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  • Phlebitis Score: Early Stage of Phlebitis Resite Cannula

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    Nurses are instructed to check intravenous access devices every shift for signs of infusion phlebitis and document any scores or actions taken. The poster provides a phlebitis scoring system from 0 to 5, with higher scores indicating more severe symptoms such as pain, redness, swelling, and palpable venous cord. Scores of 2 or higher recommend resiting the cannula, while scores of 4 or 5 also recommend considering or initiating treatment.

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    Nurses are instructed to check intravenous access devices every shift for signs of infusion phlebitis and document any scores or actions taken. The poster provides a phlebitis scoring system from 0 to 5, with higher scores indicating more severe symptoms such as pain, redness, swelling, and palpable venous cord. Scores of 2 or higher recommend resiting the cannula, while scores of 4 or 5 also recommend considering or initiating treatment.

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    167 views1 page

    Phlebitis Score: Early Stage of Phlebitis Resite Cannula

    Uploaded by

    elisa
    Nurses are instructed to check intravenous access devices every shift for signs of infusion phlebitis and document any scores or actions taken. The poster provides a phlebitis scoring system from 0 to 5, with higher scores indicating more severe symptoms such as pain, redness, swelling, and palpable venous cord. Scores of 2 or higher recommend resiting the cannula, while scores of 4 or 5 also recommend considering or initiating treatment.

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    A3 PHLEBITIS SCORE POSTER 21174 22/8/06 15:02 Page 1

    Phlebitis Score

    All patients with an intravenous access device should The cannula site must also be observed:
    have the IV site checked every shift for signs of infusion • When bolus injections are administered
    phlebitis. The subsequent score and action(s) taken (if • IV flow rates are checked or altered
    any) must be documented on the cannula record form.
    • When solution containers are changed

    0
    No signs of phlebitis
    IV site appears healthy
    OBSERVE CANNULA

    1
    One of the following signs is evident: Possibly first signs of phlebitis
    • Slight pain near IV site OR
    • Slight redness near IV site OBSERVE CANNULA

    TWO of the following are evident:

    2
    • Pain at IV site Early stage of phlebitis
    • Redness RESITE CANNULA
    • Swelling

    ALL of the following signs are evident: Medium stage of phlebitis


    • Pain along path of cannula
    • Redness around site
    • Swelling
    3 RESITE CANNULA
    CONSIDER TREATMENT

    ALL of the following signs are evident and extensive: Advanced stage of phlebitis

    4
    • Pain along path of cannula or the start of thrombophlebitis
    • Redness around site
    • Swelling RESITE CANNULA
    • Palpable venous cord CONSIDER TREATMENT
    ALL of the following signs are evident and extensive:
    • Pain along path of cannula Advanced stage thrombophlebitis
    • Redness around site
    • Swelling
    • Palpable venous cord
    • Pyrexia
    5 INITIATE TREATMENT
    RESITE CANNULA

    With permission from Andrew Jackson – Consultant Nurse,


    Intravenous Therapy & Care, The Rotherham NHS Foundation Trust
    (Adapted from Jackson, 1998)

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