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      Prevention and conduct against the Extravasation of antineoplastic chemotherapy: a scoping review Translated title: Prevención y conducta ante la Extravasación de quimioterápicos antineoplásicos: scoping review Translated title: Prevenção e conduta frente ao Extravasamento de agentes antineoplásicos: scoping review

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          Abstract

          ABSTRACT Objectives: to identify and synthesize scientific evidence on prevention and management of extravasation of antineoplastic agents in adult patients by nurses. Methods: scoping review, according to Joanna Briggs Institute and PRISMA-ScR. Research was conducted in five electronic databases, Cochrane Library and eight catalogs of theses and dissertations. Data collection occurred from April to July 2018, with no time limit. The extracted data were analyzed and synthesized in a narrative way. Results: a total of 3,110 records were retrieved and 18 studies were kept for review. Most publications (66.6%) had a qualitative approach and addressed both aspects, i.e., prevention and management of extravasation of chemotherapy in adult patients. Conclusions: the implementation of protocols based on scientific evidence on prevention and management of extravasation of antineoplastic agents is paramount in order to provide patient safety and support to the nursing staff.

          Translated abstract

          RESUMEN Objetivos: identificar y sintetizar evidencia científica sobre prevención y manejo de fugas de agentes antineoplásicos en pacientes adultos por parte de enfermeras. Métodos: revisión del alcance, según el Instituto Joanna Briggs y PRISMA-ScR. La investigación se realizó en cinco bases de datos electrónicas, la Biblioteca Cochrane y ocho catálogos de tesis y disertaciones. La recopilación de datos se produjo de abril a julio de 2018, sin límite de tiempo. Los datos extraídos fueron analizados y sintetizados en forma narrativa. Resultados: se recuperaron un total de 3.110 registros y se conservaron 18 estudios para su revisión. La mayoría de las publicaciones (66,6%) tenían un enfoque cualitativo y abordaban ambos aspectos, es decir, la prevención y el tratamiento contra la extravasación de quimioterapia en pacientes adultos. Conclusiones: la implementación de protocolos basados en evidencia científica sobre prevención y manejo de la fuga antineoplásica es primordial para proporcionar seguridad al paciente y apoyo al personal de enfermería.

          Translated abstract

          RESUMO Objetivos: identificar e sintetizar as evidências científicas sobre prevenção e conduta do extravasamento de agentes antineoplásicos em pacientes adultos realizado por enfermeiros. Métodos: scoping review, conforme Joanna Briggs Institute e o PRISMA-ScR. Realizou-se pesquisa em cinco bases de dados eletrônicas, na Biblioteca Cochrane e em oito catálogos de teses e dissertações. A coleta de dados ocorreu de abril a julho de 2018, sem limite temporal. Os dados extraídos foram analisados e sintetizados de forma narrativa. Resultados: foram recuperados um total de 3.110 registros e mantidos 18 estudos para a revisão. A maioria das publicações (66,6%) tinha abordagem qualitativa e apresentaram as duas vertentes, ou seja, prevenção e conduta frente ao extravasamento de quimioterapia em pacientes adultos. Conclusões: é primordial a implementação de protocolos baseados na evidência científica sobre prevenção e conduta diante do extravasamento de antineoplásicos a fim de fornecer segurança ao paciente e respaldo à equipe de enfermagem.

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          Most cited references23

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          Guidelines for safe handling of hazardous drugs: A systematic review

          Objective To review the scientific literature related to the safe handling of hazardous drugs (HDs). Method Critical analysis of works retrieved from MEDLINE, the Cochrane Library, Scopus, CINHAL, Web of Science and LILACS using the terms "Hazardous Substances", "Antineoplastic Agents" and "Cytostatic Agents", applying "Humans" and "Guidelines" as filters. Date of search: January 2017. Results In total, 1100 references were retrieved, and from those, 61 documents were selected based on the inclusion and exclusion criteria: 24 (39.3%) documents related to recommendations about HDs; 27 (44.3%) about antineoplastic agents, and 10 (33.3%) about other types of substances (monoclonal antibodies, gene medicine and other chemical and biological agents). In 14 (23.3%) guides, all the stages in the manipulation process involving a risk due to exposure were considered. Only one guide addressed all stages of the handling process of HDs (including stages with and without the risk of exposure). The most described stages were drug preparation (41 guides, 67.2%), staff training and/or patient education (38 guides, 62.3%), and administration (37 guides, 60.7%). No standardized informatics system was found that ensured quality management, traceability and minimization of the risks associated with these drugs. Conclusions Most of the analysed guidelines limit their recommendations to the manipulation of antineoplastics. The most frequently described activities were preparation, training, and administration. It would be convenient to apply ICTs (Information and Communications Technologies) to manage processes involving HDs in a more complete and simpler fashion.
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            European Oncology Nursing Society extravasation guidelines

            An infrequent, but potential complication of chemotherapy is vesicant chemotherapy extravasation. Vesicants have the potential to cause blistering and ulceration when they extravasate from the vein or are inadvertently administered into the tissue. In 2007, the European Oncology Nursing Society published guidelines for extravasation prevention, detection, and management. Recommended management includes topical heating for plant alkaloid extravasations and topical cooling for anthracycline and other antitumor antibiotic vesicants. For treatment of antracycline extravasations topical dimethylsulfoxide (DMSO), sodium thiosulfate, and hyaluronidase have been described in the literature but due to lack of evidence to support their use as vesicant extravasation antidotes, it is recommended that these agents are studied further. Furthermore, Savene (dexrazoxane) is the only registered drug for the treatment of antracycline extravasation. Nurses need to be aware of current evidence-based guidelines for detecting and managing vesicant extravasations and need to be prepared to administer evidence-based treatment.
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              Outcome of chemotherapy extravasation in a large patient series using a standardised management protocol.

              In a longitudinal observation, extravasation of antitumoural compounds and the efficacy of its structured interdisciplinary management were assessed in a routine setting.
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                Author and article information

                Journal
                reben
                Revista Brasileira de Enfermagem
                Rev. Bras. Enferm.
                Associação Brasileira de Enfermagem (Brasília, DF, Brazil )
                0034-7167
                1984-0446
                2020
                : 73
                : 4
                : e20190008
                Affiliations
                [2] Fortaleza Ceará orgnameUniversidade Federal do Ceará Brazil
                [1] Divinópolis Minas Gerais orgnameUniversidade Federal de São João del-Rei Brazil
                Article
                S0034-71672020000400303 S0034-7167(20)07300400303
                10.1590/0034-7167-2019-0008
                25fae5f9-5deb-4658-af0e-dae2668e0301

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 13 August 2019
                : 19 February 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 32, Pages: 0
                Product

                SciELO Brazil


                Quimioterapia Combinada,Combined Chemotherapy,Oncology,Extravasamento de Materiais Terapêuticos e Diagnósticos,Extravasation of Therapeutic and Diagnostic Materials,Oncologia,Nursing Care,Extravasación de Materiales Terapéuticos y Diagnósticos,Antineoplastic Agents,Atención de Enfermería,Antineoplásicos,Cuidados de Enfermagem,Oncología Médica

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