bruise question

[smurfynursey]

Someone sent me this picture with the preface of "nurse fail". Supposedly its from a lab draw at a Drs office. There are multiple things that don't look "right" to me...I'm thinking it might be from someone using? To all my IV experts, what are your thoughts? I've had some pretty impressive bruises from labs/IV attempts, and they've never looked quite like this. The direction of the bruising doesn't look right, and like there had been 2 attempts in the same area?

I could be wrong...I haven't done PIVs since school.

Thoughts?

[itsnowornever, BSN, RN]

I see two attempts, one lateral and one medial. I asked hubby who has experience with users and because he can't see more he's slow to say user. He says it looks like someone grabbed the person in some attempt around the injection site. At a dr office? More like MA/phlebotomist fail instead of nurse though LOL

[damrcngrl95]

I have had a couple of sticks on me that looked pretty bad. I did have one that looked like that and she had stuck me twice. My mom was with me and I had to grab her and tell her to just come on before she caused a scene. Sometimes people just have a bad day.

[sKris]

I looked almost exactly like that after a failed blood draw in June. Six months later and my skin is still slightly discolored.

[PediLove2147, BSN, RN]

My friend had her blood drawn and it was worse than that! I wouldn't be too quick to jump to "user" just because there is a lot of bruising.

[eatmysoxRN, ASN, RN]

If you saw the bruises I get even when a stick goes well.... You'd probably change your tune. Bruises happen. I have had much worse when no digging was involved. When I was able to donate blood, I'd always end up with massive bruising that came with the territory. The phlebo wasn't subpar... I just bruise really easily. And although some days make me briefly consider drug usage, I am certainly not a user.

[smurfynursey]

Thanks for all your opinions/input. I didn't mean to judge...the bruising just didn't match up with what I was told, and in the absence of further knowledge about IV starts/lab draws, that is the conclusion I came to.

Thank for teaching me otherwise :)

[Anna Flaxis, BSN, RN]

Bruising can happen if someone is a hard stick (I see two attempts as well, so this could be the case), if someone is taking anti-platelet or anti-coagulation medications, or if not enough pressure is applied to the site after the needle is removed, allowing blood to leak from the vein into the tissues. I typically have the patient hold pressure, if they are capable, so I can tube up the blood/discard the used needle/fill out the lab slip/etc, so this would be a "patient fail" if that were the case.

And, as itsnowornever points out, it is more likely an MA/phlebotomist fail than a "nurse" fail.

[KelRN215, BSN, RN]

At a dr office? More like MA/phlebotomist fail instead of nurse though LOL

That was my thought too.

[SaoirseRN]

I am a very hard stick (which is likely why I am fabulous at IV starts, oh universe!) and the last blood draw I got ended up looking a lot like this. Different spot but very similarly bruised.