IV Infiltration Injuries in Infants

An IV infiltration or extravasation injury to an infant or child while hospitalized can be devastating. You trust every precaution will be taken to ensure your child's safety when you place your child in the care of medical professionals.

When it comes to IV therapy, hospitals and medical professionals have a duty to follow certain standards of care to protect patients, especially infants, from IV infiltration and extravasation injuries. These standards of care include:

•  Following proper procedures for IV placement and insertion
•  Routine and frequent monitoring and assessment of IV site
•  Applying transparent dressing over IV site
•  Properly securing the IV catheter to extremity
•  Diligence in checking the IV site for coolness, swelling, or color changes.
•  Ensuring proper function (infusion or flow) of IV fluids
•  Checking for signs of infiltration

The following are terms and definitions that may help you better understand the types of injuries associated with IV infiltration:

IV Infiltration

When an IV slips out of the vein and the fluid escapes into the surrounding tissue. This may cause injuries from a small amount of edema (swelling) in the affected area or severe, causing tissue death.

Extravasation

Occurs at the IV site and surrounding tissue when there are actual changes in appearance or temperature. There may be edema along with blanching, coolness, blistering, discoloration and tightness to the area. The severity depends on the type of fluids and/or medications that have infiltrated the area as well as the length of time before the infiltration was discovered.

Compartment Syndrome

When the compartments around the affected site become filled with fluid restricting the muscles, nerves, and vessels within the compartments. This can result in severe pain and tissue death.
Fasciotomy
Surgical Procedure done to relieve tension or pressure as a result of compartment syndrome and treat the resulting loss of circulation to the area of tissue or muscle.

IV infiltration and extravasation injuries to children can be more severe and harder to detect than injuries to adults. Children cannot express pain or irritation the same as an adult. Often they cry because the IV hurts but the medical staff attributes their crying to something else and fails to check the IV site. As a result, IV infiltration or extravasation can go undetected for a longer period of time. If timely assessment of the IV site is not performed, harmful fluids and medications infiltrate into the tissues surrounding the IV site rather than the bloodstream. The longer the infiltration goes undetected, the worse the injury becomes.

Without medical training or experience, it is difficult to assess the care surrounding an IV infiltration injury and determine if a breach of the standard of care occurred. A review of the medical documentation must be done by someone trained to evaluate the medical evidence. This is usually done after you have consulted with an attorney. A legal nurse consultant will usually review the records to determine whether you have a cause of action against a negligent doctor, nurse, or hospital. The attorney will then advise you of your rights and provide straightforward information about how to proceed.

If you have any questions regarding IV infiltration, you may contact us at mcook@cook-legalnursing.com or call us at 1-877-347-6557.