LOCAL COMPLICATIONS

OF INTRAVENOUS

THERAPY

LOCAL COMPLICATIONS OF

INTRAVENOUS THERAPY

INFILTRATION

- occur when fluid infuses into the tissues surrounding the venipuncture site.

Possible cause:• when the tip of the catheter slips out of the vein• improper placement of catheter• the catheter passes through the wall of the vein• the blood vessel wall allows part of the fluid to infuse into the surrounding tissue because of thin and fragile veins

Signs and Symptoms:

• changes n skin color – blanching, bruising, redness surrounding insertion site

• edema in any direction from the insertion site

• changes in skin temp – cool / warm

INFILTRATION

Signs and Symptoms:

• pain, burning or stinging with injection or infusion

• impaired ability to move fingers, hand or entre extremity

•Numbness, tingling and other signs of paresthesia n the extremity

INFILTRATION

the extremity

•Slowed capillary refill.

INTERVENTIONS:

• Stop the infusion and remove the device

• Elevate the limb to increase patient comfort.

• If infiltration is small, intermittent application of ice pack may relieve swelling and discomfort. Applied for 15-30 minutes on/off intervals depending on agency policy.

severe

COLD COMPRESSCOLD COMPRESSCOLD COMPRESSCOLD COMPRESS

• If the infiltration is severe, you may consider the application of a compress in addition to elevating the affected limb. Generally speaking, if the infiltration solution was isotonic, a warm compress is used to alleviate discomfort and help absorb the infiltration by increasing circulation to the affected area. However, sloughing can occur from the application of a warm compress to an area infiltrated with certain medications such as potassium chloride. In certain situations, a cold compress is recommended.

INFILTRATION

EXTRAVASATION

- The inadvertent administration of a vesicant solution and medication such as antineoplastics into the surrounding tissue that can cause severe local tissue damage, resulting in delayed healing, infection, tissue necrosis, disfigurement, loss of function, and even amputation.

INTERVENTONSINTERVENTONS

•Stop infusion immediately and remove the I.V. line, unless the catheter should remain in

place to administer the antidote.

• Estimate the amount of extravasated solution and notify the health care provider.

• Elevate the extremity.

• Administer pan relief if required.

PHLEBITIS

- inflammation of a vein, that’s associated with acidic or alkaline solutions or those that have a acidic or alkaline solutions or those that have a high osmolarity.

Other factors include:•vein trauma during insertion•using a vein that’s too small•using a vascular access device that’s too large•prolonged use of the same I.V. site.

Signs and symptoms:

• pain/tenderness at site

•Erythema

•Warmth

•Swelling

•Induration

•Purulent drainage•Purulent drainage

•Palpable venous cord

•Elevated temperature

Steps to prevent phlebitis:

•Use proper venipuncture technique.

•If necessary, dilute drugs correctly.

•Monitor administration rates.

•Observe the I.V. site frequently.

•Change the infusion site regularly every 48 to 72 •Change the infusion site regularly every 48 to 72

hours or according to your agency’s policy.

•Select a large vein when irritating drugs and fluids

are given.

•Adhere to aseptic technique with all infusion access

and medication administration.