Needle infiltration is a common complication during intravenous (IV) therapy. It occurs when fluid administered through an IV leaks out of the vein and into surrounding body tissues.
Understanding Needle Infiltration
Infiltration is the accidental delivery of a non-vesicant solution or medication into the tissue surrounding the vein, rather than directly into the bloodstream. A non-vesicant solution does not cause blistering or significant tissue damage. This differs from extravasation, which involves the leakage of a vesicant solution that can lead to tissue injury or necrosis.
The mechanism of infiltration involves the needle or catheter puncturing through the vein wall during insertion or dislodging after successful placement. This allows IV fluid to escape the venous pathway and accumulate in the interstitial space, which is the area between cells. The fluid leakage into the tissue can cause localized bulging and potentially compress the vein, further impeding proper flow.
Common Reasons for Infiltration
Improper venipuncture technique is a frequent cause of needle infiltration. This includes inserting the catheter too far, causing it to pass through both walls of the vein, or not inserting it far enough, allowing it to back out. The catheter may also be improperly secured, leading to dislodgement.
Patient movement can also dislodge the catheter. Some patients, especially the elderly or very young, have fragile or porous veins, making them more susceptible to rupture or leakage. A vein that is already scarred or has a blood clot near the insertion site can obstruct fluid flow, leading to infiltration.
Identifying Infiltration
Common signs of infiltration include swelling around the IV insertion site. The affected area may also feel cool to the touch.
Patients often report pain or discomfort at the IV site, which can worsen as more fluid infiltrates. The skin around the affected area might appear blanched, pale, or show redness or discoloration. A noticeable slowdown or complete halt in the IV drip rate can also indicate infiltration.
Responding to Infiltration
Once infiltration is suspected, stop the IV infusion. Then, carefully remove the IV catheter from the site.
Elevating the affected limb above heart level can help reduce swelling and promote fluid reabsorption. Applying a warm or cold compress to the site can also provide comfort and aid in resolution; warm compresses are typically used for non-vesicant infiltrations to increase circulation and absorption, while cold compresses may reduce inflammation and pain. Notify a healthcare professional to assess the site, document the incident, and determine if a new IV site is needed.
Preventing Infiltration
To minimize infiltration risk, keep the affected limb as still as possible during IV insertion and while the IV is running. Patients should immediately report any discomfort, pain, or changes at the IV site to their healthcare provider.
Keep the IV site visible and uncovered for easy monitoring. Healthcare providers are responsible for proper vein selection and catheter securement, but patient awareness and communication with staff also contribute to prevention. Professionals use appropriate techniques and secure the catheter with dressings to minimize movement.