Infiltrated IV lead to infection?

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When one of my patient's IV's infiltrated, another nurse said I should pull it out IMMEDIATELY before it got infected. I don't really understand that; the cannula is still sterile, right? How's it going to get infected? Besides, before an IV infiltrates, a little bit of that same sterile cannula is still inside the tissue between the actual skin puncture and the vein puncture, so how does it make a big difference in infection risk if the whole cannula is in the tissue?

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Specializes in ICU, ER, EP,.

I could be way off here, but if an IV is infiltrated, left the vein... it's worthless number one so it has to go period.

Inflammation usually occurs and this can lead to a phlebitis... now you have a red hard inflamed vein... which leads to more problems.

As I understand it, this nurse was trying to help you prevent a phlebitis in the vein which is harm to the patient, which leads to a QCC report and non reimbursed treatment for the patient.

perhaps this nurse simply chose her words wrong and said infection instead of phlebitis... but the inflammatory response and resulting harm remains the same regardless of the word salad.

Does that make sense or am I misunderstanding your post?

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Specializes in MSP, Informatics.

the skin is a natural barrier. Anytime you break that, you have a chance of infection. Any invasive procedure...IV included. Now you have an infiltrated IV. That compromises the circulation, so that increases the chance of infection--cellulitis, phlebitis, localized infection at the IV site. Depending on what was going thrugh the IV, it could contribute also.

Pulling the bad IV as soon as possible, and trying to get the infiltrate swelling down, do help get good circulation back to the area. But I would not go as far as to say the IV is going to cause the infection. Some facilities have a policy to treat an infiltrate a certain way, and some have a policy to treat any IV or needle site a certain way. (we used to clean the site, apply betadine and a bandaid after removing any IV)

Big thing is to make sure you doccument how the site looks, and what you did to help restore circulation, and remind your patient to keep it clean. Im sure we have all seen even good IV sites go south fast. Hospitals are dirty places. Germs everywhere. And patients tend to pick at their IV sites, even in their sleep, with dirty hands. It's amazing more of them don't get infected.

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Specializes in NICU, Post-partum.

If the IV is infiltrated, you have to pull it because it's almost impossible to reposition it...plus once the skin is swollen, you cannot really assess if it works or not.

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Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.

Take it out asap and follow the protocol for infiltrated IVs.

Believe me when I tell you, we've had several million dollar lawsuits for "just" an infiltrated IVs.

And we lost a few of them....

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Phlebitis makes more sense, zookeeper3, thanks.

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Specializes in ICU, nutrition.

Before you discontinue the IV, check your policy about treating the infiltrated site if certain medications have been infused and extravasated (dopamine comes to mind). Some protocols call for the Regitine to be injected into the cannula as well as subQ around the site.

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Once the needle touched the skin, you know it's not sterile any longer, right? An IV cannula within a vein is not sterile.

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Specializes in ICU, ER, EP,.
Take it out asap and follow the protocol for infiltrated IVs.

Believe me when I tell you, we've had several million dollar lawsuits for "just" an infiltrated IVs.

And we lost a few of them....

What you said times three, I was deposed in a law suit with a claimed infiltrated IV that caused damage. The hospital settled regardless of my great documentation and a vascular surgeon claiming the vascular issue as the problem. Forget infection, that's down the road, the complications from someone coming after you and infusing a vessicant can be debilitating.

If it's out, take it out pronto, and always aspirate prior to doing so unless against policy, which would be a crazy policy...

I think this person got their verbage wrong, but the message to pull the IV quick was the correct direction. Pull up the policy and remind this person as to why... "hey, look what I came across..." I'd hate for that nurse to keep teaching something incorrect and and not stress the real dangers.

Great question, and our new nurses can learn quite a bit from these great posts.

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I'm not talking about some drug; the fluid was NS. Besides, even if it were a tissue-damaging drug, wouldn't turning off the IV be the thing that actually helps/makes a difference, not actually the action of removing the IV? The drug would still be in the tissue, whether or not the IV had been pulled; obviously, if something's infiltrated, you're going to stop flow.

I'm asking how the cannula ITSELF, not the drug, could be immediately harmful; is there actually any reason for me to IMMEDIATELY pull the cannula, as this nurse said, rather than ten minutes later, after I've put in a new IV?

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Specializes in NICU, Post-partum.
I'm not talking about some drug; the fluid was NS. Besides, even if it were a tissue-damaging drug, wouldn't turning off the IV be the thing that actually helps/makes a difference, not actually the action of removing the IV? The drug would still be in the tissue, whether or not the IV had been pulled; obviously, if something's infiltrated, you're going to stop flow.

I'm asking how the cannula ITSELF, not the drug, could be immediately harmful; is there actually any reason for me to IMMEDIATELY pull the cannula, as this nurse said, rather than ten minutes later, after I've put in a new IV?

There is simply no reason to keep it in...because you can never use it again, regardless of whether or not you can get in a new IV site.

It doesn't matter if it's NS or a drug, if it's not property positioned in the vein it does no good.

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There is simply no reason to keep it in...because you can never use it again, regardless of whether or not you can get in a new IV site.

It doesn't matter if it's NS or a drug, if it's not property positioned in the vein it does no good.

One more time, I'm talking about why the coworker said I needed to pull it out IMMEDIATELY. Obviously I wasn't going to leave it in there forever, and I'm not talking about the IV being worthless, I'm talking about its potential to do HARM.

To clarify, how does an infiltrated IV pose an IMMEDIATE RISK OF INFECTION?

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