Complications of peripheral IV therapy

When administering intravenous fluids or medications to a patient through a peripheral intravenous site, it is crucial to listen to signs and symptoms of complications, take preventive measures, and know find out how to intervene if complications occur.

Infiltration of intravenous fluids

Infiltration occurs when intravenous fluid or drugs enter the encircling tissue. Infiltration could also be attributable to incorrect placement or displacement of the catheter. Patient movement may cause the catheter to dislodge or go through the lumen of a blood vessel.

Infiltration Signs and symptoms

• Swelling, discomfort, burning and/or pressure
• Skin cooling and blanching
• Reduced or stopped flow rate

IV Prevention of infiltration

• Select an appropriate IV site, avoiding flexion areas.
• Use appropriate venipuncture technique.
• Follow facility policy regarding securing the intravenous catheter.
• Monitor the injection site continuously.
• The patient must be advised to report any swelling or tenderness on the intravenous site.

Infiltration Management IV

• Stop the infusion and take away the device.
• Elevate the limb to extend patient comfort; you possibly can apply a warm compress.
• Check the patient’s heart rate and capillary refill time.
• Perform a venipuncture at one other site and restart the infusion as directed.
• Check the web site often.
• Document your findings and interventions performed.

Extravasation

Extravasation is the leakage of burning agents into surrounding tissues. Extravasation may cause severe local tissue damage, which can result in delayed healing, infection, tissue necrosis, disfigurement, lack of function, and even amputation.

Signs and symptoms

• Blanching, burning or discomfort on the intravenous site
• Cool skin across the IV site
• Swelling at site IV or above
• Blistering and/or peeling of the skin

Prevention of extravasation

• Avoid veins which might be small and/or fragile, veins in areas of flexion, veins in extremities with existing edema, or veins in areas of known neurological impairment.
• Be aware of stinging medications akin to certain anticancer medications (doxorubicin, vinblastine, and vincristine) and hydroxyzine, promethazine, digoxin, and dopamine.
• Follow facility policy for administering a vesicant via a peripheral IV; some institutions require the administration of edemas only through a central venous access device.
• When ordering multiple medications, stinging agents must be administered last.
• Proper administration techniques should be strictly followed.

Management of extravasation

• Stop the intravenous flow and take away the intravenous line unless the catheter must be left in place for antidote administration.
• Assess the quantity of extravasated solution and notify the prescriber.
• Administer appropriate antidote in line with facility protocol.
• Lift the limb.
• Perform frequent assessment of sensation, motor function, and circulation within the affected limb.
• Record the location of extravasation, the patient’s symptoms, the estimated amount of extravasated solution, and the tactic of treatment.
• Follow the manufacturer’s instructions to use cold or warm compresses to the affected area.

Phlebitis after intravenous therapy

Phlebitis is inflammation of a vein. This complication of peripheral intravenous therapy is normally related to acidic or alkaline solutions or solutions with high osmolarity. Phlebitis can also occur from trauma to the vein during insertion, use of an intravenous catheter that is just not the suitable size for the vein, or use of the identical intravenous site for long periods of time.<

Symptoms and signs of phlebitis

• Redness or tenderness on the catheter tip or along the vein path
• Swollen area above a vein
• Warmth across the injection site

Prevention of phlebitis

• Use appropriate venipuncture technique.
• Use a trusted medication reference or, if mandatory, seek the advice of your pharmacist for instructions on diluting the medication.
• Monitor the speed of administration and continuously inspect the intravenous site.
• Change the infusion site in line with facility policy.

Treatment of phlebitis

• The infusion must be stopped at the primary sign of redness or pain.
• Apply warm, moist compresses to the world.
• Document patient condition and interventions.
• If indicated, a brand new catheter must be inserted in a unique site, preferably in the other arm, using a bigger vein or smaller device, and the infusion restarted.

Hypersensitivity response

An immediate, severe hypersensitivity response could be life-threatening, so rapid recognition and treatment are essential.

Signs and symptoms

• Sudden fever
• Joint swelling
• Rash and hives
• Bronchospasm
• Wheezing

Prevention of hypersensitivity

• Ask the patient about personal and family history of allergies.
• For infants younger than 3 months, ask the mother about her allergy history, as maternal antibodies should be present.
• Stay with the patient for five to 10 minutes to detect early signs and symptoms of hypersensitivity.
• If the patient is receiving the medication for the primary or second time, check it every five to 10 minutes or as directed by facility policy.

Managing hypersensitivity

• Stop the infusion and notify the prescriber immediately.
• Administer medications as directed.
• Monitor patient vital signs and supply emotional support.

Infection related to IV

Local or systemic infection is one other potential complication of intravenous therapy.

Signs and symptoms

• Redness and discharge on the IV site
• Raised temperature

Infection prevention

• Hand hygiene, gloves and aseptic techniques must be used during intravenous administration.
• Before inserting the intravenous catheter, clean the world with an approved skin antiseptic.
• Special hand hygiene must be maintained before contact with the infusion system or the patient.
• Clean the injection ports before each use.
• Follow your institution’s policy on changing dressings and changing the answer and administration set.

Infection management

• Stop the infusion and notify the prescriber.
• Remove the device and culture the location and catheter as directed.
• Administer medications as directed.
• Monitor the patient’s vital signs.

With special attention and skill, you’ll give you the chance to acknowledge, prevent, and manage these complications of peripheral intravenous therapy.

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