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Phlebitis vs Infiltration: Understanding These IV Therapy Complications

Understanding phlebitis vs infiltration is crucial for phlebotomists to ensure safe and effective intravenous (IV) therapy. Both conditions can arise as complications during IV catheter insertion, causing discomfort and potential risks for patients. This comprehensive guide delves into the key differences between phlebitis and infiltration, exploring their causes, symptoms, treatments, and preventive measures.

By equipping yourself with this knowledge, you’ll be better prepared to identify these complications early on, minimize risks, and deliver optimal patient care.

Key Takeaways: Phlebitis vs Infiltration
Phlebitis and infiltration are complications that can arise from IV therapy.
Phlebitis is inflammation of a vein, while infiltration is leakage of IV fluids into surrounding tissues.
Both conditions can cause pain, swelling, and changes in skin around the IV insertion site.
Proper catheter placement, infection control, and close monitoring are crucial for preventing phlebitis and infiltration.
Early detection and prompt intervention are essential for managing both conditions effectively.

Understanding Phlebitis and Infiltration

As a phlebotomist, you’re well aware of the importance of safe and effective intravenous (IV) therapy. However, complications can sometimes arise. Two common concerns are phlebitis and infiltration. Let’s delve into these issues, exploring their causes, symptoms, treatments, and preventive measures.

Phlebitis: Inflammation in the Veins

Phlebitis refers to the inflammation of a vein, often occurring as a complication of IV catheter insertion. The blood vessel walls near the catheter site become irritated, causing inflammation in the endothelium (the lining of the blood vessels).

Causes of Phlebitis:

  • Microorganisms: Bacteria or viruses present during IV insertion can increase the risk of phlebitis and potentially lead to infection.
  • Extended IV Therapy: The longer an IV remains in place, the higher the risk of phlebitis development.
  • Other Risk Factors: The site of catheter insertion, duration of IV treatment, antibiotic use, assigned sex at birth, and number of puncture sites can also influence the risk.

Symptoms of Phlebitis:

  • Pain or tenderness in the affected area
  • Swelling around the IV insertion site
  • Increased skin warmth
  • Itching
  • Skin discoloration (redness, browning)
  • Changes in skin texture (thickening, hardening)

Treatment of Phlebitis:

  • Topical Treatments: Applying soothing gels like aloe vera or chamomile can reduce inflammation.
  • Temperature Therapy: Alternating hot and cold compresses on the affected area helps alleviate swelling and pain.
  • Massage: Gently massaging the area with sesame oil can improve circulation.
  • Marigold Ointment: This ointment boasts anti-inflammatory and antibacterial properties.
  • Blood Thinners: In some cases, medication may be necessary to prevent blood clots and future phlebitis episodes.
  • Home Care: Applying warm compresses, elevating the affected limb, and taking over-the-counter pain relievers (consult your doctor regarding safe options if taking blood thinners) can offer relief.

Preventing Phlebitis:

Healthcare professionals play a crucial role in preventing phlebitis. Here are some key strategies:

  • Close Monitoring: Regularly assess the IV site for signs of inflammation (warmth, redness, tenderness).
  • Detailed Records: Maintain accurate documentation of dates, locations, and duration of IV treatments.
  • Prompt Catheter Removal: If phlebitis symptoms appear, remove the catheter immediately.
  • Catheter and Dressing Changes: Change catheters and dressings as per protocol.
  • Catheter Placement: Avoid inserting catheters near joints or wrists, as movement can dislodge the catheter.
  • Infection Control: Use antiseptic solutions to eliminate bacteria and other microorganisms.
  • Hand Hygiene: Maintain proper handwashing and wear gloves during procedures.
  • Communication: Effective communication between healthcare practitioners and patients is crucial. Explain potential signs of phlebitis and encourage patients to report any discomfort.

Infiltration: Leaking Fluids from the Vein

Infiltration occurs when IV fluids or medications leak from the vein into surrounding tissues. This can happen due to improper catheter placement or if the catheter dislodges.

Causes of Infiltration:

  • Catheter Placement: Inserting the catheter into an area with minimal soft tissue can increase the risk.
  • Large Needle Size: Using a larger needle than necessary can create a bigger opening in the vein, potentially causing leakage.
  • Frequent Cannula Insertion: Repeated insertion attempts can damage the vein and surrounding tissues, making infiltration more likely.
  • Medication Type: The type of medication being delivered through the IV can also play a role in infiltration risk.

Symptoms of Infiltration:

  • Pain at the IV insertion site
  • Swelling around the insertion site
  • Blistering on the skin
  • Blanching (pale, waxy skin)
  • Tingling, numbness, or pins and needles sensation
  • Reduced skin temperature
  • Sensitivity at the insertion site

Treatment of Infiltration:

  • IV Removal: The healthcare professional will immediately remove the IV line to prevent further leakage.
  • Hyaluronidase: In cases with soft tissue damage, medication like hyaluronidase may be used to help disperse the leaked fluids.
  • Elevation and Compression: Elevating the affected limb and applying mild compression can help reduce swelling.
  • Pain Relief: Medication may be provided to alleviate discomfort.
  • Infection Monitoring: The healthcare professional will monitor for signs of infection, which might require antibiotic treatment.
  • Complications: Doctors will check for complications like compartment syndrome (pressure buildup in muscles) that can arise due to infiltration.
  • Referral for Tissue Damage: For severe infiltration cases involving tissue damage or those involving chemotherapy medications, doctors may refer patients to plastic or orthopedic surgeons for further treatment.

Preventing Infiltration:

Early detection and prompt removal of the IV line are crucial in preventing infiltration from progressing. Here are some additional preventive measures:

  • Frequent Monitoring: Regularly check the IV insertion site and surrounding areas for any signs of infiltration. Use standardized assessment tools to evaluate potential issues.
  • Patient Awareness: Educating patients about infiltration symptoms empowers them to report any discomfort or changes at the insertion site early on.
  • Catheter Removal at First Signs: Removing the catheter upon noticing the first signs of infiltration can prevent further inflammation and complications.

Comparison Table: Phlebitis vs Infiltration

Aspect Phlebitis Infiltration
Causes Damage to blood vessel from IV catheter Leakage of IV fluids/medications
Risk Factors Long IV duration, bacteria/virus presence Large needle size, limited soft tissue
Symptoms Swelling, pain, warmth, skin color changes Swelling, pain, blistering, blanching, tingling
Treatment Topical ointments, hot/cold compresses, pain relief Remove IV, elevate area, compression, pain relief

When to Contact a Doctor

If you experience any symptoms of phlebitis while receiving IV therapy, it’s crucial to inform a healthcare professional immediately.Get emergency medical attention if you have: 

  • Thrombophlebitis Symptoms: Throbbing, cramping, or sudden swelling in the neck, arm, or leg; swollen veins that feel hard or tender; pain with warm or discolored skin in the affected area. These symptoms can indicate a blood clot, a serious complication.
  • Signs of Infiltration: Report any pain, swelling, blistering, or other changes at the IV insertion site.


Phlebitis is generally not a serious condition and often resolves on its own within 1-2 weeks. In severe cases, treatment might be necessary to prevent blood clots or other complications.

Infiltration complications are uncommon, and the issue typically resolves with IV line removal and proper management. However, severe cases can lead to poor circulation and tissue death.

Conclusion: Phlebitis vs Infiltration

Phlebitis and infiltration are potential complications associated with IV therapy. Understanding the causes, symptoms, and preventive measures empowers phlebotomists to deliver safe and effective care. By recognizing these issues early and taking appropriate action, you can minimize risks and ensure a positive experience for patients receiving IV therapy.

Extravasation vs. Infiltration: Understanding the Difference

Extravasation and infiltration are distinct complications encountered during intravenous therapy, differing primarily in the nature of the solution that escapes into surrounding tissues. Vesicant drugs, capable of causing tissue necrosis, delineate extravasation, whereas non-vesicant drugs lack this deleterious effect.


Extravasation manifests when a vesicant drug permeates beyond the vein and infiltrates neighboring tissue. This occurrence heralds serious consequences, precipitating significant tissue damage, including ulceration and necrosis, if left untreated.


Infiltration emerges when a non-vesicant drug breaches the confines of the vein and disperses into adjacent tissue. Although infiltration may provoke symptoms and signs in the affected area, resultant damage tends to be less severe compared to extravasation. Notably, complications such as ulcers, blisters, and tissue necrosis are typically absent.

Understanding the nuances between extravasation and infiltration is pivotal for healthcare professionals to administer timely interventions and mitigate potential adverse outcomes.

FAQs: Phlebitis vs Infiltration

What are the risk factors for phlebitis?

Several factors can increase the risk of phlebitis, including:

  • The duration of IV therapy (longer duration = higher risk)
  • Presence of microorganisms during insertion
  • Catheter size and insertion site
  • Use of antibiotics
  • Assigned sex at birth
  • Number of puncture sites

What are the symptoms of infiltration?

Infiltration can cause symptoms like:

  • Pain at the IV insertion site
  • Swelling around the insertion site
  • Blistering on the skin
  • Pale, waxy skin (blanching)
  • Tingling, numbness, or pins and needles sensation
  • Reduced skin temperature
  • Sensitivity at the insertion site

What should I do if I experience symptoms of phlebitis or infiltration?

If you experience any discomfort or changes around your IV site, inform your healthcare professional immediately.For treatment to be successful, early discovery is essential.  

How can I prevent phlebitis and infiltration?

As a patient, you can help prevent these complications by:

  • Informing your healthcare professional about any allergies or sensitivities.
  • Asking questions and understanding the IV insertion process.
  • Reporting any discomfort or changes at the IV insertion site promptly.

Disclaimer: The material in this article is intended for educational purposes only and should not be interpreted as medical advice. Always seek diagnostic and treatment advice from a competent healthcare practitioner. 

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We hope this article has been informative. If you have any further questions, please don’t hesitate to contact Phlebotomy Now School.

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