I just read "New Respect for the Humble Endothelium" (March 2006), which is a great resource for nurses. I'd like to add another point. All kinds of I.V. devices, fluids, and medications can damage the endothelium. Mechanical and chemical injury to the endothelium begins the inflammation and clotting process, which can lead to thrombophlebitis. This fact is the basis for many of the Infusion Nurses Society Standards of Practice, such as using the smallest gauge, shortest length catheter possible; restricting the pH and osmolarity of infusates; using manufactured catheter stabilization devices; and supporting areas of joint flexion, such as the hand or wrist, when veins in those areas must be used for catheter insertion.
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LYNN C. HADAWAY, RN, C, CRNI, MED