Understanding IV Infiltration: Prevention, Recognition, and Treatment for Nurses
Peripheral IV therapy is a foundational component of nursing care across all healthcare settings. While commonly performed, IV therapy carries risks of complications that can affect patient safety and comfort. One of the most frequent complications nurses encounter is infiltration. Understanding how to recognize, treat, and prevent infiltration is essential to providing high-quality care and improving patient outcomes.
What Is IV Infiltration?
IV infiltration occurs when a non-vesicant IV solution inadvertently leaks from the vein into the surrounding subcutaneous tissue. Unlike extravasation, which involves vesicant or irritating medications, infiltration generally involves non-irritating fluids such as normal saline.
Although it may not always cause severe harm, if not promptly recognized and managed, infiltration can result in tissue swelling, pain, and even long-term tissue damage.
Signs and Symptoms of Infiltration
Nurses should monitor IV sites frequently and be vigilant for the following symptoms:
- Swelling or puffiness at or around the insertion site
- Coolness to touch compared to surrounding tissue
- Skin blanching or tautness
- Discomfort, tightness, or pain near the IV site
- Decreased or absent IV flow rate
- Damp or wet dressing (indicating fluid leakage)
In more severe cases, patients may experience numbness or restricted limb mobility.
Contributing Factors
Several factors can increase the risk of infiltration:
- Poor vein integrity – fragile or sclerosed veins are more prone to leakage
- Improper catheter size – using a catheter that is too large for the vein can cause trauma
- Frequent site manipulation – movement of the catheter can disrupt vein integrity
- Improperly secured IV catheter – loose or poorly stabilized catheters increase the chance of dislodgment
- High-pressure infusion – rapid or pressurized fluid administration can force fluid out of the vein
Pediatric, elderly, and cognitively impaired patients may be at even greater risk due to limited ability to verbalize discomfort.
Treatment and Nursing Interventions
At the first sign of infiltration, immediate nursing action is required:
- Stop the infusion immediately to prevent further fluid from entering the tissue.
- Remove the IV catheter from the affected site.
- Elevate the affected limb to promote fluid reabsorption.
- Apply a warm or cold compress depending on facility protocol and type of infiltrated solution.
- Monitor the site closely and document findings thoroughly.
- Assess the patient for discomfort or potential complications.
- Restart IV therapy in a new site, preferably on the opposite extremity.
Always notify the healthcare provider as required and follow facility-specific guidelines for incident reporting.
Prevention Strategies
Preventing infiltration begins with skilled IV insertion and vigilant monitoring:
- Choose the appropriate catheter size and vein for the prescribed therapy
- Secure the catheter properly using stabilization devices or dressings
- Inspect IV sites regularly and assess for early signs of infiltration
- Educate patients to report any discomfort, swelling, or changes at the site
- Avoid joints or areas of high movement when selecting insertion sites
Clinical competency, adherence to protocols, and continuing education are key to minimizing complications like infiltration.
Enhance Your IV Therapy Knowledge with Pedagogy Education
Staying current with IV therapy standards and best practices is vital for all nurses. Pedagogy Education’s online course, Basics of Peripheral IV Therapy: Current Standards of Practice, provides comprehensive training on IV therapy techniques, complication management—including infiltration—and the latest evidence-based guidelines.
This convenient, online course is ideal for individual nurses or entire facilities looking to elevate their infusion therapy practice. Whether you're new to IV therapy or seeking to refresh your skills, this course delivers the knowledge you need to practice safely and confidently.
