Intravenous (IV) therapy refers to the administration of a fluid (solution) directly into a vein in the form of a therapeutic treatment. Over the years, IV has become a practical, beneficial, lifesaving therapeutic treatment for various medical conditions. The three types of IV therapy include therapy to provide fluids, to give drugs, or to obtain blood products.

Even though IV therapy is a highly beneficial therapy procedure, there are some complications that may occur due to the incorrect usage of a scalp vein set or other types of mismanagement. The complications include infiltration, hematoma, air embolism, phlebitis, extravascular drug administration, and intra-arterial injection. It is important to understand each of these complications so that they can be prevented and managed well in case they occur:

  1. Infiltration

The infusion of fluid or medication in the surrounding soft tissue, outside the intravascular space is known as infiltration. This complication usually happens because of bad placement of a needle or angiocath occurring outside the vessel lumen. One way to find out that this complication has occurred is if you notice swelling on the soft tissue around the IV. The skin will be cool, pale and rigid. It is important to note that a tiny amount of IV fluid does not make much difference, however, if it is other medications, then even small amounts can turn out to be very toxic to the surrounding soft tissues.

  1. Hematoma

A hematoma is caused when the blood leaks from the vessel into the surrounding soft tissue. One condition when this can happen is when IV angiocath is passed through more than one wall of a vessel or in case the pressure is not applied to the IV site at the time of the removal of the catheter. One way to manage this complication is by direct pressure and this issue can be resolved within two weeks.

  1. Air Embolism

When a large volume of air enters the patient’s vein via the set, air embolism occurs. These embolisms can be prevented by ensuring that there are no air bubbles in the IV tubing. Even though this is a rare phenomenon, it is important to make sure that the tube is free of air bubbles to prevent this from ever happening in the first place.

  1. Phlebitis and Thrombophlebitis

These conditions are more frequent in nature. Phlebitis refers to the inflammation of the vein that takes place because of the Ph of the agent that is being used during the administration. On the other hand, thrombophlebitis is the inflammation that is associated to a thrombus. Both conditions are common on the dorsum of the hand and are more common in patients who have been hospitalized and on IV for a few days.

  1. Extravascular Injection

Taking drugs through an extravascular injection can lead to pain, delayed absorption or tissue damage. If the skin looks raised because of a large amount of substance being injected, then 1 per cent procaine is required to be infiltrated. As procaine is a vasodilator, it improves the blood supply to the area, thus reducing the venous drainage.

  1. Intra-arterial Injection

Even though it is rare, it is more critical if it happens. By making sure that the needle is inserted in a vein, this can be prevented from happening. In this condition, the most important thing is recognition. You must observe the colour of the skin, the capillary refill, and feel the pulse. If there is a capillary refill, it can be discovered by squeezing a fingertip and then observing the red colour return. This means perfusion. However, if the capillary refill is decreased, then perfusion will also be decreased. One way to manage this complication is to leave the needle in the artery, and then slowly inject 10 CCs of 1 per cent procaine.

Some other basic and general complications involve allergic reactions. Symptoms of the same can include skin-producing urticarial, respiratory producing bronchospasm, oedema, cardiovascular-producing signs of shock, etc. This condition can be managed by stopping the treatment or implementing resuscitation procedures, depending on the severity and intensity. However, one way in which it can be prevented is by studying the medical history of the patient thoroughly and making sure that the treatment offered is in line with previous medical reactions and interactions. One should also test the blood pressure and the amount of glucose in the blood with the help of a glucometer before beginning any IV therapy on a patient.