From the Guidelines
Phlebitis from IV treatment should be managed by removing the IV catheter if it's the source of inflammation and placing a new one at a different site if continued IV access is needed, as recommended by the guidelines for the prevention of intravascular catheter-related infections 1. The management of phlebitis from IV treatment involves several interventions.
- Remove the IV catheter if it's the source of inflammation and place a new one at a different site if continued IV access is needed.
- Apply warm compresses to the affected area for 20 minutes every 2-4 hours to reduce inflammation and pain.
- Over-the-counter pain relievers like ibuprofen (400-600mg every 6-8 hours) or acetaminophen (500-1000mg every 6 hours) can help manage discomfort.
- Elevate the affected limb when possible to reduce swelling.
- For more severe cases, topical anti-inflammatory medications like diclofenac gel applied 3-4 times daily may be beneficial. Prevention is key - IV sites should be rotated every 72-96 hours, proper aseptic technique should be used during insertion, and the site should be monitored regularly for signs of inflammation, as suggested by the guidelines for the diagnosis and management of intravascular catheter-related infection 1. Phlebitis occurs because the vein wall becomes irritated from the catheter, infused medications, or bacterial contamination, triggering an inflammatory response that causes the characteristic redness, warmth, pain, and swelling along the vein. The use of midline catheters or peripherally inserted central catheters (PICCs) can help reduce the risk of phlebitis when the duration of IV therapy will likely exceed six days, as recommended by the guidelines for the prevention of intravascular catheter-related infections 1. Regular evaluation of the catheter insertion site is crucial to detect signs of phlebitis, such as warmth, tenderness, erythema, or palpable venous cord, and to remove the catheter if necessary, as suggested by the guidelines for the prevention of intravascular catheter-related infections 1.
From the FDA Drug Label
Thrombophlebitis may occur, the frequency and severity of which can be minimized by administering the drug slowly as a dilute solution (2. 5 to 5 g/L) and by rotation of venous access sites. Phlebitis Inflammation at the injection site has been reported
Phlebitis from IV treatment can occur with vancomycin administration. To minimize the risk, the drug should be administered slowly as a dilute solution and by rotation of venous access sites 2. Inflammation at the injection site has also been reported 2.
From the Research
Causes and Risk Factors of Phlebitis
- Phlebitis is a common complication in patients undergoing IV treatment, and can be caused by mechanical, chemical, or infectious factors 3.
- The use of certain antibiotics, such as dicloxacillin and erythromycin, has been shown to increase the risk of phlebitis 4.
- Other risk factors for phlebitis include the site of insertion, age, and medication with warfarin or low molecular weight heparin 4.
Prevention of Phlebitis
- Good practice when inserting a cannula, including appropriate choice of device and site, can help to prevent phlebitis 3.
- Good infection control techniques, such as the use of >0.5% chlorhexidine preparation with 70% alcohol or 2% aqueous chlorhexidine, are also vital in preventing the condition 5.
- Regular monitoring of the catheter site and removal of any catheter that is not essential can also help to prevent phlebitis 5.
Treatment of Phlebitis
- The use of warm moist compresses has been shown to be effective in reducing the degree of phlebitis 6, 7.
- A warm water compress can be a valuable and inexpensive treatment for phlebitis, and can decrease the degree of phlebitis effectively 7.
- Nursing interventions, such as vigilance and caring, and the use of medical treatment protocols, can also be effective in treating phlebitis 5.