Intravenous (IV) infusions deliver fluids, medications, or nutrients directly into a patient’s bloodstream. A burning sensation during an IV is a common concern. Understanding its causes and knowing what actions to take can help alleviate anxiety.
Why the Burning Happens
The characteristics of the infused medication often contribute to a burning feeling. Solutions with a pH level significantly different from the body’s natural pH (around 7.35 to 7.45) can irritate the vein’s inner lining, known as the intima. High osmolarity solutions, which have a higher concentration of dissolved particles than blood, can also draw water out of vein cells, leading to irritation.
The size and location of the vein also influence discomfort. Smaller veins, or those in nerve-rich areas like the hand or wrist, are more sensitive to the catheter and fluid infusion. A larger catheter in a smaller vein can create pressure against vessel walls, leading to a burning sensation. This mechanical irritation is often temporary.
The speed of fluid infusion also plays a role. Infusing fluids too quickly can overwhelm the vein’s capacity, causing it to distend or react to sudden chemical changes, resulting in a burning feeling. Slowing the infusion rate often helps mitigate this discomfort.
The temperature of the IV fluid can be a factor in burning. Fluids significantly colder than body temperature can cause blood vessels to constrict, leading to a temporary stinging or burning feeling. This sensation typically subsides once the fluid warms to body temperature. Patient sensitivity also varies, with some individuals having a lower pain tolerance or more sensitive veins, making them more prone to discomfort.
When Burning Signals a Problem
While often benign, burning can signal a more serious issue requiring medical attention. Infiltration occurs when IV fluid leaks from the vein into surrounding tissue. Symptoms include swelling, coolness, pain, and skin blanching around the IV site. A lack of blood return can also be a sign.
Extravasation is a more severe form of infiltration, occurring when the leaked fluid is a vesicant medication that can cause blistering and tissue damage. Along with infiltration symptoms, extravasation can lead to severe pain, tissue necrosis, and blistering. Both require immediate IV discontinuation and medical intervention to prevent further tissue damage.
Phlebitis, or inflammation of the vein, is another cause of burning that requires attention. It is characterized by redness, warmth, tenderness, and sometimes a hard, cord-like feeling along the vein. Phlebitis can be caused by mechanical irritation from the catheter, chemical irritation from the infused solution, or bacterial contamination. Ignoring phlebitis can lead to complications, such as a blood clot.
Nerve irritation or damage can also cause a burning sensation, often with other specific symptoms. If the IV needle or catheter injures a nerve, the patient may experience sharp, shooting pain, numbness, tingling, or limb weakness. These symptoms might be immediate or develop hours after insertion. Nerve damage can lead to prolonged discomfort or functional impairment.
Infection at the IV site is a serious complication that can cause increasing burning or pain. Signs include escalating redness, warmth, pus discharge, and sometimes systemic symptoms like fever and chills. Prompt identification and treatment of an IV site infection prevent it from spreading throughout the body.
Addressing the Burning Sensation
Immediately inform the nurse or healthcare provider if you experience a burning sensation during an IV. Communicating discomfort allows medical staff to promptly assess the situation and determine the cause, helping prevent complications from worsening.
Patients should avoid attempting to adjust the IV line, catheter, or infusion rate themselves. Manipulating the IV site without proper medical knowledge can dislodge the catheter, introduce bacteria, or exacerbate existing issues. Healthcare professionals are trained to safely manage IVs and address patient discomfort.
Healthcare providers have several interventions if a patient reports burning. They first assess the IV site for signs of infiltration, phlebitis, or nerve irritation, and check for blood return. They may slow the infusion rate to see if discomfort subsides, especially if the medication is irritating. Applying a warm compress can help improve blood flow and reduce discomfort from cold fluids or mild irritation.
In some cases, the healthcare provider may discontinue the current IV and restart it in a different location, particularly if the initial site shows signs of irritation or complications. This allows the irritated vein to recover and provides a fresh site for continued treatment. Discomfort during an IV infusion is manageable, and healthcare professionals are equipped to address these issues effectively.