Introduction
Very often, intravenous medication – i.e. medication administered via an infusion into the vein – is necessary during an inpatient stay in hospital. For this purpose, an indwelling venous catheter is placed as a venous access. During or after an infusion, the punctured vein can become inflamed and a so-called phlebitis can develop.
In most cases, it is superficial veins that receive a peripheral intravenous catheter so that the infusion can enter the bloodstream. Bacteria can penetrate through the injury to the skin and the vein wall. Depending on the medication, the infusion can also cause irritation or inflammation.
Detecting phlebitis
The first symptoms of inflammation of the peripheral vein after an infusion are pain. Usually the pain is directly in the injection site or around the venous catheter. The pain can also spread along the vein.
There is also a reddening of the area, which can also spread along the vein and in the surrounding tissue. The inflamed area heats up and may swell. These are the typical symptoms of phlebitis.
However, if bacteria also enter the vein, a fever may also develop. In this case the bacteria have entered the bloodstream. Overall, the area is touch-sensitive, reddish and warm.
An indwelling catheter in the vein without inflammation can be painful or disturbing during certain movements. It is not uncommon for the venous catheter to lie against the vein wall and cause pain. However, if the pain persists and reddening or warming is added, the doctor should be asked to change the indwelling catheter.
The infusion itself can also be painful, as it can be irritating medication. If pain persists after each infusion and the tissue around the vein becomes thick, the catheter may not be in the vein. In this case it should be removed immediately.
Diagnosis of phlebitis
The diagnosis of phlebitis is in most cases a so-called gaze diagnosis. This means that there is no need for extensive examinations, as the diagnosis can only be made by observing the patient. If the inflammation should spread and fever, chills or a feeling of illness should occur, then a blood test and possibly blood cultures should be taken. If the indwelling venous catheter was placed in a central vein, it can also be sent to the laboratory to examine possible bacterial settlements on the catheter.
