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 The Infiltration Scale was moved from the Standards of Practice to the Policy and Procedure Book from INS. The reasons for this were several and I was the primary one suggesting and supporting this action. The scale only provided signs and symptoms of infiltration from a PIV. It did not include signs and symptoms of extravasation nor any s&s from a CVAD, thus is not a complete and thorough scale for use with all events and all VADs. There never was a specific grade or rank that required completion of an incident or unusual ocurrence report. Any of these complications that produces loss of function of the extremity or severe disfiguration of the extremity requires a sentinel event process with root cause analysis. This would include amputation, compartment syndrome with nerve damage, complex regional pain syndrome, pain from neuromas, or the need for debridement and skin grafting. There are several scales in the literature which I have included along with the references for them in my online education course, Infiltration and Extravasation from VADs. Your organization must decide through the applicable committees many aspects of what your policy and procedure should actually be. This would include application of heat or cold as appropriate for each fluid or medication, use of a specific antidote for specific infiltrations or extravasations, when to require a surgical consultation with a plastic or hand surgeon, and how and to whom these events should be reported. Lynn