These microbes may be from the patient's skin, contaminated disinfectant or healthcare workers' hands. The process may happen on insertion if the catheter is contaminated and then introduced into the patient or via microbial migration at any time while the catheter is in situ.
Gram-positive bacteremia
Staphylococcus epidermidis is the most common gram-positive organism isolated from blood (~ 30% of isolates) and accounts for the majority of infections that are associated with an intravascular catheter.
What is the cause? Usually the infection is caused by bacteria. The blood may get infected when an IV line or shot is given through an infected area of skin or if an IV catheter (tube) is left in too long. There are always bacteria on the skin and on the surfaces of most objects.
Despite its benefits and frequent use, intravenous cannulation has complications that can seriously threaten patient safety such as clotting, occlusion, leakage, infiltration, extravasation, phlebitis, and infection [4]. Furthermore, it is the main source of procedure-related pain in hospitalized patients [5].
Complications include infection, phlebitis and thrombophlebitis, emboli, pain, haematoma or haemorrhage, extravasation, arterial cannulation and needlestick injuries.
Complications of gaining I.V. may include infiltration, hematoma, an air embolism, phlebitis, extravascular drug administration, and intraarterial injection.
A CVL must have a sterile dressing over the site where the catheter extends outside of the body. The dressing must be intact at all times to prevent infection. It is changed once a week or if it becomes wet, dirty or loose. When the dressing is changed, the nurse will wear a mask, gown and sterile gloves.
Use either a transparent dressing or sterile gauze to cover the cannula site. Replace cannula site dressings when they become damp, loosened, or soiled, or when the device is removed or replaced. Change dressings more frequently in diaphoretic patients.
Disinfect ports, hubs, needleless connectors and stopcocks before you connect or inject. Scrub vigorously with alcohol/chlorhexidine solution or alcohol (recommended scrub time is 15 seconds or more) and let dry.
Sepsis can be caused by any type of infection in the body, such as a chest infection which causes pneumonia, a urine infection, an infected cut or bite, an infection in a cannula, or a wound following surgery.
Many of the catheters need to be replaced due to phlebitis, infiltration, pain, or swelling at the IV site, but the rate of bloodstream infections associated with peripheral IVs is just 0.5 per 1000 catheter days.
He found that of the approximately 200 million peripheral venous catheters inserted into adult patients in the United States every year, the incidence of bloodstream infection is about 0.18 percent (i.e., close to two such infections for every 1,000 of these catheters inserted).
Superficial thrombophlebitis is an inflammation of a vein just below the surface of the skin, which results from a blood clot. This condition may occur after recently using an IV line, or after trauma to the vein. Some symptoms can include pain and tenderness along the vein and hardening and feeling cord-like.
US Centers for Disease Control guidelines recommend replacement of peripheral intravenous catheters (PIVC) no more frequently than every 72 to 96 hours. Routine replacement is thought to reduce the risk of phlebitis and bloodstream infection.
If the IV lines and cannulae are not removed or effectively flushed residual anaesthetic and sedative drugs can later be inadvertently introduced into the patient's circulation causing muscle paralysis, unconsciousness and respiratory and cardiac arrest.
Staff caring for you:
Must remove your cannula as soon as it is no longer needed for your care / on discharge (unless your doctor has stated otherwise). Must check your cannula, the site and dressing at least once on every shift, and each time it is used.
Median antecubital, cephalic and basilic veins
These should be avoided unless absolutely necessary in any infant likely to need long term IV therapy. The median nerve and brachial artery are both in the same anatomical vicinity and therefore vulnerable to damage.
Infiltration is the most common complication for peripheral IVs, occurring 24% of the time on average. (1) Infiltration occurs from erosion or penetration of the catheter into or through the vein wall. It results in the infusion of medicine into the surrounding soft tissues as can be seen in the image to the right.
Although it is common, IV therapy is an invasive procedure that carries some risks. Side effects may include bruising, bleeding, and swelling at the insertion site. It is best to receive IV therapy in a hospital setting involving trained medical professionals.
When an IV is not inserted properly or is otherwise misused, fluids or medicine can leak into the surrounding tissue. This is called IV infiltration, and it can cause harm ranging from irritation to fluid overload, infections, nerve damage, stroke, brain injury, or even death.
Thrombophlebitis. Thrombosis may occur with any cannula - particularly if it is left in too long, if the area is infected. Irritant medications such as potassium infusions can cause painful phlebitis without thrombosis.
Signs of infiltration injuries present as coolness or blanching at the cannula insertion point/swelling, tenderness or discomfort/taut or stretched skin/leakage of fluid at the cannula insertion point, inability to obtain blood return/change in quality or flow of the infusion or injection/numbness, tingling –' pins and ...
Direct contact spread
Some infections can be spread by direct contact with the infected area to another person's body, or via contact with a contaminated surface. This is the most common route of cross-infection from one person to another (transmission of infection).