Patient education: IV infiltration (The Basics)

What is IV infiltration? — "IV infiltration" is a problem that can happen when a person is getting fluids or medicines by IV. (An IV is a thin tube, or "catheter," that goes into a vein.)

An IV is used to give fluids or medicines directly into the bloodstream. IV infiltration happens when the fluids or medicines leak from the vein and build up in the tissue around the vein instead. This can cause pain and swelling. It can also cause problems if the fluids or medicines do not get into the bloodstream to work as they were supposed to.

If the buildup of fluid or medicines harms the tissue, it is called an "extravasation."

What causes IV infiltration? — IV infiltration can happen if:

●The tip of the IV catheter slips out of the vein.

●The catheter pushes through the wall of the vein.

●Fluid or medicine leaks out from where the catheter enters the vein.

These problems can happen if your veins are fragile or damaged. The catheter can also be pulled out of place if the it gets caught or pulled by accident. If something blocks the normal blood flow in the vein, the fluids or medicines can leak out from where the catheter went in.

What increases the risk of IV infiltration? — Some things increase the chance of this happening. Your risk depends on:

●Your age – Older adults and small children are more likely to have an IV infiltration.

●How secure the IV is – If the IV is not well secured, it is more likely to move out of place.

●If there were any problems when the IV was placed

●The type of fluids or medicines going through the IV

●Where the IV was placed, such as near a joint

What are the symptoms of IV infiltration? — The skin where the IV enters your body might feel cool to the touch, be swollen, or feel tight. The skin might look red, pale, blotchy, or discolored. You might feel pain, burning, itching, or numbness near the IV.

Blisters or sores might also form with an extravasation.

How serious is IV infiltration? — It depends on what types of fluids or medicines leak into the tissue. It also depends on the amount of fluid in the tissue. Minor problems from an IV infiltration can include:

●Swelling

●Pain

More serious problems can also happen, such as:

●Medicine not getting into the bloodstream

●Compartment syndrome, which is when pressure builds up in a group of muscles

●Skin burns that require a skin graft

●Tissue around the IV dying

●Nerve damage

How is an IV infiltration treated? — It depends on the types of fluids or medicines that were going through the IV. The medical staff will stop giving fluid or medicine right away. They might try to remove any fluid that has built up in the tissue. Sometimes, they can give you another type of medicine to prevent harm where a medicine leaked out of a blood vessel.

The staff will have you prop your arm or hand on pillows, keeping it above your heart. This can help lessen pain and swelling. They might suggest using heat or ice on the area for 20 minutes at a time, 4 to 6 times each day. This depends on the types of fluids or medicines that were going through the IV.

Very serious IV infiltrations or extravasations might need to be treated with surgery.

Can IV infiltration be prevented? — Not always. But there are some ways to lower the risk of this happening:

●Tell your doctor or nurse right away if you notice any pain or changes where the IV enters your skin. Also, tell them if you notice any cracks or leaks in the IV or tubing.

●Keep the IV and tubing secure. This helps prevent it from being pulled or catching on something when you move around.

●If the IV is on the inside of your elbow, keep your arm straight while you are getting fluids or medicines. You can use a splint or a pillow to keep it in position.

More on this topic

Patient education: What to watch for when you have an IV (The Basics)
Patient education: Acute compartment syndrome (The Basics)