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Dangers of Infant IV Infiltration Injuries

Steve Wagner

The March of Dimes mentions that in 2006, there were 19,000 infants who died within their first month of life. Among the causes of death are premature birth, birth defects, asphyxia, complications during pregnancy and birth, as well as infections.

Infections from infant intravenous (IV) therapy can be the result of an IV infiltration or extravasation injury. An article in The Art and Science of Infusion Nursing recently reported that “up to 78% of IVs are estimated to become infiltrations, and extravasations occur in an estimated 11% of all NICU patients, mostly in infants.” IV injuries in babies can be difficult to detect as quickly since children cannot express their discomfort as easily as an adult, and a baby’s crying can be attributed to another factor.

When an IV infiltrates, it comes out of the baby’s vein and the IV fluid then leaks into the tissue which can cause swelling (edema) or, in severe cases, death of surrounding tissue. The Infusion Nurses Society uses a scale to determine the severity of infiltration injuries, including

  1. Skin blanched with edema less than 1 inch, cool to touch, with or without pain.
  2. Skin blanched with edema 1-6 inches, cool to touch, with or without pain.
  3. Skin blanched, translucent, gross edema greater than 6 inches, cool to touch, mild to moderate pain, possible numbness.
  4. Skin blanched, translucent, skin tight, leaking; skin discolored, bruised, swollen; gross edema greater than 6 inches; deep pitting tissue edema; circulatory impairment; moderate to severe pain; infiltration of any amount of blood product, irritant or vesicant.

An IV extravasation injury occurs when the infiltration involves blood or a vesicant medication, such as dopamine, caffeine or chemotherapy drugs. Because of the nature of these fluids, blisters, compartment syndrome and chemical burns can occurs in the tissue where the extravasation occurs. Our firm was recently retained by the mother of a week old boy that sustained terrible injuries and needs multiple skin grafting procedures because the hospital nursing staff did not follow proper protocols to check the IV site at least hourly.

IV infiltration and extravasation injuries can lead to scars, amputation, complex regional pain syndrome, and loss of function. These injuries could be prevented with appropriate nursing care and selection of catheters and IV sites. Timely treatment of an infiltration can also lower the severity of the injury.

Because of the complex nature of IV injuries, it is important to have an experienced medical malpractice lawyer on your side. The medical negligence and birth injury attorneys at Wagner Reese have proven results in infant injury and wrongful death cases. Contact us today for a free consultation!


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