Radiographic and Other Studies None needed

V. Plan. Removal of catheter is first step. Assess need for continued IV

therapy. If indicated, place another catheter in a different site, preferably a smaller catheter in a larger vein to minimize chance of recurrence.

Phlebitis (Mechanical or Infusion). Elevate and place warm, moist compresses on site after removal of catheter. Topical, oral, or IV antibiotics are not necessary.

Suppurative Thrombophlebitis. After immediate removal of catheter, start broad-spectrum antibiotics to cover gram-negative rods and gram-positive cocci. Obtain surgical consultation, because surgical excision of affected vein is often necessary. Extravasated Medication. If patient experiences pain during an infusion, stop infusion immediately. Attempt to aspirate several milliliters of blood or infusate from catheter site. Remove peripheral IV catheter if placement in subcutaneous tissue is suspected. Elevate and place cold compresses on affected area. Occasionally, warm compresses or antidotes, or both, are indicated for chemotherapeutic agents. In severe cases, skin breakdown will occur and surgical debridement may be necessary.

VI. Problem Case Diagnosis. The insertion site of the catheter in this 3-year-old girl was erythematous and tender to palpation. Otherwise, she was afebrile and had no other findings. Diagnosis is phlebitis. The catheter was removed and warm soaks were applied to the site.

VII. Teaching Pearl: Question. Is it safe to place a peripheral IV catheter in the foot?

VIII. Teaching Pearl: Answer. Although there has been a higher risk of phlebitis and infection in peripheral IV catheters placed in lower extremities of adults, this is not the case in children.The CDC states that hand, dorsum of foot, and scalp can all be used safely in pediatric patients.

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