1. Peripheral IV Infiltration Tool
2017

4. Maintenance Fluids, no vesicants
72 days post infiltration

5. Rationale for Change
Current Infiltration Scale (Grades 1-4) is designed for adult assessment.
Current Infiltration Scale is very subjective in assessment.
New Tool will provide consistency with assessment and treatment.

6. Measurement of PIVIE Swelling
Measure the swelling diameter to obtain the numerator (X).
Measure the arm length to obtain the denominator (Y).
Calculate the % infiltrate.

7. Measurements will help drive treatment
Treatment for infiltrations will be guided by the Infiltration Care Procedure.
ALL Infiltrations:
Stop infusion
Elevate extremity
Remove IV
Less than 30% and NOT a vesicant:
Apply warm or cool compress
Greater than 30% OR any infiltrate with a high risk vesicant:
Notify MD/APP
MD/APP will assess and order antidote, if indicated, and outline further treatment if needed.
Complete an Event Report

8. Venous Infusion Infiltration Risk Chart
High Risk
Acyclovir
Amiodarone
Caffeine Citrate
Calcium
Dextrose >12.5%
Doxycycline
Esmolol
Mannitol
Potassium > 0.06 mEq/mL
Promethazine
Sodium Bicarbonate ≥3%
Sodium Chloride ≥3%
TPN > 950 mOsm/L
Vancomycin
Vasopressors
Chemotherapy Medications
**Increase monitoring of infusion site, see Venipuncture and IV Therapy policy.
**IV administration through central line should be considered for these medications in order to reduce infiltration risk
**For treatment in the event of an infiltration, see Infiltration Care procedure.
Medium Risk
Acetazolamide
Allopurinol
Amikacin
Aminophylline
Amphotericin B
Ciprofloxacin
Dextrose 10 to 12.5%
Diazepam
Erythromycin
Ganciclovir
Gentamicin
Lorazepam
Midazolam
Morphine
Nafcillin
Non-Ionic Radiology Contrast
Ondansetron
Phenobarbital
Phenytoin
Potassium ≤ 0.06 mEq/mL
TPN ≤ 950 mOsm/L
Low Risk
Amphotericin B Liposomal
Ampicillin
Ampicillin/Sulbactam
Cefazolin
Cefotaxime
Ceftazidime
Ceftriaxone
Cefuroxime
Clindamycin
D5LR
Dextrose <10%
Fentanyl
Fosphenytoin
Furosemide
Heparin
Imipenem
IVIG
Lactated Ringers
Lipids
Magnesium Sulfate
Meropenem
Methylprednisolone
Normal Saline
Pentamidine
Piperacillin
Piperacillin/tazobactan
Ticarcillin/clavulanate
Tobramycin
Low Risk
Methods for risk determination adapted from Cincinnati Children’s Hospital.
Consult the Department of Pharmacy for further questions.
September 5, 2016
Recognize the differences between vesicant, nonvesicant,
and irritant solutions and medications. There
is no accepted scoring system for classification of
medications as a vesicant or irritant, leaving clinicians
to rely upon specific drug information, case
reports, and other published literature. Each facility
should reach a consensus on what medication is
considered to be a vesicant and irritant based on
their internal formularies.

10. Questions? Please contact:
Sophia Sterner
Molly Hufferd