Intravenous (IV) lines deliver necessary fluids and medications directly into a vein via a small, flexible catheter. This catheter is secured to the skin, usually in the hand or arm. While gentle movement is generally acceptable, fully bending the arm, especially at a joint, carries a significant risk of causing complications or stopping the IV from working.
The Mechanics of IV Placement and Movement
A peripheral IV catheter is a soft, hollow tube precisely positioned inside a superficial vein to allow fluid flow. The location of the IV site, often in the forearm, hand, or the inner crease of the elbow (antecubital fossa), heavily dictates the degree of movement possible.
When the catheter is placed near a joint, such as the elbow or wrist, bending the limb can physically crimp the tube or push its tip against the vein wall. This mechanical compression impedes fluid flow, a problem known as occlusion. Excessive movement can also cause the catheter to shift within the vein, leading to irritation or causing the tip to migrate partially out of the vein. This migration allows fluid to leak into the surrounding tissue, which is a common complication.
Safe Movement Guidelines
The general rule for safe movement is to keep the limb with the IV relatively straight and avoid any motion that causes pulling or tension on the site. Gentle, subtle movements, such as wiggling the fingers or slowly rotating the wrist, are typically permitted to maintain comfort. Patients must limit the arm’s range of motion, especially if the IV is near the wrist or elbow, as bending the joint puts pressure on the catheter.
When resting or sleeping, position the arm on a pillow, keeping it extended and elevated to help prevent swelling. Avoid lying directly on the IV arm, as prolonged pressure can compromise the catheter’s position or restrict blood flow. If the IV is placed in an area of flexion, a splint or IV board may be used to provide additional support and immobilization. The dressing covering the IV site should always remain clean, dry, and intact.
Recognizing Complications from Excessive Movement
Excessive movement can compromise the IV site, and patients must be aware of the signs that indicate a problem is developing.
Infiltration
Infiltration occurs when the IV fluid leaks into the tissue surrounding the vein. Symptoms include swelling, tightness or discomfort around the site, and the skin feeling cool to the touch. Fluid flow may also slow down or stop completely.
Phlebitis
Phlebitis is the inflammation of the vein wall, often caused by mechanical irritation from a moving catheter. Signs include localized pain, warmth, redness, and tenderness that may track up the path of the vein. A compromised site due to kinking or occlusion may also trigger frequent alarms on an IV pump.
If any of these signs appear, stop moving the arm immediately and alert a healthcare provider. The healthcare team needs to assess the site to determine the complication, which usually involves stopping the infusion and removing the device to prevent further tissue damage.