iv cannula complication

Complications of iv cannula Complications of iv cannula include infection, phlebitis and thrombophlebitis,emboli, pain, haematoma or haemorrhage extravasation, arterial cannulation and needlestick injuries.

Careful adherence to guidelines and procedures can minimise these risks so here some steps how we can remove the iv cannula complications and what are step to stop complications.

Infiltration Complication Infiltration occurs when I.V. fluid or medications leak into the surrounding tissue. Infiltration can be caused by improper placement or dislodgment of the catheter. Patient movement can cause the catheter to slip out or through the blood vessel lumen and there are symptoms of this complication are swelling ,burning,cool skin and blanching etc .

Prevention from infiltration Select an appropriate I.V. site, avoiding areas of flexion.  Use proper venipuncture technique.  Follow your facility policy for securing the I.V. catheter.  Observe the I.V. site frequently.  Advise the patient to report any swelling or tenderness at the I.V. site. 

What management can do      

Stop the infusion and remove the device.

Elevate the limb to increase patient comfort a warm compress may be applied.

Check the patient's pulse and capillary refill time.

Perform venipuncture in a different location and restart the infusion, as ordered.

Check the site frequently.

Document your findings and interventions performed.

Extravasation Complication Extravasation is the leaking of vesicant drugs into surrounding tissue. Extravasation can cause severe local tissue damage, possibly leading to delayed healing, infection, tissue necrosis, disfigurement, loss of function, and even amputation.There are some complications like Swelling at or above the iv site or blistering and skin sloughing .

Prevention from Extravasation 

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avoid veins that are small and/or fragile, veins in areas of flexion, veins in extremities with preexisting edema, or veins in areas with known neurologic impairment.

Be aware of vesicant medications, such as certain antineoplastic drugs (doxorubicin, vinblastine, and vincristine), and hydroxyzine, promethazine, digoxin, and dopamine.

Follow your facility policy regarding vesicant administration via a peripheral I.V.; some institutions require that vesicants are administered via a central venous access device only.

Give vesicants last when multiple drugs are ordered.

Strictly adhere to proper administration techniques.

Management work Stop the I.V. flow and remove the I.V. line, unless the catheter should remain in place to administer the antidote.  Estimate the amount of extravasated solution and notify the prescriber.  Administer the appropriate antidote according to your facility's protocol.  Elevate the extremity.  Perform frequent assessments of sensation, motor function, and circulation of the affected extremity.  Record the extravasation site, your patient's symptoms, the estimated amount of extravasated solution, and the treatment.  Follow the manufacturer's recommendations to apply either cold or warm compresses to the affected area. 

Phlebitis Complication Phlebitis is inflammation of a vein. It is usually associated with acidic or alkaline solutions or solutions that have a high osmolarity. Phlebitis can also occur as a result of vein trauma during insertion, use of an inappropriate I.V. catheter size for the vein, or prolonged use of the same iv cannula site

Prevention from phlebitis Use proper venipuncture technique.  Use a trusted drug reference or consult with the pharmacist for instructions on drug dilution, when necessary.  Monitor administration rates and inspect the I.V. site frequently.  Change the infusion site according to your facility's policy 

Management work Stop the infusion at the first sign of redness or pain.  Apply warm, moist compresses to the area.  Document your patient's condition and interventions.  If indicated, insert a new catheter at a different site, preferably on the opposite arm, using a larger vein or a smaller device and restart the infusion 