Treating IV infiltration involves a multi-faceted approach focused on minimizing discomfort, preventing complications, and facilitating healing. Here's a breakdown of the steps:
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Stop the Infusion and Remove the IV Catheter: This is the most crucial first step. Immediately discontinue the infusion and gently remove the IV catheter from the insertion site.
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Assess the Infiltration: Carefully evaluate the affected area. Note the size, appearance (redness, swelling, blanching), and any reported pain or discomfort. This assessment helps determine the severity of the infiltration.
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Elevate the Affected Extremity: Elevating the arm or leg helps to reduce swelling and promote fluid reabsorption.
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Apply a Compress: The type of compress depends on the infiltrating solution:
- For most infiltrations (non-vesicant solutions): Apply a warm compress to encourage vasodilation and absorption of the fluid.
- For some specific medications (check with a pharmacist or protocol): A cold compress may be indicated to minimize inflammation and vasoconstriction if the infiltrated solution is a vesicant or irritant.
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Medication Administration (if indicated):
- Hyaluronidase: If a significant amount of a specific medication that can be broken down by hyaluronidase (e.g., certain vasopressors) has infiltrated and is causing tissue damage, hyaluronidase may be injected subcutaneously around the infiltration site. This helps to disperse the fluid and reduce pressure on the tissues. This requires a physician's order.
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Pain Management: Administer pain relief medication as needed and prescribed to manage any discomfort associated with the infiltration.
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Monitor for Complications: Closely monitor the site for signs of infection (redness, warmth, purulent drainage), skin breakdown, or nerve damage.
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Documentation: Thoroughly document the infiltration, including the date, time, solution infiltrated, estimated volume, patient's symptoms, interventions taken, and patient's response.
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Initiate a New IV Site: Choose a new IV insertion site in a different location, preferably in the opposite extremity, ensuring proper technique to prevent further infiltration.
Example Scenario:
Let's say a patient receiving a normal saline infusion complains of pain and swelling at the IV site. You notice redness and blanching around the insertion point.
- Action: Stop the infusion, remove the IV catheter.
- Assess: Note the size of the swelling, level of pain, and appearance of the skin.
- Elevate: Elevate the patient's arm.
- Apply: Apply a warm compress to the site for 20 minutes.
- Pain Management: Administer prescribed pain medication if needed.
- Monitor: Observe the site for improvement and signs of complications.
- Document: Record all findings and interventions in the patient's chart.
- New IV: Start a new IV in the opposite arm.
By following these steps, healthcare professionals can effectively manage IV infiltrations and minimize potential harm to patients.
