Intravenous Infiltration Research Articles

Quality improvement measures for early detection of severe intravenous infiltration in infants

Intravenous infiltration is one of the most commonly seen morbidity in infants admitted to the neonatal intensive care unit (NICU). The risk of intravenous infiltration in preterm infants is probably...

Everly's Intravenous Infiltration Journey

Highlights Caring for a peripheral intravenous therapy infiltration injury. Lasting impact from an intravenous infiltration. Patient perspective from a mother of a baby born in critical condition. Medical journey of a baby with interrupted aortic arch, VSD, aortic stenosis, hypoplastic aortic valve. How a care team encouraged a mother to advocate for her child.

Assess the Effectiveness of Magnesium Sulphate Dressing Versus Cold Compress in Patients with Intravenous Infiltrations

A study was conducted to compare the effectiveness of magnesium sulphate dressing versus cold compress in patients with intravenous infiltrations. The research method adopted for the study was quasi-experimental approach. Samples were divided in two groups, each consisting 30. Purposive sampling technique was used to select the sample for the study. The difference in reduction in intravenous infiltration of both groups is statistically significant; investigator feels that the magnesium sulphate dressing is better than cold compress for reducing intravenous infiltration.

When in Doubt, Pull the Catheter Out: Implementation of an Evidence-Based Protocol in the Prevention and Management of Peripheral Intravenous Infiltration/Extravasation in Neonates.

The vast majority of infants in the NICU receive peripheral intravenous (PIV) therapy for administration of fluids, nutrition, medications, and blood products. The potential complications of infiltration and extravasation are common in this population. Consequences of inf.ltration and extravasation may be prevented or mitigated by early detection and prompt treatment. In addition, innovative therapies for wound care are constantly evolving. In order to improve outcomes, a practice guideline for intravenous (IV) infiltration prevention, management, and treatment is presented based on literature review and consultation with wound care experts. The guideline includes preventive measures, standardized IV assessment, staging, an algorithm outlining injury, and wound care recommendations.

Plastic Surgery Management of Intravenous Infiltration and Extravasation Injuries

Plastic Surgery Management of Intravenous Infiltration and Extravasation Injuries

Intravenous Infiltration Resulting in Compartment Syndrome: A Systematic Review.

To determine characteristics of patients who develop compartment syndrome (CS) from IV infiltration requiring surgical intervention. A systematic review was conducted of available English literature from 1990 to date. Key terms were entered into a MEDLINE search in addition to searching grey literature and references of included manuscripts. Inclusion criteria were cases of CS requiring surgical intervention from IV infiltration. Exclusions were cases associated with phenytoin because of the unclear mechanism leading to injury (purple glove syndrome). Cases were reviewed for demographics, clinical information, and outcomes. Literature search resulted in 32 manuscripts meeting inclusion with 51 cases. Age ranged from 3 days to 81 years (19.6% age <1 year [10/51], 21.6% age 1-18 years [11/51], and 58.8% age >18 years [30/51]). IV sites were reported in 43 cases: hand 46.5%, forearm 46.5%, foot 4.7%, and leg 2.3% ([20/43], [20/43], [2/43], [1/43]). Of the 42 cases reporting patient mental status, 76.2% (32/42) had impaired mental state or limited communication including young age defined as younger than 3 years. Common associated agents were contrast 36.2%, IV fluid 34%, and mannitol 8.5% ([18/47], [16/47], [4/47]). One patient required hand amputation, 5 had persistent deficits, 36 had no long-term deficits, and 9 cases did not report patient outcomes. Compartment syndrome affects patients of all ages with a significant number of patients being pediatric and specifically younger than 1 year. Patients at highest risk of developing CS requiring surgery from IV infiltration are likely to have barriers to communication.

362 Managing Intravenous Infiltration Injuries in the Neonatal Intensive Care Unit

362 Managing Intravenous Infiltration Injuries in the Neonatal Intensive Care Unit

A Primer on the Acute Management of Intravenous Extravasation Injuries for the Plastic Surgeon.

Intravenous therapy is a common practice among many specialties. Intravenous therapy extravasation is a potential complication to such therapy. Hospitals without a dedicated wound care team trained in these interventions will often default to plastic surgical consultation, making an understanding of available interventions essential to the initial evaluation and management of these injuries. The goal of this article was to provide plastic surgeons and health care providers with a general overview of the acute management of intravenous infiltration and extravasation injuries. Though the decision for surgical versus nonsurgical management is often a clear one for plastic surgeons, local interventions, and therapies are often indicated and under-utilized in the immediate postinfiltration period. Thorough knowledge of these interventions should be a basic requirement in the armamentarium of plastic surgery consultants.

Toward Non-Invasive and Automatic Intravenous Infiltration Detection: Evaluation of Bioimpedance and Skin Strain in a Pig Model.

Intravenous (IV) therapy is prevalent in hospital settings, where fluids are typically delivered with an IV into a peripheral vein of the patient. IV infiltration is the inadvertent delivery of fluids into the extravascular space rather than into the vein (and requires urgent treatment to avoid scarring and severe tissue damage), for which medical staff currently needs to check patients periodically. In this paper, the performance of two non-invasive sensing modalities, electrical bioimpedance (EBI), and skin strain sensing, for the automatic detection of IV infiltration was investigated in an animal model. Infiltrations were physically simulated on the hind limb of anesthetized pigs, where the sensors for EBI and skin strain sensing were co-located. The obtained data were used to examine the ability to distinguish between infusion into the vein and an infiltration event using bioresistance and bioreactance (derived from EBI), as well as skin strain. Skin strain and bioresistance sensing could achieve detection rates greater than 0.9 for infiltration fluid volumes of 2 and 10 mL, respectively, for a given false positive, i.e., false alarm rate of 0.05. Furthermore, the fusion of multiple sensing modalities could achieve a detection rate of 0.97 with a false alarm rate of 0.096 for 5mL fluid volume of infiltration. EBI and skin strain sensing can enable non-invasive and real-time IV infiltration detection systems. Fusion of multiple sensing modalities can help to detect expanded range of leaking fluid volumes. The provided performance results and comparisons in this paper are an important step towards clinical translation of sensing technologies for detecting IV infiltration.

The Nursing Research of Frozen Fresh Potato Topical Treatment Infusion Leakage

Objective: Intravenous (IV) infusions are an essential part of hospital patient care, but Intravenous Infiltration in the process of the treatment. Leakage brought great pain to the patient; So far, no research has been done in this area. A simple and cheap method to relieve pain of IV infusions in this Study. Method: According to the accepted methods of treatment, all patients were divided into three groups randomly, Group A: Wash and dry the fresh potatoes. Group B:Apply the Hirudoid cream clockwise evenly and massage the puncture point within 5 to 8cm of the wound area. 20minutes three times a day. Group C: Saline flushes out and local cold. Patients in the three groups were treated with the same methods. Conclusion: Study shows 96.67% patient of Group A had recovered from symptoms, of redness and vein streaking dissipated, blood vessels returning to a normal condition. This study provides a method with frozen fresh potato chips in the treatment of symptoms of leakage.

A Development of Portable Early Detector of Intravenous Infiltration based on Optical Sensor

A Development of Portable Early Detector of Intravenous Infiltration based on Optical Sensor

Turkish Validity Reliability of the Pediatric Peripheral Intravenous Infiltration Scale and Its Adaptation to Newborns

Turkish Validity Reliability of the Pediatric Peripheral Intravenous Infiltration Scale and Its Adaptation to Newborns

Factors affecting Intravenous Infiltration among Hospitalized Children

Peripheral intravenous (PIV) insertion is one of the most common procedures undertaken for pediatric patients requiring short-term infusion therapy. Infiltration, which considered one of the most common complications of PIV insertion, may cause discomfort, pain, inconvenience or delay in treatment due to reinsertion of the IV catheter, or more serious negative consequences, such as tissue ulceration or necrosis. Such complications have not only increased the length of hospital stay and care costs for additional treatments, but also resulted in permanent damage and limitations of physical functions in pediatric patients. Nurses working at the children’ hospitals should consider the risk of IV infiltration for children receiving intravenous infusion therapy and make efforts to identify IV infiltration in high-risk children at an early stage to prevent damage. Therefore, this study aimed, firstly, to investigate the risk factors for intravenous infiltration among hospitalized children and, secondly, to develop clinical guidelines for nurses for early recognition, prevention and management of intravenous infiltration. A descriptive correlative research design was used. The study was conducted at pediatric inpatient medical and surgical wards of Children's University Hospital in Mansoura city, Egypt. The participants werehospitalized children (253) from less than one year to 16 years who received peripheral IV insertions.Interview questionnaire sheet was developed by the researcher to collect relevant data. The results indicated that the infiltration rate was 23.3% and it was from stage 1 and 2. Conclusion: the most important risk factors for infiltration were the child weight, previous experiences of insertion of peripheral catheter, dwell time, site of insertion, catheter size, repeated insertion on the same site, infusion of antibiotics and IV fluids. Recommendation:in future studies, it would be important to account for nurse-associated factors in the study design, including, educational status, experience of the nurses, the nurses' potential preference for a particular insertion site or method and catheter insertion skills.

Early Detection of Peripheral Intravenous Infiltration Using Segmental Bioelectrical Impedance: Preliminary Study

Early detection of infiltration is one of the most important tasks of nurses to minimize skin damage due to infiltration. For subjects receiving invasive intravenous treatment, the bioelectrical impedance (impedance) were measured in the frequency range of 5 to 500 kHz using bioelectrical impedance spectroscopy (BIS). After attaching electrodes at both ends of a transparent dressing mounted on the skin in which IV solution was infused into the vein, the change in impedance was measured as a function of time and frequency before and after infiltration. The experimental results are described as follows. When IV solution was properly infused into the vein, the impedance was nearly constant over time and decreased with increasing frequency. However, when infiltration occurred, the impedance decreased significantly and thereafter gradually decreased with time. In addition, impedance decreased with time for all applied frequencies. In this study, when IV solution penetrated into the surrounding skin and subcutaneous tissue by infiltration, impedance was quantitatively analyzed for as a function of time and frequency. This suggests a method for early detection of infiltration using BIS.

Early Detection of Intravenous Infiltration Using Multi-frequency Bioelectrical Impedance Parameters: Pilot Study

In this study, bioelectrical impedance analysis, which has been used to assess an alteration in intracellular fluid (ICF) of the body, was applied to detect intravenous infiltration. The experimental results are described as follows. Firstly, when infiltration occurred, the resistance gradually decreased with time and frequency i.e., the resistance decreased with increasing time, proportional to the amount of infiltrated intravenous (IV) solution. At each frequency, the resistance gradually decreased with time, indicating the IV solution (also blood) accumulated in the extracellular fluid (ECF) (including interstitial fluid). Secondly, the resistance ratio started to increase at infiltration, showing the highest value after 1.4 min of infiltration, and gradually decreased thereafter. Thirdly, the impedance (<TEX>$Z_C$</TEX>) of cell membrane decreased significantly (especially at 50 kHz) during infiltration and gradually decreased thereafter. Fourthly, Cole-Cole plot indicated that the positions of (R, <TEX>$X_C$</TEX>) shifted toward left owing to infiltration, reflecting the IV solution accumulated in the ECF. The resistance (<TEX>$R_0$</TEX>) at zero frequency decreased continuously over time, indicating that it is a vital impedance parameter capable of detecting early infiltration during IV infusion. Finally, the mechanism of the current flowing through the ECF, cell membrane, and ICF in the subcutaneous tissues was analyzed as a function of time before and after infiltration, using an equivalent circuit model of the human cell. In conclusion, it was confirmed that the infiltration could be detected early using these impedance parameters during the infusion of IV solution.

Early Detection of Intravenous Infiltration Using Multi-frequency Bioelectrical Impedance Measurement System: Pilot Study.

Early Detection of Intravenous Infiltration Using Multi-frequency Bioelectrical Impedance Measurement System: Pilot Study.

Compartment syndrome in infants and toddlers.

PurposeTo study the cause, diagnosis, treatment and outcome of acute compartment syndrome in infants and toddlers aged <3 years.MethodsFifteen patients aged <3 years with acute compartment syndrome were identified from two large pediatric trauma centers over a fifteen-year period. All children underwent fasciotomy. The mechanism of injury, time of injury, time to diagnosis, compartment pressures, time to fasciotomy, and outcome at the time of the latest follow-up were recorded.ResultsNine (60 %) of fifteen patients developed compartment syndrome secondary to trauma, four (4/15, 27 %) due to infection, and two (2/15, 13 %) due to intravenous infiltration. The average time from injury or hospital admission to fasciotomy was 31.8 h (range 2.9–136.3 h). In general, the functional outcome was excellent at the latest follow-up with thirteen (13/15, 87 %) patients having an excellent outcome. No cases of Volkmann’s ischemia were noted at the time of fasciotomy, even when performed as late as 5 days after injury.ConclusionsCompared to the general pediatric population, the diagnosis of compartment syndrome in infants and toddlers may be further delayed, i.e., >24 h after injury. Despite delays in diagnosis and time to treatment, the present study shows that outcomes in infants and toddlers remain favorable even when fasciotomy is performed 48–72 h after injury.Level of evidenceCase series, level IV.

Intravenous Infiltration Risk by Catheter Dwell Time Among Hospitalized Children

PurposeThis study was aimed to examine the cumulative risk for infiltration over IV catheter dwell time by general or catheterization-specific characteristics of pediatric patients with IV therapy. Design and methodsThis secondary data analysis was done with the data of 1596 children who received peripheral IV therapy at least once during their hospital stay between August 1st and October 30th, 2011 and in June, 2013 in an academic medical center, Yangsan, Republic of Korea. The survival functions of infiltration were determined by using the Kaplan–Meier analysis. ResultThe cumulative risk for infiltration had rapidly increased from 1.5% after 24 hours of catheter dwell time to 17.3% after 96 hours. The survival functions were significantly different in the medical than in the surgical department (p=.005), lower extremities than upper ones (p=.001), and use of 10% dextrose (p=.001), ampicillin/sulbactam (p<.001), vancomycin (p=.024), high-concentration electrolytes (p=.001), and phenytoin (p<.001). ConclusionWhen catheter dwell times are similar, the cumulative risk for infiltration was higher in cases wherein the patient had a risk factor. The cumulative risk for infiltration has rapidly increased after 24 hours in patients who have 10% dextrose, high-concentration electrolytes, and phenytoin. Practice implicationsThe results suggest that nurses are required to assess the IV site every hour after 24 hours of catheter dwell time for the infusion of irritants for a safer practice of IV therapy. However, this monitoring time may be modified by the age of child, previous IV complications, and/or hemodynamic issues which may impact IV integrity.

Non-invasive, multi-modal sensing of skin stretch and bioimpedance for detecting infiltration during intravenous therapy.

Intravenous infiltration is a condition wherein an infused solution leaks inadvertently into soft tissue surrounding a hypodermic needle site. This occurrence affects approximately 6.5% of patients in hospitals worldwide, and can lead to severe tissue damage if not treated immediately. The methods currently used by medical staff to detect an infiltration are subjective and can potentially be prone to error. Infiltration is an even larger concern in pediatric patients, who have smaller veins than adults and have more difficulty in communicating pain or other discomfort associated with the infiltration with medical staff. For these reasons, automatic IV infiltration detection could potentially reduce the risk associated with this damaging condition. This paper proposes a novel proof-of-concept system that uses non-invasive sensing in conjunction with a low-power embedded computing platform to deliver continuous infiltration monitoring around the IV catheter site. This kind of system could be able to detect an infiltration by non-invasively monitoring for known symptoms: swelling of soft tissue and increased skin firmness; these symptoms can be sensed by measuring skin stretch and local bioimpedance. Moreover, the low-power design and wireless capabilities can potentially enable continuous wear. The proposed automatic IV infiltration detection system could significantly improve the number of infiltrations identified and treated on time.

The Effect of Intravenous Fentanyl and Bupivacaine Infiltration on the Hemodynamic Respons During Mayfield Skull Clamps Fixation in Neurosurgery

The Effect of Intravenous Fentanyl and Bupivacaine Infiltration on the Hemodynamic Respons During Mayfield Skull Clamps Fixation in Neurosurgery