Infiltration and extravasation.
The Infusion Nurses Society's national standards of practice require that a nurse who administers IV medication or fluid know its adverse effects and appropriate interventions to take before starting the infusion. A serious complication is the inadvertent administration of a solution or medication into the tissue surrounding the IV catheter--when it is a nonvesicant solution or medication, it is called infiltration; when it is a vesicant medication, it is called extravasation. Both infiltration and extravasation can have serious consequences: the patient may need surgical intervention resulting in large scars, experience limitation of function, or even require amputation. Another long-term effect is complex regional pain syndrome, a neurologic syndrome that requires long-term pain management. These outcomes can be prevented by using appropriate nursing interventions during IV catheter insertion and early recognition and intervention upon the first signs and symptoms of infiltration and extravasation. Nursing interventions include early recognition, prevention, and treatment (including the controversial use of antidotes, and heat and cold therapy). Steps to manage infiltration and extravasation are presented.
Lynn Hadaway Associates, Milner, GA, USA. lynn@hadawayassociates.com
Lynn
L
Hadaway
D000671:Amputation, Surgical; D000931:Antidotes / Q000627:therapeutic use; D015984:Causality; D003161:Compartment Syndromes / Q000139:chemically induced; D020918:Complex Regional Pain Syndromes / Q000139:chemically induced; D017679:Cryotherapy; D016903:Drug Monitoring / Q000379:methods / Q000451:nursing; D042241:Early Diagnosis; D004630:Emergencies / Q000451:nursing; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006358:Hot Temperature / Q000627:therapeutic use; D006801:Humans; D007262:Infusions, Intravenous / Q000009:adverse effects / Q000451:nursing; D007509:Irritants / Q000009:adverse effects; D008875:Middle Aged; D024802:Nurse's Role; D009730:Nursing Assessment; D010347:Patient Care Planning; D017410:Practice Guidelines as Topic; D017592:Skin Care / Q000379:methods / Q000451:nursing
D000931:Antidotes; D007509:Irritants