Complications of Peripheral Intravenous Cannulation

Peripheral Intravenous Cannulation (PIVC) is a common medical procedure used to deliver fluids, medications, or blood products directly into a patient’s vein. While it is a relatively simple procedure that healthcare professionals perform regularly, there are potential complications that can arise. This article will explore some of the common complications associated with PIVC and discuss their prevention and management.

1. Infiltration

Infiltration occurs when the infused fluid leaks into the surrounding tissue instead of entering the vein. This can lead to tissue damage, swelling, and pain. Early signs include coolness, blanching, and edema around the insertion site. To prevent infiltration, proper cannula insertion technique and close monitoring of the insertion site are crucial. If infiltration occurs, removing the cannula, applying a warm compress, and elevating the limb can help reduce swelling.

2. Phlebitis

Phlebitis is the inflammation of the vein, often caused by mechanical irritation, chemical irritants, or infection. Symptoms include redness, warmth, pain, and swelling along the course of the vein. To prevent phlebitis, healthcare professionals should use aseptic technique during insertion, rotate cannula sites, and consider using a smaller gauge cannula. If phlebitis occurs, warm compresses, elevation, and anti-inflammatory medications may be recommended.

3. Thrombophlebitis

Thrombophlebitis is the inflammation of a vein with associated blood clot formation. It can occur due to prolonged cannulation, irritating infusates, or patient-specific factors such as immobility or underlying clotting disorders. Symptoms include pain, redness, and a palpable cord-like structure along the vein. To minimize the risk of thrombophlebitis, frequent assessment of the cannula site, proper securement, and timely removal when no longer necessary are essential.

4. Hematoma

A hematoma is a localized collection of blood outside the blood vessels, usually resulting from puncture of the vein during cannulation. It can cause pain, swelling, and bruising. Applying firm pressure to the site after catheter removal can help prevent hematoma formation. If a hematoma occurs, applying ice packs intermittently and elevating the limb can assist in reducing swelling.

5. Nerve Damage

Nerve damage can occur if the cannula is inadvertently inserted too deep or if the nerve is directly punctured during the procedure. This can result in pain, tingling, numbness, or motor function impairment. To prevent nerve damage, healthcare professionals should have a good understanding of anatomy, use proper insertion techniques, and apply gentle pressure during cannulation. If nerve damage is suspected, prompt removal of the cannula and close monitoring is necessary.

6. Catheter-Related Infections

Catheter-related infections can occur if the insertion site is not adequately cleaned or if proper aseptic technique is not followed during cannulation. Signs of infection include redness, swelling, pain, and pus at the insertion site, as well as fever and chills. To prevent infections, healthcare professionals should adhere to strict hand hygiene practices, use sterile equipment, and follow aseptic techniques during the entire procedure. Prompt removal of the cannula is essential if an infection is suspected.

These are just a few of the potential complications associated with peripheral intravenous cannulation. It is vital for healthcare professionals to be aware of these complications, practice proper techniques, and closely monitor patients during and after the procedure. By doing so, the risk of complications can be minimized, and the overall safety and effectiveness of peripheral intravenous cannulation can be improved.

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