Table 1.

Pharmacological and physicochemical properties of drugs and solvents that can be used for the interpretation of extravasations

Physicochemical property	Crash card definition	Therapy	Comments	For example
Osmolarity	High ≥500 mOsm/L Low ≤200 mOsm/L 200–500 mOsm/L physiological (290 mOsm/L)2	Warm compresses; possibly hyaluronidase Physiological: cold compresses when dispersion/dilution is not indicated	High osmolarity is defined in the crash card as ≥500 mOsm/L which is rather low when reviewing the literature. However, as there is no formal evidence this boundary is used in the crash card2 Higher osmolarity increases the risk of damage	Total parenteral nutrition (TPN) Infusion fluids such as glucose 5%, 10%, mannitol 10%, and dextrose 50%, etc Contrast fluids Electrolyte solutions
Cationic solutions	N/A	Warm compresses; possibly hyaluronidase	Be aware of delayed reactions	Calcium solutions Potassium solutions TPN
pH	Physiological (7.4) Low ≤5.0 High ≥9.0 Range considered ‘physiological’: 5.0–9.01 2	Warm compresses; possibly hyaluronidase Physiological: cold compresses when dispersion/dilution is not indicated	Extreme pH <2 and >11 are thought to cause most damage Closer to 7.4 means lesser damage Alkaline solutions are more likely to cause damage than acidic solutions	Alkaline Phenytoin Co-trimoxazole Dantrolene Thiopental Trometamol Aciclovir Phenobarbital Epoprostenol Acidic Vancomycin Amiodarone Doxycycline Esmolol Promethazine
Vasopressors	N/A	Warm compresses; phentolamine	Do not use cold compresses because of additional vasoconstriction	Terlipressin Desmopressin Dobutamine Dopamine Phenylephrine Norepinephrine