Newbie Question about "Blown Veins"

[jsinr]

Forgive me for asking such a basic question, but I am a new nurse and cannot find an answer anywhere. Seriously I have checked all my textbooks and online for an answer.

What exactly does it mean to "blow a vein"? What exactly is going on with the vessel? How whould I know that I blew a vein? What are the complications of a blown vein? How can I prevent blowing a vein when performing veinapuncture?

Thanks!

[Tweety, BSN, RN]

"Blowing a vein" is a term we use primarily when we're starting IV's. "It took me two tries, the first time I blew a vein". You've puctured the venous wall not only with your initial puncture but at another site. Sometimes you can tell immediately as the blood leaves the vein swelling and discoloration occur. Sometimes you don't know until you flush the IV with normal saline and the site swells. Swelling is what you look for.

Look up "infiltration" and "extravasation" in your textbooks.

[Spidey's mom, ADN, BSN, RN]

Tweety said:

"Blowing a vein" is a term we use primarily when we're starting IV's. "It took me two tries, the first time I blew a vein". You've puctured the venous wall not only with your initial puncture but at another site. Sometimes you can tell immediately as the blood leaves the vein swelling and discoloration occur. Sometimes you don't know until you flush the IV with normal saline and the site swells. Swelling is what you look for.

Look up "infiltration" and "extravasation" in your textbooks.

(Did you ever think about becoming a teacher?)

steph

[Tweety, BSN, RN]

stevielynn said:

(Did you ever think about becoming a teacher?)

steph ?

Don't you need a BSN for that?

[Binkey, BSN]

Dear JSINR,

"Blowing" a vein can occur from several things...

1. Using too large of an IV catheter. INS standards say that one should always use the smallest gauge and length IV catheter possible for the prescribed therapy.

2. Your angle of insertion is importnat as well. The elderly population have had many age related changes with their skin and blood vessels. Because their vessels are more superficial (secondary to loss of SQ tissue) you may need to insert your device at a very shallow 5-10 degree angle.

3. In addition, once you've gained successful enry into your vessel and you've advanced your catheter's hub to insertion, release your tourniquet.

You also should pay attention to how tight your tourniquet is on the pt.

Elderly pt's usually require light tourniquet application to keep from blowing the vein.

Hope this helps...

jsinr said:

Forgive me for asking such a basic question, but I am a new nurse and cannot find an answer anywhere. Seriously I have checked all my textbooks and online for an answer.

What exactly does it mean to "blow a vein"? What exactly is going on with the vessel? How whould I know that I blew a vein? What are the complications of a blown vein? How can I prevent blowing a vein when performing veinapuncture?

Thanks!

[chattypattyCRNA2B]

Tweety said:

Don't you need a BSN for that?

I love your modesty. ?

[Tweety, BSN, RN]

chattypattyCRNA2B said:

I love your modesty.:)

:rotfl:

[mandrews]

Binkey said:

Dear JSINR,

once you've gained successful enry into your vessel and you've advanced your catheter's hub to insertion, release your tourniquet.

You also should pay attention to how tight your tourniquet is on the pt.

Elderly pt's usually require light tourniquet application to keep from blowing the vein.

Hope this helps...

Good info Binkey as a new nurse I find IV's frustrating, and I am not getting alot of practice on my floor.

One thing that I noticed is after I get the flashback if i advance just a little further I don't blow the vein as if I do not. Does anyone else find this to be the case?

[Binkey, BSN]

Melissa,

Yes, It is good to advance your IV catheters a mm or so more after you've gained successful entry into the vein as your needle protrudes further out than your catheter, so when you get a flashback your needle may be in the tunica intima, but your catheter may not be. It is a good idea, however, to lower your angle once you've achieved successful entry so you don't advance through the opposite wall of the vein.

Best wishes in your Nursing Journey! :blushkiss

[enfermeraSG]

mandrews said:

Good info Binkey as a new nurse I find IV's frustrating, and I am not getting alot of practice on my floor.

One thing that I noticed is after I get the flashback if i advance just a little further I don't blow the vein as if I do not. Does anyone else find this to be the case?

Melissa, are you saying that you have better luck if you advance a little further after flashback? If so, then that is absolutely what is minimizing your chances of blowing that IV. The reason is because when you initially see flashback it doesn't mean that the entire tip of the angiocath needle has entered the vein yet. You have to advance it a touch further so that the entire tip/bevel is inside the vein. Otherwise, when you advance the catheter itself - it does not have enough needle in the vein to guide it in. SG

[mandrews]

enfermeraSG said:

Melissa, are you saying that you have better luck if you advance a little further after flashback? If so, then that is absolutely what is minimizing your chances of blowing that IV. The reason is because when you initially see flashback it doesn't mean that the entire tip of the angiocath needle has entered the vein yet. You have to advance it a touch further so that the entire tip/bevel is inside the vein. Otherwise, when you advance the catheter itself - it does not have enough needle in the vein to guide it in. SG

EXACTLY!!! Unfortunately it took several attempts before my preceptor said, "Hey I think you would have better luck if you advanced just a hair further."

melissa

[mandrews]

I forgot to add that on my sweet little fragile elderly people sometimes it blows with a tourniquet but seems to be better to not use a tourniquet at all.