Blood color with IV starts

[Matt8700, RN, EMT-B]

Hello

Maybe someone can help me out here. I always have pts comment on thr color of their blood when starting an IV. some make a comment about how dark it is, others about how bright it is.

Now I obviously understand the difference between arterial vs venous blood and can assure you that the IV is in the venous system when it is started. However, I have noticed varying colors to blood myself when starting lines. Does anyone have more info on what constitutes the darkness or brightness of a patient's blood?

Thanks for the info!

[CIRQL8]

I have no citations for you on this, but perhaps some venous blood remains more oxygenated than others. Perhaps it's the lighting. Also, everyone is different and this could certainly include one's blood with color variations. Other factors can include the quantity of usable vs end of life cells at that particular point in time. A larger amount will also absorb more light than a smaller amount in the tube, or in the hub. A larger amount will appear darker due to that fact. And in the case of just a bit of blood in the tube or spilled from the hub - not all RBCs give up their oxygen supply before returning to the heart and lungs. It depends on what percent of the blood at that particular time in that particular place remains oxygenated. So many variables. Just tell them "everyone is different. We're all the same that way"

[icuRNmaggie, BSN, RN]

Dark venous blood indicates a high CO2. I have seen it almost black in color from a life threatening high CO2 in patients with respiratory acidosis.

Carbon monoxide poisoning causes a strange bright cherry red color. The color of a sick person's blood is a big clue as to what brought them in to the ED and should be mentioned to the MD. People have died of CO poisoning after being treated and released because they returned to the same dwelling where there is a CO leak.

This is great question.

[CIRQL8]

Dark venous blood indicates a high CO2. I have seen it almost black in color from a life threatening high CO2 in patients with respiratory acidosis.

Carbon monoxide poisoning causes a strange bright cherry red color. The color of a sick person's blood is a big clue as to what brought them in to the ED and should be mentioned to the MD. People have died of CO poisoning after being treated and released because they returned to the same dwelling where there is a CO leak.

This is great question.

Excellent points.

[Matt8700, RN, EMT-B]

Thanks for the replies! Does hydration status or electrolyte imbalances have anything to do with this? Also, would you expect a differing color with an anemic patient or one with decreased RBCs?

Hopefully that all makes sense!

[icuRNmaggie, BSN, RN]

A hemmorrhaging patient receiving fluid resuscitation will have thinner watery blood.

A liver failure patient's blood will have a bright yellow plasma from the high level of bilirubin in the blood.

I have seen hyperlipidemia that was so severe that the blood sample immediately separated into a layer of white lipids.

I don't believe that people with chronic anemia have any visible difference to their blood samples.

Abnormal electrolyte values are not visible in a blood tube, except for a very high CO2.

[Esme12, ASN, BSN, RN]

For the most part it is normal variant. Explain to the patient that blood "color" is as variant as skin tone.

Keep it simple.

[calivianya, BSN, RN]

I have seen hyperlipidemia that was so severe that the blood sample immediately separated into a layer of white lipids.

Now that's just gross! I have never seen that and I hope I never do!

[Lev, MSN, RN, NP]

Does being on coumadin or other blood thinners make blood brighter red?

[Graduatenurse14]

This is interesting stuff!! Thank you!!!

[icuRNmaggie, BSN, RN]

Does being on coumadin or other blood thinners make blood brighter red?

I have never noticed any visible difference in blood drawn from people who are anticoagulated.

[brownbook]

I'm so bad with colors. I had a 6 year old patient tell me the nurse call button was maroon not red! I'm just glad to see a good strong return in the flash back....never paid that much attention to exactly what color (shade of red) it was?