Treatment of nonionic radiographic contrast material extravasation


Initial treatment provided by the radiology technologist includes:

  • Immediately discontinue the contrast injection when a problem is detected.
  • Elevation of affected extremity above the heart
  • Removal of any tight fitting clothing above the injection site
  • Milk the extravasated contrast toward the heart by intermittent compression of affected site by manual compression or an Ace wrap
  • Use caution with application of tight bandages (eg, coban) proximal to the extravasation site

Observation performed by nursing staff includes:

  • Typical observation periods depend on patient’s symptoms and site of extravasate.  Often, 1-2 hours are sufficient
  • Educate patient about signs of tissue compromise, and advise to seek medical attention if needed per UW Health Facts for You (HFFY)
  • Hot/cold compresses not specifically indicated, but can be used for comfort.
  • Plastic surgery consultation based on symptoms, not quantity of extravasation

Plastic surgery consultation should be considered for any of the following reasons:

  • Skin blistering
  • Redness or streaks at the injection site
  • Altered tissue perfusion (decreased capillary refill in the region or distal to the injection site)
  • Increasing pain
  • Change in sensation distal to site of extravasation
  • Main clinical concern is development of compartment syndrome.

Patient given Health Facts for You (HFFY) by rad tech if responsive, or printed by nursing prior to discharge.