Thrombophlebitis

(Image by User:Mattes (Own work) [CC-BY-SA-3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons)

Thrombophlebitis or phlebitis is the inflammation of vein. It may occur due to thrombus (blood clot). These blood clots are formed because of injury or prolonged immobility. Here, I am going to write about the phlebitis related to improper insertion of IV cannula, its mechanism, treatment and preventive measures.

Inflammation of superficial veins is might be due to injury, for example, when one does not insert the IV cannula properly or attempts to insert the IV cannula 2-3 times, it may irritate the vein wall.  It causes profuse bleeding. Immediately after endothelial cell  injury, platelets are activated.This response initiates leukocyte rolling and forms blood clots, which stick into the wall of the vein. The formation of blood clots in the dermis layer called as thrombosis. It leads to inflammatory reaction. The combination of inflammation and thrombosis leads to thrombophlebitis. Signs are swelling, redness, warm and pain in touch.

About the resolution of inflammation,  a number of pro-inflammatory factors including IL-1Beta and Tumor Necrosis Factor and monocytes influx into the thrombus. It is denatured by the circulating enzymes and absorbed into the blood circulation. This phenomena is called as thrombolysis.The thrombophlebitis will be resolved within 2-7 days.

Treatment

• Elevate the affected area
• Apply warm moist pack for 15-20 minutes
• Apply Glycerin Magnesium Sulfate paste for relieving inflammation and pain
• Analgesics and anti inflammatory medications can be prescribed

Preventive measures

• Must change the IV cannula after 72 hours(3 days)
• While inserting IV line, if swelling appears, withdraw it immediately and compress the area with cotton for 5 minutes.
• After infusion of medication, flush the IV cannula with normal saline or Hep Flush (Heparin lock Flush Injection).
• Inspect the area for any signs of infection such as swelling, redness, warm and pain in touch. If there are any signs of infection, remove the IV cannula and opt another site for insertion.