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Noticed large swelling at the site of intravenous catheter. Should I be concerned?

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General & Family Physician
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I had an IV placed last night (has since been removed) and developed a large lump at the IV site. It is painful to touch and move my arm. Should I seek medical attention?
Posted Sun, 16 Dec 2012 in Skin Hair and Nails
Answered by Dr. Prasad 5 hours later

Thanks for the query.

Large swelling at the site of intravenous catheter/injection is concerning. The swelling could be the result of inflammatory fluid secondary to infection or collection of blood/body fluids (traumatic injury) or extravasation of intravenous drug that was administered through the catheter.

As you describe that the lump is large and is painful, it needs medical attention. Your doctors may order for subcutaneous wash and prescribe you anti-inflammatory drugs along with antibiotics.

In the interim, ice the affected area and apply topical antiinflammatory agents such as diclofenac creams.

Hope this answers your query. Let me know if you need further assistance.

Wish you a speedy recovery.

Above answer was peer-reviewed by
Follow-up: Noticed large swelling at the site of intravenous catheter. Should I be concerned? 5 minutes later
The lump has actually decreased in size and can now only be felt under the skin. The ER suggested that it was just a subcutaneous collection of blood -- is this possible? I didnt get any fluids pumped through the IV, just blood withdrawn.
Answered by Dr. Prasad 27 minutes later
That's assuring!!!!

Inflammatory fluids from an infection will not be absorbed this early and fluid extravasation is unlikely if there was no intravenous drug administration. That leaves us behind with only the collection of blood resulting from trauma as the cause of this swelling.

It now becomes a less sinister problem.

Subcutaneous blood over the due course of time will get resolved. Occasionally a bacterial contamination can result in worsening.

I would recommend you to continue icing the region and apply anti-inflammatory agents. You may also add oral analgesics such as Tab. Ibuprofen 400mg twice a day after food for 2-3 days to this above regimen. Watch the progress. Medical attention would be needed if there is increase in the size, becomes more tender, local rise of temperature or you develop fever.

Hope it's clear now... I will be available to answer you if you have any doubts/concerns.

Above answer was peer-reviewed by
Follow-up: Noticed large swelling at the site of intravenous catheter. Should I be concerned? 1 hour later
Thanks! I was worried about this being a potential blood clot traveling up to my lung -- is this unlikely?
Answered by Dr. Prasad 2 hours later
No, Extravascular blood clots (outside blood vessel) do not embolize. It gets resorbed in the due course of time. You may find some skin color changes during the process of resorption.

As I said in my previous reply, a small percentage of subcutaneous collection gets infected. This can be treated easily when detected early. Apart from that, it will not harm you. Chances of embolization and subsequent pulmonary vein thrombosis, XXXXXXX vein thrombosis, etc., are nil.

Hope you feel relaxed now. Feel free to write back if you have other concerns.
In case there are no more follow-ups, please close this discussion. Your reviews are appreciated.

Good luck!!!
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