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.

1. IV infiltration and
extravasation.
SRCHUNG
03/03/2018

2. Infiltration
Leakage of I.V. fluid or
medications (nonvesicant) into
the surrounding tissue

3. Causes
IV catheter is improperly placed.
IV catheter is dislodged or
slipped out or through the blood
vessel lumen.

4. Risks factors
Type of therapy – 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. Complications
Tissue extravasation

8. Prevention
Select an appropriate I.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 infusion and 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 the leaking of
vesicant drugs into surrounding
tissue.

11. Signs and symptoms
Blanching
Burning
Discomfort at 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
Delayed healing
Infection
Tissue necrosis,
Disfigurement,
Loss offunction
Amputation.

13. Prevention
Avoid IV insertion into 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 facility policy 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. flow and 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 assessments of 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 Peripheral I.V. Therapy
https://www.nursingcenter.com/ncblog/february-
2015-(1)/complications- of-peripheral-i-v-therapy