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What Causes Deep Venous Thrombosis After Intravenous Line Insertion?

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Posted on Mon, 13 Apr 2015
Question: My wife was discharged from a 2 week hospital stay on Thursday, March 12. She was there for a septic UTI and infected PICC line, both uccessfully streated with antibiotics for 10 days of IV administered cipro and vancomycin after culter of the infections. She has type 2 diabetic; normal pressure hydrocephalus with a VP shunt which is functioning well; a 15 year history of NPH associated very serious UTIs; a supra pubic catheter which she has had for seven (7) years, changed last Friday, 2 days ago; and with a wide range of drug allergies. All her vitals are good (98 gluc; 110/84; 84 pulse; 97.6 temp; 96% O2); and her urine output was 1200cc, clear, lite yellow for the last 24 hours, no visible sediment. She was started on Xarelto 4 days before leaving the hospital and is continuing it now. Because of the nature of her veins --I am told they are small, roll, and generally not good-- and the nature of the antibiotics she was on it was necessary to restart the IV numerous times during the 10 days of the cipro / vanc treatment. Many of these IV sites showed some varying degrees of swelling and redness during the treatment but soon reverted to normal once the site was changed/closed. One of the last IV sites, however, has stayed red and swollen and has continued so since leaving the hospital, worsening somewhat, but not drastically. It is now more swollen, red, has a hard center, and is very tender to the touch. About an hour ago I elevated the arm and used a cold compress for about 15 minutes. It has not yet improved, but has not visibly worsened. It is still elevated, and I plan to use the cold compress again in the next hour. Before I do so I wanted to be sure I was doing the right thing and that I didn't need to take her to the ER.
Should I continue the elevation / compress procedures; change to something else; take her to ER for evaluation?
doctor
Answered by Dr. Dr. Praveen Tayal (2 hours later)
Brief Answer:
You are doing the right thing.

Detailed Answer:
Hello,
Thanks for posting your query.
From your description it seems that she has developed superficial thrombophlebitis as a result of the i.v. line inserted. It is inflammation of the superficial veins of the arm. For relief of symptoms, you can follow some simple measures like-
* Apply moist heat to reduce inflammation and pain
* Keep pressure off of the area to reduce pain and decrease the risk of further damage
* Raise the affected area to reduce swelling.
She can have mild pain killers like acetaminophen for pain and inflammation. Applying thrombophob ointment locally will also help to reduce the swelling.
If she develops fever, intense pain or the swelling spreads further proximally then it indicates infection and spreading of the venous clot in which case you need to consult a physician immediately.

I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Praveen Tayal (2 hours later)
Thanks for your reply. I'll let you know if there art further questions.
doctor
Answered by Dr. Dr. Praveen Tayal (1 hour later)
Brief Answer:
You are welcome.

Detailed Answer:
Hello.
Thank you.
I am happy I could help.
Please do recommend our services to others too in case you found them helpful. For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal
Wishing you the best in whatever you do.
Best regards.
Note: For further follow-up it is advisable to consult an emergency medicine specialist. Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Dr. Praveen Tayal

Orthopaedic Surgeon

Practicing since :1994

Answered : 12315 Questions

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What Causes Deep Venous Thrombosis After Intravenous Line Insertion?

Brief Answer: You are doing the right thing. Detailed Answer: Hello, Thanks for posting your query. From your description it seems that she has developed superficial thrombophlebitis as a result of the i.v. line inserted. It is inflammation of the superficial veins of the arm. For relief of symptoms, you can follow some simple measures like- * Apply moist heat to reduce inflammation and pain * Keep pressure off of the area to reduce pain and decrease the risk of further damage * Raise the affected area to reduce swelling. She can have mild pain killers like acetaminophen for pain and inflammation. Applying thrombophob ointment locally will also help to reduce the swelling. If she develops fever, intense pain or the swelling spreads further proximally then it indicates infection and spreading of the venous clot in which case you need to consult a physician immediately. I hope this answers your query. In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out. Wishing you good health. Regards. Dr. Praveen Tayal. For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal