Will her hands fall off one day?????

[AlisonBSN]

My patient asked me something today that I didn't quite know how to answer, and I was wondering how you all answer those off-the-wall human body trivia questions that everyone likes to ask nurses.

This may not be so off-the-wall, but here goes:

I was drawing blood from the hand of a patient, and she was showing me all the places where she'd been stuck before and the veins had blown. She said that she once had a really big vein in the middle of her hand, but it hasn't come back since it was blown in October. (I suppose she's not exaggerating.) She asked if she's losing circulation to her hands because we keep blowing her veins, and mentioned that she doesn't want to lose her hands. (She then made the non-joking comment that she uses her hands a lot, and I almost laughed because...Who doesn't?) Anyways, this lady is a little cooky, but assuming that she did have a collapsed vein, how does that affect blood flow? When she asked I told her I'd never heard of anyone losing their hands from too many IVs or needlesticks, and I mentioned something about collateral circulation, but was I right? Will that vein that she "lost" grow back one day? And...Should I know this?

[TazziRN, RN]

I've never heard of a vein being lost, but you're right about collateral circ. I had a vein that was no good for pokes after some idjit shoved full-strength Phenergan into my IV port for a couple of years, but that resolved slowly and it's fine now. With serious venous necrosis it is possible to lose a hand because of loss of circ, but it would have to be pretty bad.