IV administration is a highly common procedure practiced in the medical world. It is a valuable tool for medical professionals. However, it is important to know that IV therapy is often associated with a number of risks and complications.
6 Common Complications Associated With I.V. Therapy
The most common complications associated with IV therapy are discussed below:
Infiltration as an I.V. Complication:
Infiltration is a complication caused by infusion of medications or fluid outside the intravascular space into the soft tissue surrounding the area. It is usually caused by improper placement of needle or the angiocath outside the vessel. It is often noted as a swelling of the soft tissue around the site of insertion associated with pale appearance of the affected area which feel firm and cool upon touching it. While infiltration of small amount of fluid may not cause a serious issue, infiltration of large amount of fluid can cause serious complications.
Hematoma is defined as a condition when there is leakage of blood from the blood vessels into the surrounding soft tissues. This is commonly seen after an I.V. if the angiocatheter passes through more than one wall of a vessel. It is also seen if adequate pressure is not applied while removing a catheter. Hematoma is generally accompanied by pain and resolves within 2 weeks. In most of the cases application of direct pressure resolves the condition.
Air Embolism as an I.V. Complication:
Air embolism generally occurs when a considerable amount of air enters the veins through an I.V. administration set. This is a rare complication but it can have serious consequences. Standard I.V. tubing has a capacity of holding about 13 cc of air, whereas a patient can tolerate only 1 cc per kilogram of weight of air. It is important to note that children are at a higher risk of air embolism after an I.V. Air embolism can be prevented easily by ensuring that there are no air bubbles in the IV tube before administering I.V.
Phlebitis and Thrombophlebitis:
This is the most common complication associated with I.V administration. Phlebitis is caused due to inflammation of the vein due to local trauma. Thrombophlebitis is a serious form of phlebitis associated with formation of a thrombus. It is commonly seen in the arms of hospitalized patients. Older patients are more prone to this complication than younger patients. Management involves elevation of the site involved, warm compresses and non-steroidal medications. In most of the cases, the use of anticoagulants and antibiotics are not required.
This complication can cause delayed absorption of the medicine, pain over the site and even tissue damage if the pH of the fluid being administered is too low or too high. If the skin appears raised and ischemic after administration of a large amount of fluid, infiltration of 1% procaine is recommended. This is because, procaine is potent vasodilators which will improve the blood supply over the area and will also improve the venous drainage from the area.
Intra-arterial Injection as an I.V. Complication:
This is a rare complication, but if it occurs it is very critical. The only way to prevent this is to ensure that the needle is inserted into a vein. It is important to keep in mind that veins are more superficial than arteries. If there is appearance of bright red blood in the angiocath, it indicates that artery has been punctured and the needle should be withdrawn immediately. It can cause arterial spasm and even loss of a limb from gangrene.
The I.V. complications can range from being mild to being serious. It is very important to make sure that there isn’t an extravascular or intra-arterial injection. As for the other complications, appropriate measures must be taken to manage the conditions immediately without any delay to avoid worsening of the condition or any further complications.