Blown Vein

[Angelasc]

I want to ask something over IV cannulation. If you've blown a vein, but you go over the breaking point and you get a good flashback and it no longer swells up... What would you do? Better to remove? Are you in the vein?

[Wuzzie]

Depends on what I'm using it for and where it blew. If it blew immediately on insertion and I was able to get the tip of the catheter well past AND it had a good return AND flushed well AND I wasn't giving a vesicant or blood product I would go ahead use it but would watch it closely. 

[Angelasc]

Thaaanks,! I  had given a new one. But good to know, if it happens again ?

[Tweety, BSN, RN]

I'm no expert but have 30 years experience and when I blow a vein I quit and pull it out then and there.  Are we supposed to keep trying and get past it?

[Wuzzie]

Tweety said:

I'm no expert but have 30 years experience and when I blow a vein I quit and pull it out then and there.  Are we supposed to keep trying and get past it?

Sometimes you don't have a choice. Plus with your 30 years you know there's blowing and then there's blowing. I certainly wouldn't advocate trying to get past a giant hematoma. 

[Tweety, BSN, RN]

Wuzzie said:

Sometimes you don't have a choice. Plus with your 30 years you know there's blowing and then there's blowing. I certainly wouldn't advocate trying to get past a giant hematoma. 

Fair enough and I can see in the scenario described above that it's a good IV and I would use it.   I do understand there's blowing and there's blowing.  Nine out of ten times I don't know I've blown until I flush and it's an obvious stop, but also if I see it blow I stop and don't try to get past it, maybe I should.

[Wuzzie]

Tweety said:

Nine out of ten times I don't know I've blown until I flush and it's an obvious stop, but also if I see it blow I stop and don't try to get past it, maybe I should.

I probably should clarify. If I fully seat an IV and flush and it's clearly blown at the terminus of the catheter then I do not try to make it work. However, we've all had the experience where you insert and get a tiny bruise at the insertion site but are able to reposition and get the tip of the catheter well-past the bruised area, have a positive blood return and there is no swelling or pain upon flushing. Although technically a "blow"  it really isn't a reason to pull the catheter and start over.