Upper extremity thrombophlebitis

Upper extremity thrombophlebitis



Thrombophlebitis is a preventable iatrogenic process that may stem from intravenous cannulation.



The consequences of intravenous cannulation include: and increased healthcare costs.




 Life-threatening complications may occur and include: bacteremia, septic pulmonary emboli, acute endocarditis.



Thrombophlebitis may appear as an infection at the site of the cannula insertion, or may masquerading as a benign process in septic patients.



The rate of peripheral vein phlebitis ranges from 20-80%, and far exceeds acceptable incidence of 5%.



Care of intravenous catheter includes noting the duration of the replacement of catheters, frequency of inspection of the side of catheter insertion, secure ent with a transparent dressing, and indication for the removal of the catheter  with the development of phlebitis.



Thrombophlebitis is identified as the presence of two more of the following signs or symptoms on the examination of the catheter insertion site or adjacent vein: pain, tenderness, erythema, swelling, purulence, and a palpable venous cord.



Vulnerable patients include those with: intercurrent illness, immunocompromised state, comorbidities such as diabetes, malignancy, previous thrombophlebitis, and burns.



Catheter replacement is based on clinical indication rather than routine replacement for prevention. 



Splintage should be considered.



Prevention is the cornerstone of minimizing occurrence of upper extremity thrombophlebitis.




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