Patient is Injured After Misplaced IV Injects Medication into Soft Tissue

Case Overview

This case involves a patient who suffered an extravasation injury while receiving IV chemotherapy. The nurse administering the IV therapy inserted the IV into a vein on the back of the patient’s hand. The patient immediately complained to the attending nurse that she was experiencing burning in her hand, however the nurse proceeded and did not stop the therapy. As a result, the patient suffered soft tissue damage and hypesthesia. It was alleged that the defendant nurse should have immediately stopped the infusion and that medications should have been used to try to arrest or minimize damage from the extravasation.

Questions to the Nursing expert and their responses

Should IVs for medications which are vesicants be given through dorsum of the hand?

As a matter of proper practice, the hand should not be accessed for infusions. The catheter to vein ratio is generally insufficient to allow proper hemodilution.

Is burning a known side effect of administration? Should therapy be stopped if patient indicates discomfort?

Burning at the vein site is not a known side effect during administration. Any therapy should be stopped immediately if any discomfort is felt; this includes pain, stinging and burning.

Should medication be stopped to arrest or minimize damage from extravasation?

In cases like this, medications should be stopped and any remaining medication should be removed from the catheter via aspiration.

About the expert

This highly qualified expert is board certified in Infusion Nursing. She earned her RN from Middlesex Community College. She earned her BSN and MSN from Western Governors University. She has over ten years of experience as an infusion nurse and places over 5,000 peripheral catheters per year. She has held several supervisory and academic positions during her career. She serves as President of her local chapter of the Infusion Nurses Society in addition to seat on the national chapters education council. In addition to her clinical responsibilities, her duties include writing educational sessions for re-certification and continuing education for infusion nurses.