org
• National Cancer Institute: www.cancer.gov

Tips for Medical Coders

• Ensure documentation specifies "initial encounter" for accurate coding as T80.810A.
• Be cautious not to confuse with non-vesicant extravasation or later encounters such as subsequent visit codes.
• Double-check descriptions to confirm the specific use of vesicant drugs involved in the incident.