An infiltrated intravenous (IV) line occurs when fluid or medication leaks into the surrounding tissues instead of remaining within the vein. This leakage happens outside the intended blood vessel, entering the soft tissue near the insertion site. Infiltration is a common complication that can hinder IV therapy, which aims to deliver fluids, nutrients, or medications directly into a patient’s circulatory system.
Why IV Infiltration Occurs
Several factors can contribute to IV infiltration. It often stems from the physical dislodgment of the IV catheter, which may slip out of the vein or puncture its wall. Improper insertion technique, such as pushing the IV line too far or using a catheter too large for the vein, can also lead to the catheter piercing the vessel.
Inadequate securement allows for movement that can damage the vein or cause dislodgment. Patient activity, including excessive movement of the limb where the IV is placed, can also jostle or pull the catheter out of its correct position.
Fragile veins, particularly in elderly or pediatric patients, are more susceptible to damage. Blood clots forming near the insertion site can block fluid flow, forcing the solution into surrounding tissues. Prolonged use of the same IV site also increases the risk of vein irritation.
How to Spot IV Infiltration
Recognizing IV infiltration involves observing physical signs and patient symptoms. The area around the IV insertion site typically becomes swollen and may appear puffy or tight. The skin might change color, often becoming pale or blanched, and can feel noticeably cooler to the touch compared to the surrounding skin. Patients commonly report pain, tenderness, or discomfort at or near the IV site.
Other indicators include a slowed or completely stopped IV drip, as the fluid is no longer entering the vein efficiently. You might also observe wetness or leakage of fluid around the bandage or at the puncture site. In some cases, there might be a lack of blood return when attempting to aspirate the IV line. Comparing the affected limb to the opposite limb can help identify swelling or changes in circumference.
Immediate Steps and Care
If IV infiltration is suspected, stop the infusion immediately to prevent further fluid leakage. The IV catheter should then be carefully removed from the site. Elevating the affected limb above heart level can help reduce swelling and promote the reabsorption of the leaked fluid.
Applying a compress can also aid recovery, though the type of compress depends on the infused solution. For most non-irritating fluids, a cold compress can be applied initially to reduce swelling and discomfort. After the first 24 hours, a warm compress may be recommended to promote circulation and help the body absorb the fluid.
Keep the site clean and dry and avoid applying lotions or tight clothing to the area. Healthcare providers may mark the outline of the affected area to monitor changes.
When to Seek Medical Attention
While many IV infiltrations are minor, some can lead to more serious complications requiring prompt medical attention. Seek care if the swelling, pain, or redness at the IV site worsens or does not improve within 24 hours.
Blistering, bruising, or darkening of the skin around the site, along with potential peeling, indicate more severe tissue damage. If there is any fluid, blood, or pus leaking from the IV site, or if the skin develops red streaks, medical consultation is necessary. Signs of infection, such as fever, increasing pain, or warmth at the site, also warrant immediate medical evaluation.
Although rare, severe infiltrations can lead to nerve damage, presenting as persistent numbness or tingling, or even impaired blood circulation. In extreme cases, if a large volume of fluid infiltrates or if the fluid is particularly irritating, it can lead to tissue death (necrosis) or, in very rare instances, compartment syndrome, which requires urgent surgical intervention.