Contrast extravasation

Recognize

• Swelling, pain, erythema at injection site
• Most resolve without sequelae

Act — tap each step

1. 1Stop injection immediately
2. 2Aspirate any contrast back through cannula if possible, then remove
3. 3Elevate the extremity above heart level
4. 4Apply cold OR warm compress (provider preference)
5. 5Observe 2–4 h
6. 6Surgical consult if: skin blistering, altered tissue perfusion, increasing pain, sensory changes, compartment syndrome signs

Notes

• Most extravasations < 100 mL resolve uneventfully.
• Compartment syndrome more likely with large volumes (> 100 mL) or in small extremities.
• Document volume, site, exam, intervention, and follow-up plan.