5 Infiltration and Extravasation
Learn how to distinguish infiltration from extravasation, recognize possible signs, respond safely, and reduce risk through monitoring and prompt reporting.
Distinguish the complications
involves leakage of a IV solution or medication into surrounding tissue. involves leakage of a , a substance capable of causing tissue damage, into surrounding tissue. Some facilities use these terms differently, so identify the infusing agent and follow local policy.
The potential harm depends on the substance, the amount that enters the tissue, the location, and the duration of exposure.
Recognize possible signs
Possible findings include swelling, discomfort or pain, burning or unusual tightness, coolness or blanching, redness, leakage at the site, and a slowed or stopped infusion. Blistering or skin discoloration can also be warning signs. Findings vary by agent and may initially be subtle.
A pump alarm is not required for an event to occur. Neither an alarm nor the absence of an alarm establishes that an IV site is safe.
Respond to a suspected event
If or is suspected, stop the infusion, assess the affected area, and follow the medication-specific and facility protocol. Do not flush the line, because flushing can force more medication into the tissue. Notify the appropriate clinician promptly.
After a suspected , protocols commonly call for attempting aspiration through the catheter before it is removed. The catheter may be left in place briefly for aspiration and, if indicated, delivery of a medication-specific antidote. Follow the agent-specific protocol rather than assuming that every event requires the same catheter management or antidote.
Match care to the infusing agent
For ordinary of a fluid, stop the infusion and assess the affected area. Follow facility policy for catheter removal, limb elevation, and compresses. These actions depend on the fluid, severity, and local policy; do not restart the infusion through the affected site.
For , use the agent-specific protocol for aspiration, antidote, catheter management, compresses, escalation, and follow-up. Do not apply heat or cold without checking the solution and protocol.
Escalate and document
Increasing pain, tense swelling, numbness, or reduced movement after an may indicate serious tissue injury or neurovascular compromise. Escalate urgently for clinical assessment rather than delaying evaluation.
Document and communicate the medication involved and the approximate amount, if known; the event time; symptoms and site findings; actions taken; notifications; and the patient’s response. Continue follow-up assessments as directed.
Reduce risk and detect changes early
Secure the catheter and dressing, and choose a site that can be observed and assessed. Check the site during infusion and ask about discomfort, especially when high-risk medications are being infused.
Teach the patient to report pain, burning, swelling, or tightness promptly. Pump monitoring alone is insufficient; direct site assessment and patient-reported symptoms support early recognition.