S/S of IV Infiltration

[sports2245]

What are the s/s of an infiltrated IV site? I have pallor, edema, pain, coolness of the skin. Am I missing something? Thanks in advance.

[MikeyJ, RN]

You basically have it right. You may see bruising as well. And another "sign" would be stopped or slowed infusion, and you may see some IV fluid leaking out of the infiltrated site.

[Lisa CCU RN, RN]

Pain and edema, I get, but why coolness? I'd think it be a little red, warm , and tight.

[abcrn84]

redness, swelling, does the tape look tighter than it did previously...does it feel warm...does the patient c/o burning at the site? Are your meds working? If not evaluate to be sure they are not going in the skin.

[MikeyJ, RN]

Pain and edema, I get, but why coolness? I'd think it be a little red, warm , and tight.

Warmth and redness is associated with inflammation, trauma, etc. An infiltrated IV basically involves the IV fluid infiltrating into the surrounding tissues rather than into the vein. Thus, you have fluid in the tissues which will feel kind of cool and will be pale in color. Make sense or no?

[Bonny619]

Perfectly explained.

Warmth and redness is associated with inflammation, trauma, etc. An infiltrated IV basically involves the IV fluid infiltrating into the surrounding tissues rather than into the vein. Thus, you have fluid in the tissues which will feel kind of cool and will be pale in color. Make sense or no?

[beth66335, BSN, RN]

I would think an IV of NS would feel cool from the temp of the fliud in the skin, red and warm would be likely in an infiltrated IV with meds piggybacked that are irritating the tissues? Maybe?

Warmth and redness is associated with inflammation, trauma, etc. An infiltrated IV basically involves the IV fluid infiltrating into the surrounding tissues rather than into the vein. Thus, you have fluid in the tissues which will feel kind of cool and will be pale in color. Make sense or no?

[Lisa CCU RN, RN]

Warmth and redness is associated with inflammation, trauma, etc. An infiltrated IV basically involves the IV fluid infiltrating into the surrounding tissues rather than into the vein. Thus, you have fluid in the tissues which will feel kind of cool and will be pale in color. Make sense or no?

Yes, that makes sense, but like poster below pointed out, would fluids that are irritating not make the site red and inflamed?

This is an interesting thread btw.

Kinda off topic, but is there a way to know beforehand if a fluid or medication that is going to be pushed will burn as it goes in? I guess most nurses just learn about that as they go, but it'd be nice to know about some of the ones I should dilute or push really slow.

Is it just best to ask patient how they feel?

[Bonny619]

You mean like a vesicant? Or just in general what solutions burn?

[onyx77]

Yes, that makes sense, but like poster below pointed out, would fluids that are irritating not make the site red and inflamed?

This is an interesting thread btw.

Kinda off topic, but is there a way to know beforehand if a fluid or medication that is going to be pushed will burn as it goes in? I guess most nurses just learn about that as they go, but it'd be nice to know about some of the ones I should dilute or push really slow.

Is it just best to ask patient how they feel?

Infiltration s/s are swelling, cool to touch (as swelling is from IV fluids in the tissue and this fluid is cool), possible pain, and pale collor. Treat with a warm moist compress.

Phlebitis s/s are tenderness, redness, warmth, and puffiness at site. This is an infection.

With both d/c IV and start at another site.

The pt will probably have considerable pain if irritating fluids are infiltrating. As for knowing what meds are irritating, you should be looking up each med prior to administering and you would then find this info.

[beth66335, BSN, RN]

That makes sense. Thanks!

Infiltration s/s are swelling, cool to touch (as swelling is from IV fluids in the tissue and this fluid is cool), possible pain, and pale collor. Treat with a warm moist compress.

Phlebitis s/s are tenderness, redness, warmth, and puffiness at site. This is an infection.

With both d/c IV and start at another site.

The pt will probably have considerable pain if irritating fluids are infiltrating. As for knowing what meds are irritating, you should be looking up each med prior to administering and you would then find this info.

[sodiumH20taffy]

There's a great article in the August 2007 issue about IV infiltration & extravasation with lists of problem medications and their classifications. I was just reading this today and thinking I should make a copy and put it with my clinical notes.