Fear of nerve damage during blood draws

[tmb79]

Hi all, I'm new to this site. I am seeking some advice. I've been drawing blood on my job for about a year now, and have developed a fear of hitting a nerve during venipuncture. It's probably my own fault because I googled a lot of info about it, and got myself scared. I love what I do. I just dont want to hurt a patient in the process. Is it very common to hit a nerve during venipuncture? Is there any thing I can do to prevent this from happening? Any advice would be greatly appreciated. Thanks!

[Okami_CCRN, BSN, RN]

I've been drawing blood for about seven years and have not hit a nerve (that I know of). Nerves are usually deeper than the superficial veins from which you are drawing blood.

Unless you jam the needle down at a 90 degree angle I think you will be alright.

[CarryThatWeight, BSN]

I am fairly certain my nurse hit a nerve during an attempted IV start when I had surgery last year. I felt immediate, sharp, burning pain down into my thumb--much worse pain than should be had with an IV. She didn't get the vein, and I told her I couldn't hang with the pain even if she was able to get it, so she took it out and another IV was started in my other arm. Months later, anytime I run my hand over that IV site, like while washing up in the shower, I feel tingling in that thumb. Really weird, but it does seem to be fading over time. The moral of the story? People heal, and I don't think it will be a huge deal if you do hit a nerve. Simply take the needle out and start again in another spot, and try to relax!

[IVRUS, BSN, RN]

It can be a HUGE deal. Nurses performing IV therapy worry about this constantly as nerve damage can occur anywhere while performing therapy, or doing a phlebotomy. Some areas like the underside of the wrist, or median antebrachial veins, have a greater potential to have this occurance than say the accessory cephalic vein. The nerves of the brachial plexus are plentiful in this area. One sign of nerve contact is what another poster wrote " an immediate, sharp pain." This pain can become progressively worse and lead to Causalgia or RSD... both are chronic conditions causing debillitation.

Do not take it lightly, but rather know normal anatomy, and never do a "Blind Probe". One MUST be able to palpate a vein, even though you may not see it... Not being able to palpate it, but rather saying... "Gosh darn, It's in there some place," can lead to this occurring.

[CarryThatWeight, BSN]

It can be a HUGE deal. Nurses performing IV therapy worry about this constantly as nerve damage can occur anywhere while performing therapy, or doing a phlebotomy. Some areas like the underside of the wrist, or median antebrachial veins, have a greater potential to have this occurance than say the accessory cephalic vein. The nerves of the brachial plexus are plentiful in this area. One sign of nerve contact is what another poster wrote " an immediate, sharp pain." This pain can become progressively worse and lead to Causalgia or RSD... both are chronic conditions causing debillitation.

Do not take it lightly, but rather know normal anatomy, and never do a "Blind Probe". One MUST be able to palpate a vein, even though you may not see it... Not being able to palpate it, but rather saying... "Gosh darn, It's in there some place," can lead to this occurring.

I suppose I shouldn't say it's not a huge deal. I completely agree with the above. Obviously, there are certain sites that are not generally appropriate for IV's. And never poke blindly, absolutely! I do think, however, that hitting a nerve isn't too common an occurrence, because in six years of phlebotomy with some pretty huge needles, it never happened to me. And my botched IV site hurt like heck but it's all healed now :-)