An intravenous (IV) occlusion is a blockage within the line that stops the necessary flow of fluids, medications, or nutrients into the bloodstream. Since IV therapy bypasses the digestive system, it allows for the rapid and efficient delivery of substances directly into the circulatory system, making it a common and effective medical procedure. Recognizing and addressing a blockage quickly is important to ensure continuous therapy, especially when a patient relies on the infusion for hydration, medication delivery, or nutritional support.
Identifying the Blockage
The first indication of a blockage on the patient’s side is typically the cessation of fluid flow, often accompanied by an alarm from an electronic infusion pump. Even without a pump, a partial occlusion will be noticeable as the drip rate slows down or stops completely. Observing the IV site and the tubing closest to the patient can reveal several specific signs of an issue.
Blood may backflow into the clear tubing, appearing as a dark streak extending from the insertion site, which can happen if the infusion is not flushed quickly enough or if the flow stops. Additionally, the site itself may present with changes such as swelling, localized pain, or skin redness. These symptoms can indicate that the fluid is leaking out of the vein and into the surrounding tissue, a complication known as infiltration or extravasation, which may be caused by a positional blockage.
Safe Positional Adjustments
If a blockage is suspected, the immediate focus should be on identifying and correcting any mechanical issues. These blockages often occur when the catheter or the tubing is compressed externally, and these are the only types of occlusions a patient or caregiver should attempt to resolve without professional assistance. Start by carefully inspecting the entire length of the tubing from the pump down to the catheter hub for any obvious kinks or tight bends that are pinching the line.
Once the tubing is verified to be straight, attention should turn to the patient’s body position. A common cause of a “patient-side” occlusion is a positional placement of the catheter, where movement compresses the catheter tip against the vein wall. For example, if the IV is placed near a joint like the elbow or wrist, simply bending the arm can temporarily obstruct the flow. Gently and slowly straighten the limb where the catheter is inserted to see if the flow resumes immediately.
Changing the patient’s posture can also help if the occlusion is related to the catheter tip resting against a vessel wall. If the patient is lying down, ensure they are not resting their body weight directly on the tubing, which can compress the line against the bed. These adjustments must be performed with extreme care, and the patient or caregiver should never attempt to manipulate the catheter itself or the dressing covering the insertion site.
When to Seek Professional Help
If simple positional adjustments do not immediately restore the fluid flow, it is imperative to stop the infusion and contact a nurse or care provider right away. A blockage that is not easily cleared by correcting a kink or straightening a limb is likely caused by an internal issue, such as a blood clot or the precipitation of incompatible medications.
A patient or caregiver should never attempt to forcefully flush the line with a syringe or use any household tools to push the blockage through. The act of forcing fluid into an occluded line that contains a blood clot, known as a thrombotic occlusion, carries the severe risk of pushing the clot into the circulation, which could result in a dangerous embolism.
Only trained personnel can safely assess whether the blockage is a clot, which requires a specialized thrombolytic agent, or a precipitate, which may require a different chemical solution. Medical staff are equipped to use appropriate techniques, such as gentle aspiration with a large syringe, or to administer specific medications to dissolve the obstruction.