infiltration

Even nonmedical people may have heard of the word 'infiltration' used in terms of military-speak. You know, like when the good guys infiltrate enemy lines. They weasel in --- sneak one past the goalie, if you will.

The Hater says that infiltration is the intent to decieve and trick to gain status or information. For example, if he was a spy and my Dad was an ambassador to a fancy foreign country, then he would have successfully infiltrated my family. He dreams of ruling the world.

But I don't want to talk about that kind of infiltration. I was thinking more on the lines of IV infiltration. This is where the IV catheter slides out of the vein and IV fluid is then infused into the tissues instead of the vein.

This could be really really bad if an IV infiltrates and a strong chemotherapy is being infused.

But it's not always a really really bad thing. Sometimes it just swells up the tissue around the IV site and causes some general discomfort.

That's what happened to one of my patients today.

He was okay and wasn't getting a vessicant, but what I don't understand is how he could notice that the IV was burning and felt different from any other time he'd gotten this medicine -- oh, and his arm was swelling up. And it had bothered him for thirty minutes before he said anything.

So let's all learn a lesson here. If the IV's been running and all the sudden you notice that it feels different, or if the tissue around your arm (or your port site) is swelling up like a water balloon, please let someone know.

This public service announcement was brought to you by the letters Y and M and the number 12.

*****

Special notes to the random student nurses who happen upon this site:

1. The first thing you do if you suspect IV infiltration is turn off the infusion. I know, sounds easy, but if you get caught-up in the moment you might forget.

2. Next, check to make sure that whatever was infusing is not a vessicant. In other words, make sure that you're not giving someone something really hard core potent, else you might have an extravasation on your hands. Don't look at the following link if you're squeamish. This is a bad extravasation, a picture I googled to find.

3. For a regular, run of the mill infiltration (yet another googled picture), restart the IV somewhere else, preferably on the opposite site. For example, if something has infiltrated into the left hand or forearm, try to start another one on the right side.

4. Elevate the affected site, and apply moist heat, unless otherwise indicated by the type of drug infused.

5. When all else fails, call the pharmacist on call. If they don't know it by heart, they can look it up faster than you can. A good pharmacist is a nurse's best friend.

6. You don't have to use half a roll of tape to secure an IV, but it's obviously got to be secured. If possible, try to start them in places other than the hands or close to the wrists; these are places that are at higher risk just because people move around, eat, read, etc.

7. Disclaimer: This was random off of the top of my head and is not meant to be a line-by-line for medical advice. If you would like more information about starting IVs, post a comment and I'll help you research some good sites.