Treatment for Blood Infiltration in a Peripheral IV Catheter
Remove the peripheral IV catheter immediately when blood infiltration is identified. 1
Immediate Management
The catheter must be removed as soon as infiltration is recognized to prevent further tissue damage and complications. 1 The CDC guidelines emphasize that any peripheral venous catheter showing signs of infiltration should be promptly discontinued. 2
Initial Steps After Removal
- Clean the affected area with an appropriate antiseptic solution, preferably 2% chlorhexidine-based preparation or 70% alcohol. 1
- Submit any exudate from the insertion site for Gram staining and culture, particularly in immunocompromised patients. 1
- Assess the extent of tissue damage to determine severity of the infiltration. 1
Wound Care and Monitoring
Dressing Selection
- Apply sterile gauze dressing if the site is bleeding, oozing, or weeping. 2, 1
- Use transparent semi-permeable dressing for dry sites to allow visual monitoring. 1
- Do not apply topical antimicrobial ointments to the insertion site. 2, 3
Ongoing Assessment
- Monitor the site daily for signs of improvement or deterioration. 1
- Do not submerge the affected area in water until complete healing occurs. 2, 1
- Change dressings regularly and inspect for worsening signs. 3
Prevention of Recurrence
Catheter Selection and Placement
- Select upper extremity sites rather than lower extremity sites for catheter insertion in adults. 1
- Avoid placing new catheters in the same area where infiltration occurred. 1
- Replace peripheral venous catheters at least every 72-96 hours in adults to prevent complications. 2, 1
Key Risk Factors to Consider
Infiltration is the most common reason for peripheral IV catheter failure, occurring in 13.7-55.4% of cases depending on the setting. 4, 5 Risk factors include:
- Age over 50 years and female gender are associated with higher complication rates. 6
- Duration of catheterization longer than 24 hours increases infiltration risk. 4
- Emergency department-inserted catheters have significantly higher infiltration rates (25.2%). 5
Critical Pitfalls to Avoid
- Do not delay catheter removal when infiltration is suspected—waiting increases tissue damage risk. 1
- Do not attempt to continue using a catheter showing signs of infiltration. 7
- Do not routinely apply prophylactic antimicrobial ointments as they may promote fungal infections and antimicrobial resistance. 2