Signs of Infection Under IV Dressing — Assessment Guide

PIVC site infection affects 0.1-4.5% of catheterized patients, but phlebitis occurs in 6-38% without proper monitoring. Early detection prevents systemic infection.

VIP Score — Standardized Assessment Tool

Key Visual Signs

• Erythema: Redness extending >=1cm beyond site along vein track
• Edema: Unilateral swelling at or above site vs contralateral limb
• Purulent discharge: Cloudy yellow/green discharge — definitive infection sign
• Moisture under dressing: Visible fluid, fogging — compromised sterile barrier
• Tracking: Red line along vein path — chemical thrombophlebitis

Patient Symptoms (May Precede Visual Signs)

• Pain or burning at insertion site — detects phlebitis 12-24h before visible signs
• Tenderness along vein path
• Fever or chills — possible bloodstream infection

Assessment Frequency (INS 2021)

• Adult acute care: every 4 hours
• Critically ill, sedated, pediatric: every 1-2 hours
• Long-term care: every shift minimum
• Immediately if patient reports pain or pump alarms

References: Jackson A. "Infection Control in Intravenous Care." BJN, 1998. Ray-Barruel G, et al. "International Prevalence of PIVC Failure." JHM, 2019. Gorski LA, et al. "INS Standards." 2021.