Detecting an infiltrated intravenous catheter using indigo carmine: a novel method

An extravasated IV catheter may have serious clinical consequences. These include the inability to circulate emergency medications, cause pain on injection, infection at the site, and tissue damage. Clinical signs such as swelling, redness, and pain with injection are valuable, but may not be helpful in the presence of obesity, edema, or in a tracheally intubated and sedated patient. Here we describe a case illustrating a novel approach in which we used an IV dye injection (indigo carmine) to detect a correctly placed and then an extravasated IV. The ability to see visible flow of IV dye intravascularly helped confirm the correct placement. The technique we describe is quick, safe, and inexpensive.