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Mechanical Complications Cause IV Lines to Fail

IV lines fail at a miserable rate - 46% of the time to be exact. Mechanical complications are the main culprit. Forces on the line can cause IV catheters to dislodge. The IV catheter moving back-and-forth in the vein can cause irritation known as phlebitis. Catheter movement can cause the catheter to bust through a vein wall and infuse medication into the soft tissues - called infiltration. And lastly, build up of material on the opening of the IV catheter can cause it to stop working properly. This is called occlusion. The table to the right shows the rate at which each of these mechanical complications occur.

Mechanical IV Complications

dislodgement

Dislodgement occurs when forces across the IV line are stronger than the adhesives and securement devices ability to hold onto the IV line. IV dislodgement is very common, occurring 11% of the time on average.(2) Dislodgement can occur either on purpose or accident with some of the most common reasons being:  patient transfer from one bed to another, patients with cognitive issues unknowingly pulling out their IV, and IV lines getting caught underneath hospital bed rails. The two images below show some common situations where IV dislodgement occurs.

IVs are frequently removed by patients experiencing delirium or going through alcohol or drug withdrawal

IVs are frequently caught underneath hospital bed rails causing IV dislodgement

Below are pictures of a standard IV adhesive applied to the arm of a 50 year old male with increasing amounts of force applied. Most adhesives completely pull completely off between 5 and 8-pounds of force. SafeBreak is designed to separate at 4 pounds of force and prevent the most damaging forces from causing dislodgement and other mechanical complications.  If you would like additional technical information about IV dislodgement, click here. If you would like more information about forces across IV lines and various securement device performance, click here.

0-pound pull force

1-pound pull force

1-pound pull force

2-pound pull force

3-pound pull force

3-pound pull force

4-pound pull force

4-pound pull force

5-pound pull force

5-pound pull force

6-pound pull force

6-pound pull force

7-pound pull force

7-pound pull force

Infiltration

A hand showing infiltration of infusate into the soft tissues by a peripheral IV

A hand showing infiltration of infusate into the soft tissues by a peripheral IV

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. The erosion of the vein wall can be caused by forces on the IV line moving the IV catheter back and forth in the vein, injury to the vein due to a caustic medicine being infused, or a needle injury to the vein during IV insertion. Securing and preventing harmful forces from pistoning the catheter are tools in the battle to prevent infiltration. If you would like additional technical information on infiltration, click here.

During the insertion of a needle into a vein, it is possible to pass the needle and/or the IV catheter all the way through the vein and cause infiltration.

Micro-movement of the catheter tip against the endothelial wall of the vein can cause the tip of the IV catheter to puncture the vein wall, infusing fluid into soft tissue.

Phlebitis

A forearm with an example of phlebitis

A forearm with an example of phlebitis

Phlebitis, or vein irritation as seen in the picture to the right, occurs 15% of the time on average in peripheral IVs and is the second most common mechanical complication.(1) There are three different types of phlebitis: mechanical, chemical and infectious, or any combination of the three. Mechanical phlebitis is caused by the traumatic movement of the IV catheter against the vessel wall and stabilization devices have shown reductions in phlebitis rates in some studies. There are many different ways to address mechanical phlebitis, but the bottom line is the need to stop the motion of the catheter in the vein. Securement devices, sterile glue, dressings with good adhesives, and/or SafeBreak Vascular all can play a role in solving mechanical phlebitis problems. If you would like additional technical information on phlebitis, click here.

Pistoning of a catheter inside a vein can cause damage that results in phlebitis

Pistoning of a catheter inside a vein can cause damage that results in phlebitis

Micro-movement of the catheter tip back and forth against the endothelial wall of the vein can cause irritation.

MKG-0009 09/17


1 Helm, R.E., et al., Accepted but Unacceptable: Peripheral IV Catheter Failure. Journal of Infusion Nursing. 2015; 38(3):189-203.

2 For full reference list that determines the 11% average dislodgement rate, refer to www.lineusmed.com/dislodgement.