Emergencies >> Extravasation

Please document the patient:
Last name (will not be saved)
First name (will not be saved)
Date of birth (will not be saved)
Venous line:
Application:
Place of puncture (e. g. ri. lower arm)
Cytostatic drug in extravasation:
Other substances:
Extravasation volume:
Infusion:	administered completely was stopped
Aspiration possible:	yes no
Contacted surgeon?	yes no
Documenting physician:
Pager:
Telephone:

Important notice: This software is in a beta-stage (test version) and MUST NOT be used for patient care! It is only suitable for academic or research (theoretic) purposes.

PLEASE NOTE: This staging system can contain errors (as every computer software)!
It cannot replace your hematological expertise and should be confirmed by current literature.