Bedside Decision Aid · Interactive Tool

Interactive IV Site Symptom Checker: Infiltration vs. Extravasation

A clinical decision support tool allowing patients, caregivers, and bedside nurses to evaluate localized IV symptoms, determine risk severity, and take immediate action.

Clinical Peer Review: Arthur Vance, MD, FACP Published: October 2026 Verified Board Member →

1. Interactive IV Site Diagnostic Calculator

Select the options below that match what you or your patient is experiencing at the IV or catheter insertion site:

Interactive Decision Aid

Infiltration vs. Extravasation Bedside Differential Diagnostic Tool

INS 2024 Algorithm
1. Sensation at IV / Infusion Site:
2. Measurable Edema (Swelling) Diameter:
3. Skin Temperature & Surface Color:
4. Solution / Medication Being Infused:
Clinical Diagnostic Assessment:

Normal / Minimal Infiltration (Grade 0)

Grade 0 · Routine

No acute extravasation or significant infiltration observed. Continue routine monitoring per unit protocol every 1 to 2 hours.

Bedside Action: Inspect insertion site, confirm brisk blood return, verify gravity drip or pump pressure baseline.

2. Clinical Comparison: Infiltration vs. Extravasation vs. Phlebitis

Understanding the clinical differential diagnosis helps patients and providers identify complications early:

TABLE 1: COMPLICATIONS DIFFERENTIAL DIAGNOSIS MATRIX
Physical Signs · Immediate Actions
Clinical Feature Infiltration (Non-Vesicant) Extravasation (Vesicant) Phlebitis (Inflammation) Catheter-Site Infection
Skin Temperature Cool / Cold to touch Cool or normal; may progress to burning heat Warm / Hot to touch Warm / Hot to touch
Skin Color Blanched / Pale / Translucent Pale initially; progresses to redness, blistering Red streak along vein path Erythematous halo (>1 cm around site)
Pain Sensation Discomfort, tightness, feeling of fullness Severe burning, stinging, intense ache Tenderness, aching along vein course Localized tenderness, throbbing
Swelling Morphology Diffuse edema extending from insertion Edema, hardening, blistering, sloughing Slight edema; vein feels cord-like Purulent drainage, fluctuance
Immediate Action Stop infusion; elevate limb; warm/cold compress STOP INFUSION IMMEDIATELY; aspirate; notify doctor for antidote Discontinue IV; apply warm moist compress Culture exudate; remove catheter; notify MD

Evidence Base & Literature Citations

  1. Hadaway L. Infiltration and extravasation: Prevention, detection, and intervention. Am J Nurs. 2007;107(8):64-72. DOI: 10.1097/01.NAJ.0000282299.03441.c7
  2. Infusion Nurses Society. Infusion Therapy Standards of Practice, 9th Edition. J Infus Nurs. 2024;47(1S):S1-S228. DOI: 10.1097/NAN.0000000000000532

Clinical Practice Boundary Notice

This protocol provides evidence-based guidance reflecting INS 2024 Standards of Practice and CDC recommendations. Clinical judgment, institutional policy, and patient-specific variables must guide individualized bedside care.