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The Difference between Phlebitis and Infiltration

During medical emergencies, an intravenous line is mandatory in order to administer medications and fluids to reach a patient’s circulatory system immediately. This is very vital because it can save a person’s life. The cannulation procedure involves aseptically inserting a cannula into the skin, targeting the vein. The presence of “backflow” or blood oozing out of the cannula is an indication that it is inserted right into the vein. A line with an IV fluid is then inserted into the cannula, and flow is regulated as per physician’s order. The cannula should be properly secured and stabilized to prevent complications.

The procedure of cannulation can help in-patients in many ways. However there are some complications that may arise from this. The common complications are grouped in four categories, the following are:

  1. Infection

  2. Embolism

  3. Hematoma

  4. Infiltration

  5. Phlebitis

The first three complications, infection, embolism and hematoma are easily differentiated because they have unique characteristics. However, with the two latter – infiltration and phlebitis can be quite difficult to discern because they share the same signs and symptoms which, if you are not careful enough you might render the wrong treatment and make matters worse. To further understand the differences and the similarities between the two, read on.


Phlebitis is the inflammation of the vein. This is the most common IV therapy complication. Research shows that it occurs 20% to 80% among patients having this therapy. Older patients are more susceptible to phlebitis because of the decreased elasticity of the blood vessels due to aging. There are three possible types of phlebitis. These are the following:

  • Mechanical Phlebitis – inflammation caused by the cannula or the IV catheter

  • Chemical Phlebitis – inflammation caused by fluids or IV medications

  • Bacterial Phlebitis – inflammation caused by infection by a bacteria

Phlebitis is rated based on the following criteria

  1. No signs and symptoms

  2. Erythema with or without pain

  3. Erythema and/or edema, pain , no palpable cord

  4. Pain, erythema and/or edema,  palpable cord

  5. Pain, erythema and/or edema, palpable cord more than 1”, purulent discharge


Infiltration is another leading complication of IV therapy. This involves the leakage of IV fluids to the surrounding tissues. Take not that infiltration and extravasation may involved the leakage of fluids into the surrounding tissue but they differ. Infiltration is the escape of IV FLUID and extravasation involves the leaking of VESICANT FLUIDS.

Infiltration doesn’t usually causes harm not unless large amount of IV fluids enters the tissue and causes nerve compression or compartment syndrome, which can be harmful not unless prompt treatment is rendered. On the other hand, when extravasation occurs, even a little amount of vesicant fluid escaping from the vascular space can cause tissue damage, more so with large amount – it can result in blistering, burning of tissue and the like.

Phlebitis vs. Infiltration – The Comparison







  • Injury during IV insertion

  • Prolonged use of the IV site

  • Irritation

  • Adverse reaction to IV medications and fluids

  • The vein is too small for the IV flow rate

  • Incompatible or large needle for the vein size

  • Infection from bacteria

  • As mentioned, infiltration is caused when the cannula becomes dislodge from the vein or the vein is perforated and the IV fluids leaks or infused into the surrounding tissues.

Signs and Symptoms

  • Pain on the affected site

  • Redness

  • Vein on the affected site is sore, tender (cord like) and warm upon palpation

  • Possible signs of infections

  • Increasing edema

  • Patients complaints of feeling of tightness, discomfort, burning, pain on the site

  • Decreased temperature or cold upon palpation

  • Blanching at the affected site

  • No backflow of blood upon assessment

  • Decrease or no IV flow rate

A lot of these complications are very harmful to the patients and some are even detrimental. Prevention is always the best cure. However, if these complications are unavoidable, early detection and prompt intervention must be done. Failure to do so can cause permanent damage and even death.

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  1. This is a very clear and informative article. I am working on a PowerPoint presentation on PIV education for my hospital and would like permission to use pieces of your article. Please respond to the email address noted above.
    Thank you – Laurie Robinson

  2. hi!,I love your writing so a lot! percentage we communicate
    more about your post on AOL? I need an expert in this space to resolve
    my problem. May be that is you! Taking a look forward to look

  3. I received 50 mg of benadryl via iv for an allergic reaction and had infiltration. What can happen?

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