The Guide To Infusion Related Complications Septicemia In Hospice

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In this article, we will review the causes, signs and symptoms, intervention, and preventative measures of septicemia in hospice patients.

Septicemia Definition

Septicemia is the presence of bacteria in the blood (bacteremia) and is often associated with severe infections.

Causes

  • Poor aseptic technique during insertion or site care
  • Severe phlebitis
  • Poorly secure line which allows manipulation of catheter
  • Prolonged dwell time of catheter
  • Patient that is immunocompromised
  • Contaminated drug or fluid

Signs and Symptoms of Septicemia

  • Sudden onset of chills, fever, general malaise, and headache
  • Increased pulse and respirations as fever increases
  • Flushed face, backache, nausea, vomiting, and hypotension are possible
  • Symptoms become severe, with cyanosis, increased respirations, and hyperventilation if condition goes undetected or untreated
  • Vascular collapse, shock, and death as organisms overcome the system
  • Usually no visible signs of infection at IV site

Intervention

  • Notify physician immediately
  • Follow physician’s orders which may include removing catheter, blood cultures, and antibiotics
  • Hospitalization likely in most cases
  • Monitor vitals

Preventive Measures

  • Wash hands thoroughly before initiating infusion therapy or handling any part of the intravenous system
  • Check all solution for clarity, cracks, and presence of a vacuum
  • Cleanse site with antimicrobial agent (povidone-iodine, alcohol, or chlorhexidine)
  • Secure catheter to prevent in and out movement
  • Change dressing, tubing, and site per protocol
  • Use aseptic technique for all procedures
  • Change injection caps with each dressing change and after each blood draw

Reference

Core Curriculum for Infusion Nurses Edition 3; Lippincott Williams & Wilkins 2004 

 

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