Intravenous (IV) infiltration and extravasation are complications that can occur during IV therapy, where fluid or medication leaks outside the vein into the surrounding tissue. The severity of these events can vary, and they are typically categorized into stages to help healthcare professionals assess the extent of tissue damage and guide appropriate treatment. Here's an overview of the stages:

IV Infiltration Stages

  1. Stage 0: No symptoms; the IV is functioning as expected.
  2. Stage 1: Early infiltration; symptoms might include slight swelling at the IV site, skin blanching (turning pale), coolness around the IV site, or a slight discomfort. There might be a noticeable decrease in the IV fluid flow rate.
  3. Stage 2: Moderate infiltration; increased swelling, more pronounced discomfort, and possible reduction in limb mobility near the IV site. The skin may start to look stretched and shiny.
  4. Stage 3: Advanced infiltration; significant swelling, possibly extending beyond the immediate IV site, substantial pain, and tightness. The skin may appear reddened or bruised due to the tissue injury.
  5. Stage 4: Severe infiltration; massive swelling, severe pain, and possible skin blistering, necrosis (tissue death), or ulceration. There may be a loss of function in the affected area.

IV Extravasation Stages

Extravasation specifically refers to the leakage of vesicant substances, which can cause blistering and severe tissue damage. The staging for extravasation can be similar to infiltration but with more emphasis on the severity of tissue damage due to the nature of the substances involved:

  1. Stage 1: Mild symptoms of pain and swelling, with possible redness at the site. The skin may feel warm to the touch.
  2. Stage 2: Moderate symptoms with increased pain, swelling, and redness. There may be some blistering or changes in skin color.
  3. Stage 3: Severe symptoms including intense pain, rapid swelling, extensive skin blistering, and evidence of tissue damage. Skin may start to slough off, and there can be signs of necrosis.
  4. Stage 4: The most severe form, involving not just the skin and subcutaneous tissues but also potentially affecting deeper structures like tendons, muscles, and nerves. There may be significant necrosis, requiring surgical intervention such as debridement or even amputation in extreme cases.

It's important for healthcare professionals to monitor IV sites closely and respond quickly to signs of infiltration or extravasation to minimize tissue damage and other complications. Treatment may include stopping the IV infusion, elevating the affected limb, applying cold or warm compresses (depending on the type of infiltrate or extravasate), and, in more severe cases, administering antidotes or surgical intervention.

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J.P. Gonzalez-Sirgo
J.P. Gonzalez-Sirgo, P.A.
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