HELP !!! ! accidental arterial stick

Nurses General Nursing

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I am in a panic overhere....

RN 1yr now, work in a VERY BUSY ER.

Last night, needed blds & iv line on pt (obese)

Left arm option only (rt arm shunt)

AC not an option (badly scarred, keloids etc..)

Can't feel/find anything on forearm or hand, but I feel (what I thought was nice vein) on radial area.

OK, so I stick w/a 20g & rcvd. an immed. flashback. Started to think I might have hit an artery by the color, but thought "no way could this be an artery so close to the surface" & continued to fill my tubes & secure iv lock.

(Shoot, i should have realized by the mess I made & the pt's pain reaction!)

NOW I see pulsating in line, I'm quietly freaking out inside & bring dr. over & YEP....it's an artery!!!!

I remove & apply pressure apprx 5min.

Now I ask you......anyone....what, if any, damage I may have done?

I have started sooo many lines & have never come across an artery so close the surface.

(By the way, dr went for an left EJ & it blew, so no iv lock.)

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First let me say I AM NOT A NURSE. This is from my experience and thinking from that. I am thinking there was no real damage, I mean I have had an arterial line in the past so it does get stuck from time to time.

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Specializes in CVICU.

Meh.

Next time make sure you don't need an ABG before you pull it out. ;-)

Probably didn't cause any more damage than an intentional arterial stick does. The important thing is you realized your mistake and fixed it immediately! Especially - before infusing drugs. Eek!

Chalk it up as one of those things you'll never mess up on again! In a few weeks you'll chuckle when you think about it.

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I would think that as long as you held pressure until bleeding stopped, made sure circulation was still intact and made the doctor aware/documented, no real harm was done. In our ED, the radial artery is usually the first place RT sticks for ABGs and we do those all the time.

I wouldnt worry about it...

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Also....I did flush it w/10cc NS, is this a problem?

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Specializes in med-surg, telemetry,geriatrics.

Honestly, I have never heard or seen anyone place an IV in a radial artery. Myself, I stick veins I know are anatomically correct to start an IV in, and never have seen a radial vein. However, doc's art stick patients regularly to obtain emergency labs( in the case that the nurse was unable to get them with a normal venipuncture) or blood gases and cause no harm other than the intense pain it causes. FYI, in obese patients look at the proximal end of their arms sometimes you will find a vein available in a crunch. I consider myself to be good at IV starts but I still get nervous when I see a 300 plus pound renal patient that states " I'm a very hard stick" I feel for ya.

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OK, I may be incorrect in stating "Radial".

What I mean is site above the thumb area & I HAVE had iv sites in this area.

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Specializes in med-surg, telemetry,geriatrics.

In any case, chalk it up to a learning experience. Unless they did not have good perfusion from the ulnar artery, which if they didn't the doc was aware and I'm sure thats not the case, its really no biggie. Really its kinna funny! I had to LOL, don't sweat the small stuff. RT and nurses art stick all the time they check for allen's sign, if perfusion is good no need to worry

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Specializes in med-surg, telemetry,geriatrics.

BTW, next time you are palpating veins to start a IV, check for a pulse first! LOL just kidding I couldn't resist myself.:D:D:D:D

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Specializes in ICU.
Also....I did flush it w/10cc NS is this a problem?[/quote']

Nope, having an Arterial line there is always the slow infusion of pressurized tubing which delivers 3cc/hr of saline.

So flushing an artery with saline does no damage, remember saline is isotonic.

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Specializes in NICU.

I did this once on a superficial brachial artery. Thought I was sticking the AC.... When I saw pulsating in the line I knew what i did.. I pulled it out, held pressure, no harm was done.

BUT one time I D/C'd an IV when a pt was being discharged and I swear to you that thing was in the artery! when I looked to see if it had stopped bleeding blood shot up about 6 inches in the air!!!! It had been in her arm the whole admission. She was fine by the way... Just held pressure for a while. I was just an extern then so I don't know what the doc said about it (I told the primary RN who talked to the doc).

Tiger

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Specializes in EMS, ER, GI, PCU/Telemetry.

ive done this before myself when i was working EMS but in the brachial artery on a very obese renal patient. when i hung her fluids with a pressure bag i noticed my line was still backing up and sure enough i was in an artery so i removed i right away and went for the ankle instead. but like the PP said, saline is isotonic and is not going to be anything to worry about. i wouldnt worry about it :)

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