IV Infiltration Injuries

Infusion of fluids and medication through an IV is very common. The idea is that a catheter tip is inserted into a vein; a solution is then transfused through the catheter directly into the blood stream as it flows back towards the heart. A nurse is usually the provider that places the IV into the patient. The insertion site can be the hand, the arm, the leg, the neck, and even the foot in some circumstances.

Injuries can happen when the IV catheter tip finds itself outside of the patient’s vein. The cause may be due to poor placement of catheter. Many times the catheter tip wears through the vein over time. Other causes include the high pressure of the infusion or the caustic nature of the infused solution itself.

Once the infused solution gets out of the vein and into the surrounding tissue, an injury occurs. This is called an IV infiltration. The damage done depends on the type of medication being administered. Some medications are more “acid-like” and can burn the tissue badly. Known as a vesicant, these medications are usually involved in the worst IV infiltration injuries. Examples of vesicant medications include:

  • Potassium Chloride
  • Total Parenteral Nutrition (TPN)
  • Phenergan
  • Nitroglycerine
  • Digoxin
  • Morphine
  • Calcium Chloride or Calcium Gluconate
  • Many chemotherapy drugs
  • Many antibiotics

Legal claims involving IV infiltration injuries usually involve the failure of nursing staff to properly manage and monitor the infusion. Oftentimes, the patient’s serious complaints of pain are discounted as the usual discomfort of IV therapy. Sometimes the negligent medical provider selected an unsafe site for the IV.

Pediatric IV management requires even closer attention by the nursing staff, especially when a known vesicant medication is being administered. 

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