ONC-FRM-003: Extravasation management record

Standards › Standard 51 › Forms

Form · ONC-FRM-003 · Version 1.0 · Approved by the ASF Expert Committee

Supports: 51.4

Purpose

Records each suspected extravasation, the early signs seen, and the management steps and times.

How to complete

• Record the drug, the site and the early signs seen.
• Record when the infusion was stopped and each management step taken.
• Record the review of the event.

Checks

Check	Entry
Drug and site	Yes
Early signs seen	Yes
Infusion stopped (time)	Yes
Management steps and times	Yes
Review date	Yes

Evidence

Reference	Note
E-006	ASF Policy Framework v1.2. Adapted.
E-009	ASF Expert Committee consensus.

Change history

Version	Date	What changed	Approval
1.0	the date of approval	First version	set Expert Committee approval

E-learning for this document

• Oncology & Infusion Therapy Safety Endorsement (AMB-11)

References

• Accréditation Sans Frontières (2026). ASF Policy Framework v1.2. (E-006)
• Accréditation Sans Frontières (2026). ASF Expert Committee consensus on Standard 1. (E-009)