Phlebitis is inflammation of a vein. When a blood clot is causing the inflammation the term used is thrombophlebitis. This usually occurs in the legs, but does happen in the arms on occasion. Superficial phlebitis affects veins toward the skin surface.
With proper treatment this condition is rarely serious and heals rapidly. Deep vein thrombophlebitis occurs in the larger deep veins of the leg. Left untreated, the blood clots that form may break off and travel to the lungs. This very serious and potentially life-threatening condition is called pulmonary embolism.
Symptoms of superficial phlebitis
- Slow onset of a reddened area that may expand as the inflammation follows the path up the superficial vein.
- The reddened area and surrounding tissue may be warm or hot to the touch.
- Area may become tender, swollen and develop a hardened area.
- Itching in the area around the vein.
- Throbbing or burning sensation.
- When legs are lowered to the ground (such as when arising in the morning from bed); symptoms may worsen.
- Low grade fever
- Skin may breakdown and burst open, especially if infection is present.
Symptoms of deep vein thrombophlebitis
- Signs and symptoms may be similar to superficial phlebitis.
- Some people may exhibit no symptoms at all.
- The classic signs and symptoms include redness, warmth, swelling, and pain in the leg.
- Pain and swelling throughout the affected limb.
Causes of phlebitis:
- Phlebitis can occur as a result of a medical procedure or on its own.
- Long periods of inactivity. When a person sits or reclines for long periods of time; blood can pool and clot. Long trips in a car or bed rest after surgery or illness are examples of this.
- Obesity and smoking contribute to phlebitis by obstructing blood flow through the veins.
- Hormone replacement and birth control pills increase blood clot risk. Thrombophlebitis can occur when blood clots are present.
- Varicose veins and pregnancy increase phlebitis risk.
- Trauma or injury with bruising or bleeding may allow a clot to form.
- Medical conditions can increase the clotting potential of the blood. Some conditions that can lead to phlebitis are cancer, blood disorders and connective tissue diseases.
Diagnosing the patient who presents with phlebitis symptoms is done through ultrasound and blood test. When a clot begins to disintegrate it releases a chemical. A blood test will show if the chemical (and a blood clot) are present. A false positive may occur if the patient has had a recent bruise or surgery. An ultrasound probe held against the skin can help detect a blood clot, it’s size and location. You can help prevent phlebitis by avoiding long periods of inactivity, getting enough exercise, smoking cessation, and weight loss if needed. If a healthy person shows superficial phlebitis on evaluation; medical treatment includes:
- Anti-inflammatory medications
- Compression stockings on the legs
- Elevate the affected extremity and apply warm compresses
- Rare cases may require antibiotics
For the patient with a history of deep vein thrombosis, or if there is risk the phlebitis may spread to the deep veins; the following treatments may be added to the above care plan:
- Blood Thinners
- For signs of infection, the patient will need antibiotics.
Focusing on prevention is the best approach to phlebitis if possible.