From the Guidelines
Thrombophlebitis caused by cannula management should be prevented by using aseptic technique during catheter placement and care, choosing the smallest gauge possible, and using polyurethane or silicone catheters, as these measures can significantly reduce the risk of thrombophlebitis 1. To manage thrombophlebitis, it is essential to remove the cannula immediately and apply warm compresses to the affected area.
- Elevate the affected limb when possible to reduce swelling and pain.
- For pain management, oral non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or acetaminophen can be used.
- Topical anti-inflammatory gels such as diclofenac gel may also help. The prevention of peripheral vein thrombophlebitis is based on several interventions, including
- aseptic technique during catheter placement and catheter care
- choice of the smallest gauge possible
- use of polyurethane (PUR) and silicone catheters rather than Teflon cannulas
- appropriate osmolarity of the solution
- use of lipid-based solutions
- pH higher than 5 and lower than 9
- adequate fixation of the catheter 1. Volume load and osmolarity appear to have equal relevance in determining phlebitis, with the osmolarity rate correlating well with the phlebitis rate 1. If symptoms worsen or show signs of infection, medical evaluation is necessary as antibiotics or further treatment may be required 1.
From the Research
Causes and Risk Factors
- Thrombophlebitis caused by cannula management can be attributed to mechanical, chemical, or infectious causes, as stated in the study 2.
- The use of peripheral venous catheters can lead to inflammation of the vein at the cannula access site, resulting in phlebitis 2.
- The choice of device and site for cannula insertion can significantly impact the risk of developing phlebitis, with the cubital fossa region being more prone to severe phlebitis 3.
Prevention and Management
- Good practice when inserting a cannula, including appropriate choice of device and site, can help prevent phlebitis 2.
- The use of phlebitis scoring systems can aid in identifying and treating early signs of peripheral venous cannulation 2.
- Evidence-based clinical guidelines can significantly improve the care and handling of peripheral intravenous cannulae, reducing the frequency of thrombophlebitis 4.
- Anticoagulation therapy may not be necessary in most cases of upper extremity superficial vein thrombophlebitis (UESVT) 5.
Treatment Options
- Conservative treatment may be sufficient for mild cases of phlebitis, while surgical intervention may be necessary for more severe cases 3.
- The Baxter scale can be used to grade the severity of phlebitis and guide treatment decisions 3.
- Anticoagulation therapy, such as direct oral anticoagulants or vitamin K antagonists, may be recommended for preventing and treating venous thromboembolism 6.