By: Ryan MacArthur |

Quick read:

The current IV failure rate reaches up to 50%, meaning a significant number of patients will experience some type of IV failure. Factors like age, nutrition, medical history and body size may play a role in the likelihood of complications like phlebitis and infiltration.

Full story:

Healthcare professionals use millions of intravenous devices like cannulas and catheters each year, but the IV failure rate still reaches as high as 50%. With four out of every five patients requiring intravenous (IV) therapy, that means a significant number of patients will experience some type of IV failure.

Factors like age, nutrition, medical history, and body size can all play significant roles in causing complications like phlebitis and infiltration. Read on to learn more about what factors can influence IV failure and how the complications affect different demographics.

Age

As we age, the outer layer of skin thins and can appear paler or even translucent. Blood vessels also become more fragile making them prone to damage or movement during catheter insertion. These factors can contribute to pain, swelling and reddening of the skin, which are common symptoms of phlebitis.

Fragile veins are harder to stabilize and more prone to puncture through the vein wall, which may also lead to another common complication: infiltration. Fluids and medications leak into the surrounding soft tissue, resulting in inflammation near the insertion site. The area may feel tight and cool to the touch.

Nutrition

A patient’s diet can play a role in potential IV failure. Malnourished patients’ veins have less support, making them more mobile and fragile. This makes it more challenging to maintain a catheter without puncturing the vein’s outer wall. It’s also more likely for the IV to become dislodged altogether because of the lack of structure keeping the catheter in place in the vein.

Patients who are obese have a different set of challenges when it comes to IV placement. Their veins tend to be difficult to locate because they are below more tissue and fat. For this reason, IVs in the hand are typically more easily accessible for these patients.

However, IVs placed in the hand come with their own complications, such as phlebitis – more commonly associated with IVs placed on the back of the hand. American Nurse Today recommends avoiding veins in the hands and wrist altogether because of the increased risk of dislodging the catheter when the patient moves.

Clinical History

The number of times a patient receives intravenous treatment can also be a contributing factor. Multiple IV punctures can make the vessel wall much more fragile, leading to issues like infiltration due to the vein’s weakened structure.

Studies show while age makes a significant difference when it comes to IV failure occurrences, a combination of poor diet and repetitive IV placements in the same spot typically results in more incidents of IV failure.

Talk to your healthcare provider about how these factors may influence your IV treatment and the probability of experiencing IV failure. Not sure where to start? Check out How to Talk to Your Health Professional for conversation starters.

 

 

 

References:

Risk Factors for Venous Thromboembolism – http://circ.ahajournals.org/content/107/23_suppl_1/I-9

Trainer’s tip: Age-related considerations for intravenous therapyhttp://www.hcpro.com/LTC-279423-1983/Trainers-tip-Agerelated-considerations-for-intravenous-therapy.html

Australia failing to meet best practice guidelines for IV treatment – http://www.abc.net.au/radionational/programs/breakfast/australia-fails-to-meet-best-practice-guidelines-iv-treatment/7379770

Tips for inserting an I.V. device in an older adult – http://journals.lww.com/nursing/Citation/2008/12000/Tips_for_inserting_an_I_V__device_in_an_older.8.aspx

Intravenous Therapy in Nursing Practice – https://books.google.com/books?id=4mRIHiHnOf4C&pg=PA235&lpg=PA235&dq=are+veins+more+difficult+to+locate+in+malnourished+patients&source=bl&ots=ExiUjcJ2zz&sig=vbDdeoEqZHcBSFoLl8UF0G_tSsQ&hl=en&sa=X&ved=0ahUKEwiKpYvi26LXAhUD2IMKHddCDgsQ6AEIKDAA#v=onepage&q=are%20veins%20more%20difficult%20to%20locate%20in%20malnourished%20patients&f=false

Portable Fluids and Electrolytes – https://books.google.com/books?id=JIyocEe1B3IC&pg=PA324&lpg=PA324&dq=are+fragile+veins+more+likely+to+infiltrate&source=bl&ots=s8kcy5lR9o&sig=6hOa0aXcUVEKpkYtQ5dYBsYWWlk&hl=en&sa=X&ved=0ahUKEwi4xfvJ8c_XAhXhmuAKHQNUBlUQ6AEIKDAA#v=onepage&q=are%20fragile%20veins%20more%20likely%20to%20infiltrate&f=false

Intravenous sedation: Complications – http://ccnmtl.columbia.edu/projects/aegd/mod01_mec_ivcomp.html

American Nurse Today – https://www.americannursetoday.com/protect-patients-from-i-v-infiltration-3/

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