IV Infiltration Injuries Are Becoming More Frequent In Atlanta, Georgia Area Hospitals
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As an IV infiltration injury attorney in Atlanta, I have represented people who have been burned and suffered permanent disfigurement as a result of IV infiltration injuries. Not surprisingly, many patients have IVs placed during hospital stays. Intravenous needles deliver all sorts of medications and are, without question, a vital part of modern healthcare delivery. However, IV needles are prone to infiltrate and cause damage to patients if they are inserted incorrectly or not properly monitored.
The Infusion Nursing Standards of Practice (INS) define infiltration as “the inadvertent administration of nonvesicant medication or fluid into the surrounding tissue instead of into the intended vascular pathway.” What does that mean in plain English? The IV system malfunctions, allowing the medication (which is supposed to go into the veins) to spill out into areas where it shouldn’t be. (By the way, “vesicant” agents are those with irritants which can cause tissue necrosis and other damage when the agent (fluid) escapes from the intended path into surrounding tissue.). A vesicant agent can cause injury when it escapes from the vascular structure where it is supposed to be and invades the surrounding tissue. As you would probably guess, “non-vesicant” agents do not have such irritants. The INS Standards classify extravasation as “the inadvertent administration of vesicant medication or fluid into the surrounding tissue instead of into the intended vascular pathway.”
How does the IV infiltrate or allow for extravasation? Sometimes the catheter is not properly placed into the patient’s vein; there may be damage to the vein at, or near, the insertion site; or, the patient may accidentally pull or tug at the IV, resulting in a dislodging of the catheter. Of course, there are many other ways the catheter may become dislodged.
IV infiltration injuries are commonplace in hospitals and other healthcare settings. Unfortunately, too often, the infiltrate goes unrecognized for too long, resulting in serious injury to many patients. IV infiltrations are serious matters, and can be very harmful to everyone; however, children are uniquely affected by IV infiltrates because they are often unable to speak for themselves or convey to a healthcare provider that something is wrong. Pedatric wings in hospitals have policies that are designed to minimize the chance that an IV will infiltrate, but nurses are frequently busy and over-worked, resulting in failure to follow such guidelines. IV sites should be assessed at least hourly and there should be documentation of that assessment. Another safeguard which is available is specialized IV equipment which restricts fluid flow to a preset volume.
IV infiltrates are commonly diagnosed when nurses find: the patient has discomfort at the insertion site; edema (swelling) at the site where the IV was placed; skin which appears “stretched”; blanching or coolness of the skin; slowing or stopping of the IV infusion; leaking of fluid out of the IV site. IV infiltrate injuries may result in burns, nerve damage, tissue sloughing, pain, scarring, and a host of other undesirable effects.
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