Pain Placement of an<unk>  line inherently causes pain when the skin is broken and is considered medically invasive. For this reason, when other forms of administration may suffice,<unk>  is usually not preferred. This includes the treatment of mild or moderate dehydration with oral rehydration<unk>  which is an option, as opposed to parenteral rehydration through an IV line. Children in emergency departments being treated for dehydration have better outcomes with oral treatment than<unk>  due to the pain and complications of an<unk>  line. Cold spray may decrease the pain of putting in an IV. Certain medications also have specific sensations of pain associated with their administration IV. This includes potassium, which when administered IV can cause a burning or painful sensation. The incidence of side effects specific to a medication can be affected by the type of access (peripheral versus central), the rate of administration, or the quantity of drug administered. When medications are administered too rapidly through an IV line, a set of vague symptoms such as redness or rash, fever, and others may occur; this is termed an "infusion reaction" and is prevented by decreasing the rate of administration of the medication. When vancomycin is involved, this is commonly termed "Red Man syndrome" after the rapid flushing which occurs after rapid administration. Infection and inflammation As placement of an<unk>  line requires breaking the skin, there is a risk of infection. Skin-dwelling organisms such as coagulase-negative staphylococcus or Candida albicans may enter through the insertion site around the catheter, or bacteria may be accidentally introduced inside the catheter from contaminated equipment. Infection of an IV access site is usually local, causing easily visible swelling, redness, and fever. However, pathogens may also enter the bloodstream, causing sepsis, which can be sudden and life-threatening. A central IV line poses a higher risk of sepsis, as it can deliver bacteria directly into the central circulation. A line which has been in place for a longer period of time also increases the risk of infection. Inflammation of the vein may also occur, called thrombophlebitis or simply phlebitis. This may be caused by infection, the catheter itself, or the specific fluids or medication being given. Repeated instances of phlebitis can cause scar tissue to build up along a vein. A peripheral IV line cannot be left in the vein indefinitely out of concern for the risk of infection and phlebitis, among other potential complications. However, recent studies have found that there is no increased risk of complications in those whose IVs were replaced only when clinically indicated versus those whose IVs were replaced routinely. If placed with proper aseptic technique, it is not recommended to change a peripheral IV line more frequently than every 72–96 hours. Phlebitis is particularly common in<unk>  drug users, and those undergoing chemotherapy, whose veins can become sclerotic and difficult to access over time, sometimes forming a hard, painful “venous cord”. The presence of a cord is a cause of discomfort and pain associated with IV<unk> , and makes it more difficult for an IV line to be placed as a line cannot be placed in an area with a cord. Infiltration and extravasation Infiltration occurs when a non-vesicant IV fluid or medication enters the surrounding tissue as opposed to the desired vein. It may occur when the vein itself ruptures, when the vein is damaged during insertion of the intravascular access device, or from increased vein porosity. Infiltration may also occur if the puncture of the vein by the needle becomes the path of least resistance—such as a cannula which has been left inserted, causing the vein to scar. It can also occur upon insertion of an IV line if a tourniquet is not promptly removed. Infiltration is characterized by coolness and pallor to the skin as well as localized swelling or edema. It is treated by removing the<unk>  line and elevating the affected limb so the collected fluids drain away. Injections of hyaluronidase around the area can be used to speed the dispersal of the fluid/drug. Infiltration is one of the most common adverse effects of IV<unk>  and is usually not serious unless the infiltrated fluid is a medication damaging to the surrounding tissue, most commonly a vesicant or chemotherapeutic agent. In such cases, the infiltration is termed extravasation, and may cause necrosis. Others If the solutions administered are colder than the temperature of the body, induced hypothermia can occur. If the temperature change to the heart is rapid, ventricular fibrillation may be caused. Furthermore, if a solution which is not balanced in concentration is administered, a person's electrolytes may become imbalanced. In hospitals, regular blood tests may be used to proactively monitor electrolyte levels.
Intravenous therapy
Intraoperative blood salvage
Expanded access
Continuous hyperthermic peritoneal perfusion
Moral treatment
Infusion therapy
Damage control surgery
Minimized extracorporeal circulation