what's the appropriate name for this procedure?

  1. when an IV goes interstitial, and the person's hand becomes extremely swollen (the IV is removed), and when the swelling doesn't go down, then staff insert a needle and withdraw fluid from tissues?

    What is the proper name for this procedure?
    How is it actually done?
    And why does the fluid return again the next day (the IV is already gone?)

    thanks if anyone knows
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  2. 26 Comments

  3. by   SCRN1
    Is the word you're looking for infiltration or extravasation?
    Last edit by SCRN1 on Dec 8, '06 : Reason: to add another word
  4. by   student456
    is this right? im just a 2nd year nursing student so im not too sure but i think this is it

    infiltration

    this occurs when the tip of the iv catheter withdraws from the vein or pokes through the vein into surrounding tissue, or when the vein's wall becomes permeable and leaks fluid (in this instance it is said that the cannula has 'tissued'). it occurs frequently with peripheral ivs, and requires replacement of the iv at a different location. the symptoms of pain and swelling are temporary and not dangerous, unless giving a highly irritating medication, such intravenous contrast or amiodarone. additionally it can become dangerous if the person monitoring the iv site fails to recognize that an infiltration has occurred and fluid continues to drip in the tissue under the skin. it can cause a compression injury. this known as an infiltration injury.
  5. by   SuesquatchRN
    Infiltration is when the IV becomes "clogged" and the site swells. I don't know what the procedure afterwards is called.
  6. by   Daytonite
    GingerSue. . .I was an IV therapist for 6 years as well as nationally certified in IV therapy and never heard of anyone inserting a needle into swollen tissues to withdraw infiltrated IV fluid! Was this a question you were asked from a textbook or workbook? I never heard of anything like this. The treatment for a grossly swollen infiltrated IV is to elevate the limb and perhaps apply some warm compresses to help increase the circulation and help bring the swelling down.
  7. by   SCRN1
    Quote from Daytonite
    GingerSue. . .I was an IV therapist for 6 years as well as nationally certified in IV therapy and never heard of anyone inserting a needle into swollen tissues to withdraw infiltrated IV fluid! Was this a question you were asked from a textbook or workbook? I never heard of anything like this. The treatment for a grossly swollen infiltrated IV is to elevate the limb and perhaps apply some warm compresses to help increase the circulation and help bring the swelling down.
    Thanks for answering the other part of her question. I was racking my brain, trying to think if I've ever heard of that because I've not seen it done either. I also will use elevation and warm compression (unless caught quickly and not really edematous). Of course I stop the fluids & remove the IV first thing and get another IV site started.
  8. by   Dixielee
    could this be what the op was talking about?

    2. prevention or treatment of dermal necrosis and sloughing following intravenous administration or extravasation of norepinephrine.
    for prevention: 10 mg of phentolamine mesylate is added to each liter of solution containing norepinephrine. the pressor effect of norepinephrine is not affected.
    for treatment: 5 to 10 mg of phentolamine mesylate in 10 ml of saline is injected into the area of extravasation within 12 hours.
  9. by   GingerSue
    thanks everybody

    to explain:
    there was an IV in the R arm, then the area swelled
    so the IV was removed and a new one inserted into the L arm

    but the R hand became then really swollen

    then the next evening I saw that the R hand was incredibly less swollen, and I asked about it, the patient said that someone had used a needle to remove the fluid

    but the next evening, I saw that the R hand was again extremely swollen, and it doesn't have the IV in it.

    Why does the R hand swell again, when it doesn't have the IV?
    And what is the procedure that was used with the needle to remove fluid?

    I haven't heard of this being done before?
    I did some googling about the use of cold or warm - and in different situations (depending on the medication that was being administered), sometimes cold is more helpful, and sometimes warmth is more helpful.

    I'm still interested in the procedure that was used to remove the fluid?
    There is a small red spot on the back of the hand that appears to be a puncture site.

    Anybody know about this procedure?
  10. by   P_RN
    I can't remember anything like what you describe.

    There is one procedure called clysis where fluid is intentionally infused into the tissues of the abdomen etc. It's then slowly absorbed by the body.

    As far as the hand "re-swelling" the next day, I guess if there were damage to the vein wall then there might be some continued edema when the hand is below heart level.

    Please ask the person who told you about the needle procedure to explain it.
  11. by   GingerSue
    I've read about hypodermoclysis (in the Policy and Procedure manual) used to add fluid to body tissues
  12. by   maolin
    Without being there it's hard to know for sure - but what you are describing sounds like an I&D to me (incision & drainage) - often done to remove pus & fluid from an abcess. Have not heard of this to treat an infiltration - but perhaps this wasn't a typical infiltration to begin with.
  13. by   allantiques4me
    Quote from Daytonite
    GingerSue. . .I was an IV therapist for 6 years as well as nationally certified in IV therapy and never heard of anyone inserting a needle into swollen tissues to withdraw infiltrated IV fluid! Was this a question you were asked from a textbook or workbook? I never heard of anything like this. The treatment for a grossly swollen infiltrated IV is to elevate the limb and perhaps apply some warm compresses to help increase the circulation and help bring the swelling down.
    Ive never heard of a procedure to drain the fluid either.Allantiques
  14. by   Lacie
    Quote from dixielee
    could this be what the op was talking about?

    2. prevention or treatment of dermal necrosis and sloughing following intravenous administration or extravasation of norepinephrine.
    for prevention: 10 mg of phentolamine mesylate is added to each liter of solution containing norepinephrine. the pressor effect of norepinephrine is not affected.
    for treatment: 5 to 10 mg of phentolamine mesylate in 10 ml of saline is injected into the area of extravasation within 12 hours.
    we used to do dimilar to this for dopamine infiltrations, etc. i hated doing it as it took numerous sq injections in one session around the site. we used reglan if i remember correctly. not sure if still done same way. i've never heard of essentially drawing off fluid. they can develope as described above necrosis or sloughing. another would be cellulitis due to the inflammation which can result in significant edema/pallor. very tender and painful to boot. some of the old schoolers may remember this.

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