• Mitchell Dufficy, Mari Takashima, Jacqueline Cunninghame, Bronwyn R Griffin, Craig A McBride, Deanne August, and Amanda J Ullman.
• School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Queensland, Australia.
• J Hosp Med. 2022 Oct 1; 17 (10): 832842832-842.

BackgroundPediatric extravasation injuries are significant healthcare-associated injuries, with sometimes significant sequelae. Evidence-based guidance on management is necessary to prevent permanent injury.PurposeA systematic review of the literature, including aggregated case series, investigating extravasation injury management of hospitalized pediatric patients.Data SourcesPubMed, Cummulative Index to Nursing and Allied Health Literature (CINAHL), and Excerpta Medica database (EMBASE) were searched on December 13, 2021.Study SelectionPrimary research investigating extravasation injury management of hospitalized pediatric patients (to 18 years), published from 2010 onwards and in English, independently screened by two authors, with arbitration from a third author.Data ExtractionData regarding the study, patient (age, primary diagnosis), extravasation (site, presentation, outcome), and treatment (first aid, wound management) were extracted by two authors, with arbitration from a third author.Data SynthesisFrom an initial 1769 articles, 27 studies were included with extractable case data reported in 18 studies, resulting in 33 cases. No clinical trials were identified, instead, studies were primarily case studies (52%) of neonates (67%), with varied extravasation symptoms. Studies had good selection and ascertainment, but few met the causality and reporting requirements for quality assessments. Signs and symptoms varied, with scarring (45%) and necrosis (30%) commonly described. Diverse treatments were categorized into first aid, medical, surgical, and dressings.ConclusionsDespite infiltration and extravasation injuries being common within pediatric healthcare, management interventions are under-researched, with low-quality studies and no consensus on treatments or outcomes.© 2022 The Authors. Journal of Hospital Medicine published by Wiley Periodicals LLC on behalf of Society of Hospital Medicine.

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