How do you know if you put an IV in an artery?

I have three years of nursing experience. Over the past 6 months I have been doing IV insertion. I still get anxiety about it. My patient insisted that I put the IV into her antecubital area. I felt a nice fat vein that was superficial. She said that is where they draw blood. I was in without any resistance. I put my transfer device on to draw blood and the blood flowed out so easily and fast. I think I felt a pulsation when drawing blood. I had my fingers above the sight. I thought I was just feeling the bracial artery that was close to the site. The patient had been on plavix. I usually make a mess when I draw blood when I put in an IV like I did this time.

The patient did not complain of any pain. Blood did not squirt. It looked the same color as always. I flushed it once and blood went back into the tubing to the point where I clamped it. I flushed it again and it was fine.

I asked my charge nurse to look at it and she said that it fine. She said that she felt a pulse beside it so she doesn't think I hit an artery. After I put the IV in, I felt the pulse proximal and a tiny bit to the left. I ran in saline through a pump with no complications. I gave her morphine IV and she immediately felt the effects.

How will I know if I ever put an IV in artery. Will there be pain?

Will the IV pump beep constantly beep due to the pressure. (The patient's systolic B/P was 143) This really has me worried.

I had the patient a couple of more hours and checked on her. The IV was fine with no pain. Good circulation and good radial artery.Please help!! I don't want to worry about this anymore.

[merlee]

Trust me, you will know - the blood will spurt across the room when you remove the stylet. And accessing an artery is somewhat more painful. You will not be able to run anything through the line without a pressure system.

Don't lose any sleep over this - arteries tend to be deep even though you can feel a pulse, they are not very easy to access.

[cjcsoon2bnp, MSN, RN, NP]

Jolie said:

You will see pulsation in the connecting piece of tubing.

Also, if you flush an arterial "IV" you will likely cause an arteriospasm, resulting in immediate blanching along the path of the artery and possible pain reported by the patient.

I've done it once (in a newborn) and it was very obvious.

I'm curious, when you did it to the newborn what exactly did you see after you inserted the IV? If you don't mind me asking, I work in a Peds. ED where this happened to a nurse I know and I want to avoid it ever happening to me if possible.

!Chris

[mama_d, BSN, RN]

I've had twice where I've accidentally accessed an artery...and it was ridiculously obvious every time. It's not unusual for me to make a mess by hitting a good fat vein...it is unusual to have the bright red blood spurt five feet across the room though! One of the times it didn't spurt as badly as the other, but when I drew back the syringe to check for blood return, it was the wrong color, which led me to just let go of the plunger. If the blood fills the syringe up on it's own, it's arterial. I actually called some of the newer nurses in to show them what it looks like since it happens so rarely.

[psu_213, BSN, RN]

In an AC vein, you will can get a very vigorous blood return using the access device (or when you remove the needle from the cath). I was once observing a nurse attempt to get an IV on a very tough stick (P.S., if you put it in the artery, it is not an IV, but I digress) and he hit an artery. You could tell because he hooked up the saline lock and with each pulse, blood would go up the line (with each pulse, blood would go another few mm up the line).

It would be very tough to access an artery. Either way, though, make sure you flush before you give any med through the line.

[nerdtonurse?, BSN, RN]

Over the years, you're going to hit arteries and bone by mistake. I worry more about someone getting a vein instead of an artery during an ABG...they pull back and the blood looks purple, you're either not in an artery, or your patient's about to be seriously deceased.