IV Infiltration vs. Extravasation: Key Differences for Nurses

Understanding IV Infiltration

• 💡 Infiltration occurs when IV fluid leaks out of the blood vessel and into the surrounding tissues.
• 🎯 The substance leaking in infiltration is typically a nonvesicant fluid, such as normal saline or D5W.
• 📌 Signs of infiltration include swelling, coolness to the touch, paleness, and patient complaints of tightness, discomfort, or pain.
• 🏥 Treatment involves stopping the infusion, removing the IV, elevating the limb, and applying warm or cold compresses as per facility policy.

Defining IV Extravasation

• ⚡ Extravasation is essentially an infiltration, but involves a vesicant medication that can cause tissue damage.
• ⚠️ Examples of vesicant medications include certain antibiotics (like vancomycin), chemotherapy drugs, and vasopressors (like norepinephrine).
• 🚨 Signs can be similar to infiltration but may be more severe, including blistering, necrosis, and significant tissue injury, with higher pain levels.

Differentiating Treatment and Prevention

• 🛠️ For extravasation, after stopping the infusion, the IV catheter is often left in place to potentially administer an antidote.
• 🔬 Following pharmacy recommendations for treatment, such as using nitroglycerin paste for vasodilation in norepinephrine extravasation, is crucial.
• 🔍 Always notify the physician and follow facility policies for extravasation management.
• ✅ Vigilant IV site assessments are critical to catch these issues early, especially when infusing vesicant medications.
• ⚠️ Never ignore patient complaints of pain at the IV site, as this can be an early indicator of infiltration or extravasation.