I.V. ROUNDS: When your patient develops phlebitis

February 2006 
Volume 36  Number 2
Pages 14 - 14
  PDF Version Available!


PHLEBITIS, OR INFLAMMATION of the vein, can have many causes, including irritation of the vein by a foreign body or irritating medication, injury of the vessel wall from the catheter, or infection linked to bacterial contamination of the I.V. system. Mechanical phlebitis , the most common type, may occur from a large catheter placed in a small vein, vein trauma during catheter insertion, or movement of an improperly secured catheter within the vein.

Chemical phlebitis can be caused by irritating I.V. drugs or fluids that are too acidic or too alkaline (pH less than 5 or greater than 9), and by hypertonic solutions (osmolality over 500 mOsm/liter). It may also develop when the skin preparation solution isn't allowed to dry before venipuncture, and is tracked into the vein.

Bacterial phlebitis is caused by contamination of the I.V. system during catheter insertion or manipulation, or by poor skin antisepsis.

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