An intravenous (IV) line is so common in hospitals, emergency rooms, surgery centers, and infusion facilities that patients may assume some pain or discomfort is simply part of the process. But significant pain, burning, swelling, tightness, leaking, numbness, or other unusual sensations around an IV site should not simply be ignored.
When an IV “feels wrong,” speaking up promptly can be important. An IV that has moved out of the vein may allow fluid or medication to enter the surrounding tissue instead of the bloodstream. This is generally known as IV infiltration. When certain medications or solutions leak into the tissue and have the potential to cause significant injury, the event may be referred to as extravasation.
Although many IV complications resolve without permanent injury, serious infiltration or extravasation can potentially cause tissue damage, nerve injury, scarring, infection, compartment syndrome, or—in severe cases—surgery or other significant medical consequences.
Florida patients should know how to advocate for themselves when something does not feel right.
Trust What You Are Feeling
You do not need medical training to know that something has changed.
If an IV was initially comfortable but suddenly begins to hurt, burn, sting, swell, or feel unusually tight, tell a nurse or other healthcare provider immediately. Do not assume that because the IV was inserted by a medical professional, everything must be functioning properly.
The patient is often the first person to recognize that something has changed.
Possible warning signs of an IV infiltration or extravasation may include:
- Pain or tenderness around the IV site;
- Burning or stinging;
- Swelling or puffiness;
- Tight or stretched skin;
- Redness or discoloration;
- Blanching or unusually pale skin;
- Coolness or warmth around the IV site;
- Fluid leaking near the IV;
- Numbness or tingling;
- Increasing pressure in the arm, hand, leg, or other affected area;
- Difficulty moving the affected extremity; or
- Blistering or other changes to the skin.
Not every one of these symptoms means medical malpractice has occurred. They do, however, provide a reason to alert the healthcare team and request an evaluation.
Be Specific When Telling the Nurse What You Feel
Instead of simply saying, “My IV is bothering me,” describe exactly what you are experiencing.
For example:
“The area around my IV is burning, and my hand is starting to swell. Can you please check whether the IV is still in the vein?”
Specific information can help healthcare providers understand the nature and urgency of the complaint.
Tell the nurse when the symptoms started, whether they are getting worse, where the discomfort is located, and whether you notice swelling, leaking, discoloration, numbness, or difficulty moving the extremity.
Ask That the IV Be Checked Before More Medication Is Given
If you believe something is wrong with an IV, you can ask the healthcare provider to evaluate the IV before additional medication or fluid is administered through it.
This can be particularly important when the IV is being used to administer medications or solutions capable of causing significant tissue injury if they escape from the vein.
A patient might say:
“Before anything else goes through this IV, would you please check the site? It is painful and swollen.”
The purpose is not to diagnose the problem yourself. It is to make sure your concerns are communicated clearly enough that they can be appropriately evaluated.
Do Not Be Afraid to Repeat Your Concern
Sometimes a patient reports IV discomfort and is reassured that the IV is fine. If the pain, burning, swelling, or other symptoms continue or worsen, speak up again.
A prior evaluation does not mean a complication cannot subsequently develop or progress.
Tell the healthcare provider that the symptoms have continued or changed. For example:
“I know the IV was checked earlier, but the swelling has increased and the pain is getting worse. I would like it evaluated again.”
Persistent or worsening symptoms deserve attention.
Ask for Another Nurse or Supervisor When Necessary
If you believe your concern is not being adequately addressed, you can request additional assistance.
Depending upon the healthcare facility, this might mean asking for:
- The charge nurse;
- A nurse supervisor;
- The treating physician;
- An advanced practice provider;
- The IV or vascular access team; or
- Another appropriate healthcare professional.
Patients sometimes hesitate because they do not want to appear difficult or demanding. Your priority should be communicating a legitimate concern about your medical care clearly and respectfully.
Ask What Medication or Fluid Is Going Through the IV
If an IV complication occurs, knowing what was being infused may become extremely important.
Ask the healthcare provider what medication or solution is being administered and why you are receiving it. If you experience an infiltration or suspected extravasation, you can also ask what medication was infusing when the problem occurred.
Different medications can have dramatically different effects when they enter surrounding tissue. The identity and concentration of the substance, amount potentially infiltrated, location of the IV, duration of exposure, and patient's response can all affect the seriousness of an injury.
Ask What Is Being Done After an Infiltration Is Discovered
Discovering an infiltration or extravasation may only be the beginning of the medical response.
Depending upon the circumstances, appropriate management may involve stopping the infusion, assessing the affected area, determining what medication was involved, following facility protocols, notifying the appropriate provider, monitoring the extremity, administering appropriate treatment, and obtaining consultations when indicated.
A patient can reasonably ask:
- What happened to the IV?
- What medication or fluid infiltrated?
- Approximately how much may have entered the tissue?
- What treatment is being provided?
- What symptoms should I watch for?
- Will someone reassess the area?
- Do I need a specialist consultation?
- What should I do if the symptoms worsen after discharge?
The appropriate treatment will depend on the particular medication, injury, and patient's clinical circumstances.
Pay Attention to Symptoms After the IV Is Removed
Removal of the IV does not necessarily mean the problem is over.
Some tissue injuries may evolve over time. Continue to pay attention to the affected area after the IV has been discontinued.
Seek appropriate medical attention if you develop significant or worsening symptoms such as increasing pain, swelling, blistering, discoloration, weakness, numbness, decreased movement, skin breakdown, or other concerning changes.
Follow the discharge instructions provided by your healthcare team, and seek urgent medical care when symptoms are severe or rapidly worsening.
Take Photographs of Visible Changes
If you develop visible swelling, bruising, blistering, discoloration, wounds, or other changes, photographs can help document how the affected area changes over time.
Consider taking clear photographs at reasonable intervals, particularly if the appearance is changing.
Photographs can potentially assist subsequent healthcare providers in understanding the progression of the injury. They may also become relevant if there is later a question about whether negligent medical care contributed to a serious injury.
Do not delay medical treatment in order to take photographs.
Keep Track of What Happened
After a significant IV complication, write down what you remember while the events are still fresh.
Useful information may include:
- When the IV was inserted;
- Where the IV was located;
- When pain, burning, or swelling began;
- What symptoms you reported;
- Who you notified;
- What you were told;
- Whether the infusion continued after you complained;
- What medication or fluid was being administered;
- When the IV was eventually stopped or removed;
- How the affected area changed afterward; and
- What additional medical treatment you required.
Medical records may contain important information, but your own contemporaneous account can help you remember the sequence of events later.
Request and Preserve Your Medical Records
If an IV infiltration or extravasation results in a significant injury, medical records can be important in determining exactly what happened.
Potentially relevant records may include nursing notes, medication administration records, IV documentation, physician notes, photographs, wound-care records, consultation reports, operative reports, discharge instructions, and records of subsequent treatment.
In a potential Florida medical malpractice case, an attorney may also investigate whether relevant hospital policies, IV protocols, medication-specific procedures, or other evidence should be obtained.
When Does an IV Injury Become Medical Malpractice?
An IV infiltration or extravasation does not automatically mean medical malpractice occurred.
IV complications can happen even when healthcare professionals provide appropriate care. A viable Florida medical malpractice claim generally requires evidence that a healthcare provider failed to meet the applicable professional standard of care and that the failure caused or substantially contributed to the patient's injury.
Depending on the circumstances, potential issues may include whether healthcare providers:
- Properly inserted and monitored the IV;
- Responded appropriately to complaints of pain, burning, or swelling;
- Recognized signs of infiltration or extravasation;
- Continued an infusion despite warning signs;
- Followed appropriate procedures after discovering the complication;
- Properly documented the event;
- Provided appropriate treatment or monitoring; or
- Obtained necessary consultations when the injury became serious.
These issues are highly dependent on the facts and usually require review of the medical records and evaluation by qualified medical experts.
Why Early Investigation Can Matter in a Serious IV Injury
A severe IV infiltration or extravasation injury may involve much more than the IV insertion itself.
A legal investigation may need to determine what substance infiltrated, when the infiltration likely began, how long the infusion continued, what symptoms the patient reported, how healthcare providers responded, what hospital protocols applied, and whether an earlier intervention could have prevented or reduced the injury.
Florida medical malpractice claims also involve specific legal requirements, including presuit investigation procedures and deadlines. Waiting too long to investigate a potential claim can create significant problems.
If an IV injury has caused substantial or permanent harm, obtaining legal advice promptly can help determine whether further investigation is warranted.
Florida Patients Have a Voice in Their Medical Care
Patients sometimes worry about being perceived as difficult when questioning their medical care. But communicating pain, swelling, burning, or other concerning symptoms is an important part of patient safety.
If your IV feels wrong:
- Say something immediately.
- Describe the symptoms specifically.
- Ask that the IV be evaluated.
- Speak up again if symptoms persist or worsen.
- Request another healthcare professional if your concerns are not being addressed.
- Know what medication or fluid is being administered.
- Follow up on worsening symptoms after discharge.
- Document significant visible injuries and preserve relevant records.
You do not have to determine whether an infiltration or extravasation has occurred. Your job as a patient is to communicate what you are experiencing. The healthcare team's responsibility is to appropriately evaluate and respond to those concerns.
Injured by an IV Infiltration or Extravasation in Florida?
If you or a family member suffered a serious IV infiltration or extravasation injury in a Florida hospital, emergency room, surgery center, infusion center, or other healthcare facility, you may have questions about whether the injury could have been prevented.
Attorney J.P. Gonzalez-Sirgo represents Florida patients and families in medical malpractice matters, including claims involving IV infiltration and extravasation injuries. A legal investigation can examine the medical records, circumstances surrounding the infusion, response to warning signs, applicable standards of care, and resulting damages.
Contact J.P. Gonzalez-Sirgo, P.A. for a free and confidential consultation to discuss a potential Florida IV infiltration or extravasation malpractice claim.
Have you or someone you know been injured as a result of medical malpractice? Contact Florida Hospital and Medical Malpractice Lawyer J.P. Gonzalez-Sirgo by dialing his direct number at (786) 272-5841, calling the main office at (305) 461-1095, or Toll Free at 1 (866) 71-CLAIM or email Miami Attorney Gonzalez-Sirgo directly at jp@yourattorneys.com or by text at (305) 929-8935.
This article is for informational purposes only and does not constitute legal advice.
