Editing Nursing Skills and Procedures (section)

=== Complications and immediate actions ===
* '''Infiltration''': nonvesicant fluid leaks into tissue. Coolness, pallor, swelling, slowed rate, and no blood return. Stop the infusion, discontinue the catheter, elevate the limb, and apply a warm or cool compress per protocol.
* '''Extravasation''': the same event with a vesicant such as a vasopressor or many chemotherapy agents. Stop the infusion, leave the catheter in place initially, aspirate residual drug, notify the provider, and give the specific antidote such as phentolamine for norepinephrine extravasation. This causes tissue necrosis.
* '''Phlebitis''': redness, warmth, pain, and a palpable cord along the vein. Discontinue, apply warm compress, and restart in the opposite extremity.
* '''Local or bloodstream infection''': purulence at the site, fever, chills. Discontinue, culture as ordered, and notify.
* '''Fluid overload''': dyspnea, crackles, jugular venous distension, bounding pulse, rising blood pressure, and weight gain. Slow the infusion to keep the vein open, raise the head of the bed, administer oxygen, notify the provider, and anticipate a diuretic.
* '''Air embolism''': sudden dyspnea, chest pain, hypotension, tachycardia, and altered mental status. Clamp the line, place the patient on the left side in Trendelenburg to trap air in the right ventricular apex, administer 100 percent oxygen, and notify the provider immediately.
* '''Speed shock''': systemic reaction to a bolus given too rapidly, with flushing, headache, chest tightness, irregular pulse, and possible cardiac arrest. Stop the infusion and support the patient.
* '''Catheter embolism''': suspected when the removed catheter tip is not intact. Apply a tourniquet high on the extremity, place the patient on the left side, and notify immediately.