What happens if you do an IV wrong?

September 27, 2025 •

4 min read

Intravenous (IV) therapy is a common medical procedure, with approximately 90% of hospitalized patients receiving a peripheral IV during their stay. However, improper IV administration can lead to serious complications and severe injuries, making it critical to understand what happens if you do an IV wrong.

Quick Summary

An improperly administered IV can cause various complications, from mild irritation to severe tissue damage and infection, depending on the error and the medication involved. Improper placement can lead to IV infiltration, where fluid leaks into surrounding tissue, or more dangerous extravasation with certain medications.

Key Points

IV Infiltration: This is a common error where non-irritating IV fluids leak into surrounding tissue, causing swelling, pain, and discomfort.
IV Extravasation: A more serious and dangerous complication, involving the leakage of chemically irritating vesicant drugs that can cause tissue burns and necrosis.
Nerve Damage: An incorrectly inserted IV can strike a nerve, leading to persistent pain, numbness, tingling, or even long-term disability.
Air Embolism: Although rare, air bubbles entering the bloodstream via the IV line can block blood flow and cause a stroke or heart attack, posing a life-threatening risk.
Compartment Syndrome: Severe, unaddressed extravasation can lead to a dangerous buildup of pressure that cuts off blood supply, requiring emergency surgery.
Infection: Unsterile technique or improper site care can introduce bacteria, leading to a site infection or systemic bloodstream infection.
Prompt Action is Key: For both patients and healthcare providers, immediate recognition of signs like swelling or pain and quick action can prevent minor complications from becoming severe.

Complications of Improper IV Placement

When an IV is inserted incorrectly or becomes dislodged, the intended fluid or medication can leak into the surrounding tissue instead of flowing into the bloodstream. This is known as IV infiltration, and it can cause a range of localized and systemic issues. For patients, this can result in pain, swelling, and a slowed or completely stopped infusion. For healthcare providers, recognizing and addressing these issues promptly is paramount to prevent more severe consequences. Negligence in monitoring IV sites can escalate a relatively minor issue into a serious medical event with lasting repercussions for the patient.

Infiltration vs. Extravasation

It is important to differentiate between two primary forms of fluid leakage that can occur when an IV is done wrong:

IV Infiltration: This is when a non-irritating intravenous fluid or medication leaks into the tissue surrounding the vein. The most common cause is the IV catheter either dislodging or puncturing through the wall of the vein.
IV Extravasation: This refers to the leakage of a vesicant medication, which is a substance that can cause severe tissue damage, including blistering and necrosis (tissue death). Examples include certain chemotherapy drugs and vasopressors. Extravasation is far more dangerous than infiltration and requires immediate intervention to mitigate serious harm.

Table: Comparison of Infiltration vs. Extravasation


Feature	IV Infiltration	IV Extravasation
Cause	Leakage of non-irritating fluid into tissue.	Leakage of a vesicant medication into tissue.
Symptoms	Swelling, cool skin, pain, tautness around site.	Pain, burning, blistering, tissue death (necrosis).
Severity	Ranges from mild to moderate, depending on duration.	Can be severe, potentially leading to permanent damage.
Risks	Minor swelling, bruising, and discomfort.	Severe scarring, permanent nerve damage, amputation.
Treatment	Remove IV, elevate limb, apply warm/cold compress.	Immediate removal of IV, specific neutralizing agents.

Serious Injuries from IV Errors

Beyond infiltration, other significant complications can arise from improper IV administration, leading to severe patient harm.

Nerve Damage

Direct nerve injury is a possible consequence if the IV needle is inserted incorrectly, too deeply, or in a compromised location. Symptoms of nerve damage can include paresthesia (a pins and needles sensation), persistent pain, numbness, or loss of function in the affected limb. Some nerve damage may be temporary, while more severe cases can result in permanent disability.

Air Embolism

A rare but life-threatening complication, an air embolism occurs when air enters the bloodstream through the IV line. This can happen if the line runs dry or air is not properly removed from the tubing before infusion. A significant air bubble can travel to the heart, lungs, or brain, blocking blood flow and potentially causing a heart attack, stroke, or death.

Compartment Syndrome

If severe infiltration or extravasation is left untreated, it can lead to compartment syndrome. This painful and dangerous condition involves a buildup of pressure within a muscle compartment, restricting blood flow and causing damage to nerves and muscle tissue. It is a medical emergency that may require a fasciotomy, a surgical procedure to relieve the pressure.

Infections

Poor aseptic technique during IV insertion or inadequate care of the IV site can introduce bacteria, leading to a localized infection (cellulitis) or a more serious bloodstream infection. Symptoms include warmth, redness, pus, and fever. Proper hygiene and sterile procedures are crucial for prevention.

What to Do If an IV Goes Wrong

Both patients and healthcare providers have roles to play in ensuring IV safety. Prompt action is key to mitigating harm when complications arise.

For Healthcare Providers

Assess the Site: Regularly check the IV site for signs of infiltration or extravasation, such as swelling, coolness, or pain.
Stop the Infusion: If complications are suspected, immediately stop the infusion to prevent further fluid leakage.
Remove the IV: Gently remove the IV catheter and apply pressure to the site to stop any bleeding.
Elevate the Limb: Elevate the affected arm or leg to help reduce swelling.
Notify a Physician: Report the incident to the prescribing physician and follow specific protocols, especially for vesicant extravasation.
Document: Accurately document the incident, including signs, symptoms, and actions taken.

For Patients and Caregivers

Speak Up: Do not hesitate to tell a nurse or doctor if you feel pain, burning, or discomfort at the IV site.
Monitor the Site: Pay attention to the IV site for any changes in appearance, like swelling or discoloration.
Call for Help: If you notice something is wrong, call for a nurse immediately. Early detection can prevent serious harm.

For more information on the standards of care expected in IV administration and patient safety, you can consult resources from professional organizations such as the Infusion Nurses Society, whose guidelines help ensure best practices in IV therapy nationwide. IV Administration: Risks, Risk Factors, and Prevention

Conclusion

While IV therapy is a routine and generally safe procedure, it is not without risks. Understanding what happens if you do an IV wrong is crucial for ensuring patient safety and promoting better health outcomes. By being aware of potential complications like infiltration, extravasation, and nerve damage, both healthcare professionals and patients can take proactive steps to prevent and address these issues promptly. This vigilance can prevent minor issues from escalating into serious, long-term health problems.

Frequently Asked Questions

The most common early signs that an IV is not properly placed include swelling, pain, a feeling of coolness or tightness at the insertion site, or if the IV flow rate slows down or stops completely.

Yes, if an IV is inserted improperly and directly hits or compresses a nerve, it can cause nerve damage that may result in permanent numbness, pain, or loss of function. Early identification and removal of the IV are critical to minimize the risk.

Infiltration involves the leakage of non-harmful fluid into surrounding tissue, causing swelling and discomfort. Extravasation is much more dangerous, involving the leakage of a vesicant or chemically irritating drug that can cause severe tissue damage, burns, and necrosis.

If you suspect your IV is wrong due to pain, swelling, or other unusual symptoms, you should immediately alert a nurse or healthcare provider. Do not try to adjust or remove the IV yourself, as this can cause further injury.

Air embolisms are rare but serious complications of IV therapy. They are typically preventable by ensuring proper technique, such as flushing all air from the IV line before starting and monitoring it carefully.

Yes, improper IV administration or prolonged use can lead to phlebitis (inflammation of the vein) and increase the risk of a blood clot forming at the insertion site. A serious deep vein thrombosis (DVT) is also a risk.

Initial treatment for IV infiltration involves stopping the infusion, removing the IV catheter, and elevating the affected limb. A warm or cold compress may also be used, though the specific type depends on the type of medication that was leaking.