Intravenous (IV) therapy is a common medical procedure that delivers fluids, medications, or nutrients directly into a person’s vein. While generally safe and effective, understanding potential complications associated with IV therapy is important for patient well-being.
What Infiltration Means
IV infiltration occurs when fluid or medication leaks out of the intended vein into the surrounding soft tissue. This happens when the catheter, the small tube inserted into the vein, either dislodges or punctures the vein wall. The fluid then accumulates, causing swelling and other noticeable changes at the IV insertion site. Infiltration specifically refers to the leakage of non-irritating fluids, such as saline or common antibiotics, differentiating it from extravasation, which involves more damaging substances.
Why Infiltration Happens
Several factors can contribute to an IV infiltration. One common reason is improper placement or securement of the IV catheter. If the needle or catheter is not inserted correctly or is pushed too far, it can pierce through the vein wall, creating an exit point for the fluid. The catheter might also become dislodged from the vein if it is not adequately secured with tape or dressings.
Patient movement is another frequent cause of infiltration. Moving the limb where the IV is inserted can jostle the catheter, causing it to back out of the vein or puncture the opposite wall. Additionally, certain patient conditions, such as having fragile or small veins, can increase the risk of infiltration, as these veins are more susceptible to damage during insertion or infusion. Sometimes, a blockage within the vein, like a blood clot, can force the fluid to leak out into the surrounding tissues.
How to Spot Infiltration
Recognizing the signs of IV infiltration is important for prompt intervention. One of the most common signs is swelling around the IV insertion site, as fluid accumulates in the surrounding tissue. The affected area may also feel cool to the touch due to the presence of non-circulating fluid. Patients often experience pain or tenderness at the site, which can worsen with continued infusion.
The skin around the IV site might also show changes in appearance, such as blanching, where it appears paler than the surrounding skin, or discoloration, like redness. Another indicator is a noticeable slowdown or complete stop of the IV drip, as the fluid is no longer flowing correctly into the vein. The skin near the site might also feel tight or puffy. These symptoms arise because the fluid is exerting pressure on the tissues and impacting local circulation.
Taking Action
If an IV infiltration is suspected, immediate action is necessary to prevent further complications. The first step is to stop the infusion of fluid or medication to prevent additional leakage into the tissue. After stopping the flow, the IV catheter should be carefully removed from the site. It is important for individuals to avoid attempting to remove the IV themselves; this should be done by a healthcare professional.
Once the IV is removed, elevating the affected limb can help reduce swelling and discomfort by promoting fluid drainage. A healthcare professional will then assess the site and may apply a warm or cold compress, depending on the type of fluid that infiltrated. The site will be monitored regularly for improvement or worsening of symptoms. Pain management may also be provided if the patient experiences discomfort.
Reducing the Risk
Several proactive measures can help minimize the chances of IV infiltration. Keeping the limb with the IV site as still as possible is important, as excessive movement can dislodge the catheter. Patients should avoid pulling on the IV tubing or allowing it to get caught on clothing or bedding. Regularly checking the IV site for any signs of discomfort or visible changes, and promptly reporting them to a healthcare professional, can lead to early detection.
Ensuring the IV site remains visible, not covered by blankets or clothing, allows for continuous monitoring by both the patient and caregivers. Proper IV insertion technique, including selecting an appropriate vein and securing the catheter well, significantly reduces the risk. Healthcare providers also play a role by regularly assessing the IV site, especially in patients who may not be able to communicate discomfort effectively.