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IV infiltration and Extravasation
This document discusses infiltration and extravasation which are complications of intravenous (IV) therapy. Infiltration occurs when IV fluid leaks into surrounding tissue due to improper catheter placement or dislodgement. Extravasation is when vesicant (toxic) drugs leak into tissue. Both can cause swelling, pain, and tissue damage. To prevent these complications, health care providers should select appropriate IV sites, use proper insertion technique, securely fix catheters, and monitor sites frequently. If complications occur, the IV should be removed and the site elevated, documented, and further treated based on symptoms and severity.
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IV infiltration and Extravasation
- 1.
- 2. Infiltration Leakage of I.V.fluid or medications (nonvesicant) into the surrounding tissue
- 3. Causes IV catheter isimproperly placed. IV catheter is dislodged or slipped out or through the blood vessel lumen.
- 4. Risks factors Type oftherapy – concentrated fluid, excessive or continuous IV fluids or medications Age – young and elderly Mental status - disorientated Overall physical condition – ill or injured, fat or thin, veins visibility Type of IV access – inappropriate sizes Practice setting – inexpert, changes of IV site, timing and monitoring.
- 5. Signs and symptoms Swelling, Discomfort Burning,and/or tightness sensation Cool skin Blanching Decreased or stopped flow rate
- 6.
- 8. Prevention Select an appropriateI.V. site, avoiding areasof flexion. Use propervenipuncture technique. Follow facility policy for securing the I.V. catheter. Observe the I.V. sitefrequently.
- 9. Management Stop the infusionand remove the device Elevate the limb to increase patient comfort; a warm compress may be applied. Check the patient's pulse and capillary refill time. Perform venipuncture in a different location and restart the infusion, as ordered. Check the site frequently. Document your findings and interventions performed. Extravasation
- 10. Extravasation Extravasation is theleaking of vesicant drugs into surrounding tissue.
- 11. Signs and symptoms Blanching Burning Discomfortat the I.V. site Cool skin around the I.V. site Swelling at or above the I.V. site Blistering and/or skin sloughing
- 12. Complications Severe localtissue damage Delayedhealing Infection Tissue necrosis, Disfigurement, Loss offunction Amputation.
- 13. Prevention Avoid IV insertioninto small and/or fragile, areas of flexion, extremities with preexisting edema, or areas with known neurologic impairment. Careful IV monitoring for patients on vesicant medications, such as certain antineoplastic drugs (doxorubicin, vinblastine, and vincristine), and hydroxyzine, promethazine, digoxin, and dopamine.
- 14. Adhere to facilitypolicy in vesicant administration via a peripheral I.V.; certain institutions administer vesicants via a central venous access device only. Always administer vesicants last after giving multiple drugs. Practice proper administration techniques strictly
- 15. Management Cease I.V. flowand keep the I.V. line onlyto administer the antidote otherwise remove it. Record the amount of extravasated solution and notify the doctor. Give antidote according to facility's protocol ordoctor’s order. Elevate the extremity.
- 16. Perform frequent assessmentsof sensation, motor function, and circulation of the affected extremity. Record the extravasation site, patient's symptoms, the estimated amount of extravasated solution, and the treatment. Follow the manufacturer's recommendations to apply either cold or warm compresses to the affected area.
- 17. Reference Complications of PeripheralI.V. Therapy https://www.nursingcenter.com/ncblog/february- 2015-(1)/complications- of-peripheral-i-v-therapy