What Are the Dangers of Infant IV Infiltration Injuries?

Originally published Aug 19, 2013; Updated Jan 28, 2021

IV infiltrations and extravasations can occur when medical providers fail to properly place IV access and oversee IV therapy during the administration of medications and IV fluid. When an IV catheter is improperly inserted or becomes dislodged, the fluid can leak into the surrounding tissue at the IV insertion site, causing swelling, pain around the IV site, and tissue damage. Early detection of infiltration and extravasation is crucial, as it can prevent severe side effects and treatment complications.

Common infiltrations and extravasations causes include poor peripheral IV therapy techniques, improper monitoring, or failure to detect signs of leakage. Recognizing extravasations causes signs—such as redness, firmness, or swelling—can help healthcare providers take immediate action to minimize damage. Infants and elderly patients are particularly vulnerable due to their delicate veins and increased sensitivity around the IV site.

An early infiltration detection solution can help identify issues before they cause significant harm. Proper placement of the IV at the IV insertion point and regular assessment of the IV site can prevent fluid from entering unintended areas. With appropriate care and close monitoring, the risks associated with infiltrations and extravasations can be significantly reduced, ensuring safer and more effective treatment for all patients.

How Common are Infant IV Injuries?

An article in The International Journal of Clinical and Experimental Medicine reported in 2015 that up to 78% of IVs are estimated to become infiltrations, and extravasations occur in an estimated 11% of all NICU patients. IV injuries in babies can be difficult to detect as quickly since children cannot express their discomfort as easily as an adult can, and a baby’s crying may be attributed to another factor.

How Do IV Infiltrations Happen?

An IV infiltration occurs when fluid infuses into soft tissues that surround the IV access site. IV extravasation injury occurs when the infiltration involves a vesicant medication, which can cause blisters, tissue necrosis, compartment syndrome, and chemical burns. Examples of vesicant drugs include dopamine, calcium chloride, potassium chloride, caffeine, and chemotherapy drugs. Extra care should be taken when infusing vesicant medications for infants and young children.

As one example, our firm assisted the mother of a one-week-old boy who sustained terrible injuries and needed multiple skin grafting procedures because the hospital nursing staff did not follow proper protocols to check the IV site at least hourly.

How Do Healthcare Workers Know When an IV Infiltration Has Occurred?

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:

• Grade 0: No symptoms
• Grade 1: Skin blanched with edema less than 1 inch, cool to touch, with or without pain.
• Grade 2: Skin blanched with edema 1-6 inches, cool to touch, with or without pain.
• Grade 3: Skin blanched, translucent, gross edema greater than 6 inches, cool to touch, mild to moderate pain, possible numbness.
• Grade 4: Skin blanched, translucent, skin tightness, 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.

What Are the Consequences of an IV Infiltration?

IV infiltration and extravasation injuries can lead to scars, amputation, complex regional pain syndrome, and loss of function. Appropriate nursing care and selection of catheters and IV sites can help prevent these injuries from occurring. Timely treatment of infiltration can also reduce the severity of the injury.

Understanding the Dangers of Infant IV Infiltration Injuries

When IV infiltrations and extravasations occur, the consequences can be devastating for infants due to their delicate veins and soft tissue. IV infiltration happens when iv fluid or medications via a peripheral IV leak into the surrounding tissue instead of staying within the vein, causing swelling, pain around the IV site, and potential tissue damage. In more severe cases, extravasations occur when fluid such as chemotherapy drugs or potassium 60 meq/l leaks into the affected limb, leading to tissue necrosis, nerve damage, and loss of function.

Extravasations cause signs include inflammation, tightness of the skin, and skin discoloration near the IV insertion site. If left untreated, complications like compartment syndrome can arise, sometimes requiring emergency surgery. Infiltrations and extravasations causes can range from improper IV catheter placement to failure to monitor the IV site closely. It’s critical to have an early infiltration detection solution in place to catch these issues before they lead to severe complications.

When fluid or medication leaks into the tissue, healthcare providers must immediately stop the infusion, remove the IV, and take steps to reduce swelling and prevent infection in the affected area. Signs of infection, such as redness, heat, and oozing, may develop and require additional medical treatment.

With approximately 50% of IVs failing due to complications, it’s vital for medical professionals to follow best practices for intravenous IV therapy and to address complications as soon as possible. If your child has experienced harm from peripheral IV therapy, including IV infiltration or extravasation, you may be entitled to compensation. Contact Wagner Reese today to learn more about your legal rights and how we can help you pursue justice for your child’s injuries.

Parents Whose Children Were Harmed by IV Infiltration Deserve Compensation

For new parents, watching their child suffering or in pain is heartbreaking. Unfortunately, many children are severely injured by measures designed to relieve their suffering, including IV therapy. Placing IVs is a common practice for older children and adults who need medical treatments and surgeries, but it can be extremely risky in infants when performed incorrectly, resulting in serious consequences.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 achieved years of proven results in infant injury and birth trauma cases. Contact us today for a free consultation!