Originally published Aug 19, 2013; Updated Jan 28, 2021
IV infiltration or extravasation injuries can occur when medical providers fail to properly place IV access and fail to properly oversee IV administration of medications and other IV solutions. The fluid from the IV can leak into surrounding soft tissue, causing pain around the IV site and tissue damage. Unfortunately, these types of injuries are all too common. People of any age can suffer from an IV infiltration or extravasation injury, but infants are one of the most vulnerable populations to this type of injury.
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.
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!