What is what to do when iv infiltrates?

When an IV infiltrates (meaning the IV fluid leaks out of the vein and into the surrounding tissue), prompt action is crucial to minimize discomfort and potential complications. Here's what to do:

1. Stop the Infusion Immediately: The first and most important step is to halt the flow of IV fluid. Turn off the pump, if applicable, and clamp the IV tubing.

2. Assess the Site: Carefully evaluate the affected area. Look for signs of infiltration, such as:

   • Swelling
   • Pain
   • Burning
   • Redness
   • Coolness to the touch
   • Tightness of the skin around the IV site
   • Blanching (skin turning pale)

3. Discontinue the IV: Gently remove the IV catheter. Apply light pressure to the insertion site with a sterile gauze pad.

4. Elevate the Extremity: Raising the affected arm or leg can help reduce swelling.

5. Apply Warm or Cold Compresses: The type of compress to use depends on the solution that infiltrated. Generally:

   • Warm Compress: Often used for infiltrations of non-vesicant solutions. This helps to promote vasodilation and absorption of the fluid.
   • Cold Compress: May be preferred for certain medications or to reduce inflammation.
   • Follow healthcare provider's orders. The specific protocol will depend on the solution infiltrated, the patient's condition, and institutional guidelines.

6. Document the Infiltration: Meticulously record the following information in the patient's chart:

   • Date and time of infiltration
   • IV solution and rate of infusion
   • Location of the IV site
   • Signs and symptoms of infiltration
   • Interventions taken
   • Patient's response to the interventions

7. Notify the Healthcare Provider: Inform the physician or nurse practitioner about the infiltration. They may order specific treatments or monitoring.

8. Monitor the Patient: Continue to observe the patient for any worsening symptoms or complications, such as tissue damage or infection.

9. Consider Hyaluronidase: For certain types of infiltrations, particularly those involving vasopressors or other medications that can cause tissue damage, the healthcare provider may order hyaluronidase. This enzyme helps to break down hyaluronic acid, a component of connective tissue, which can facilitate the absorption of the infiltrated fluid.

10. Prevention: Implement strategies to prevent future infiltrations, such as:

    • Selecting an appropriate IV site
    • Using proper insertion techniques
    • Frequently assessing the IV site for signs of infiltration
    • Educating patients about the signs and symptoms of infiltration and instructing them to report any concerns.