Intravenous (IV) therapy
This morning I was scrolling through my favorite daily news sites, and came across an article regarding bacterial infections in the application of Intravenous therapy. This instantly caught my attention because I am constantly looking for up to date news and breakthroughs in the medical field. It is my priority as a medical malpractice attorney to be able comprehensive knowledge in the world of pharmaceuticals. Below is a summary of the article, including a basic layout of the functionality, application, uses, and risks of using intravenous therapy.
Medical staff at a local hospital in Montgomery Alabama unknowingly administered infected IV nutritional bags to nineteen (19) patients. The bacteria that had infected the IV bags is known as serratia marcescens, a human pathogen involved in nosocomial infections, particularly catheter-associated bacteremia, urinary tract infections and wound infections Due to its ubiquitous presence in the environment, and its preference for damp conditions serratia marcescens is commonly found growing in bathrooms. Sadly, nine (9) of the patients have since died, while the remaining ten (10) are become extremely ill. As of now officials have not definitively tied the deaths to the bacterial outbreak, investigations will continue.
Intravenous therapy is the fastest way to administer liquid nutrition into the body. Intravenous therapy is usually applied to correct electrolyte imbalances, to deliver medications, for blood transfusion or as fluid replacement to stop dehydration. Intravenous therapy is commonly referred to as a drip because many systems of administration employ a drip chamber, which prevents air entering the blood stream (air embolism) and allows an estimate of flow rate. Most of the time the benefits of using intravenous therapy or a catheter far outweigh and associated risks or dangers, however everyone should be informed of such risks so that they may make a properly informed decision.
As is evidenced by the news article, infection is the most common side effect of intravenous therapy. Any break in the skin carries a risk of infection. Although IV insertion is an aseptic procedure, skin-dwelling organism such as candida albicans may enter through the insertion site. Bacteria may also be accidentally introduced inside the catheter from contaminated equipment. Moisture introduced to unprotected IV sites through washing or bathing substantially increases the infection risks. Other concerns can include:
Phlebitis: Inflammation of a vein that may be caused by infection, the mere presence of a foreign body, the IV catheter or the fluids or medication being given. Symptoms are warmth, swelling, pain, and redness around the vein. The IV device must be removed and if necessary re-inserted into another extremity.
Infiltration / Extravasation: Infiltration occurs when an IV fluid or medication accidentally enters the surrounding tissue rather than the vein. It is also known as extravasation which refers to something escaping the vein.
Fluid overload: Occurs when fluids are given at a higher rate or in a larger volume than the system can absorb or excrete. Possible consequences include hypertension, heart failure, and pulmonary edema.
Hypothermia: If large amounts of cold fluids are infused rapid temperature changes in the heart may precipitate ventricular fibrillation.
Electrolyte imbalance: Administering a too-dilute or too-concentrated solution can disrupt the patient's balance of sodium, potassium, magnesium, and other electrolytes.
Embolism: A blood clot or other solid mass, as well as an air bubble, can be delivered into the circulation through an IV and end up blocking a vessel.
