I DID notify my doctor but

[ZZTopRN, BSN, RN]

I could only reach the nurse.

I went for an endoscopy on Monday and an IV was started in my hand. It was very painful and a large hematoma came up. Ice was put on it and I did this the rest of the day and yesterday. When I called back, as instructed on my discharge sheet, it said call your doctor if you have any problems. This got me a nurse to say put ice on it and that was it. I don't even know if it was reported to the doctor.

I know you all out there have had iv experiences, but I have never had a problem like this starting one or ever had it happen to me before. Not asking for medical advice but wondering if you have experienced this kind of thing. Most of the swelling has gone down, this is the 3rd day, but I still have pain with it when flexing my fingers and wrist. Fentynal and Versed was used. I don't think these are vesicant drugs but I wanted to head off anything that might be developing and if I am still having pain, portions of redness, and the site is still hard, I will go to another doctor tomorrow.

Meantime, I'm just wondering if this is just a normal sequela of a hematoma from a bad iv start. I am pretty sure I have no nerve damage. I didn't get that "classical shock." But it was in our IV Cert that I learned that hematomas are the most common causes of lawsuits. I just don't want to wait too long to have it checked out if something might develop.

Anyway, my question, is this pretty normal for a hematoma on the hand?

Thanks for any of your observations.

[clee1]

Hi ZZ....

I had this happen to me, nearly exactly, 3x while in the military - being the "practice dummy" for new medics learning to start IVs.

In each case, it took almost 1 wk for the s/s to disappear.

[canoehead, BSN, RN]

After the first 24 hours use heat to facilitate reabsorption of the blood. I would expect it to start getting better, not worse, otherwise see your MD.

[SharonH, RN]

It may take several days or even a couple of weeks for this to go away. I have had an IV infiltrate and it took over a week for it to go away. I'm surprised to hear that hematomas are a cause of lawsuits. Unless they cause nerve damage due to compression or something like that, I can't imagine why someone would sue over that.

[EricJRN, MSN, RN]

I'm surprised to hear that hematomas are a cause of lawsuits. Unless they cause nerve damage due to compression or something like that, I can't imagine why someone would sue over that.

In infants, esp premies, a bad infilatration can lead to permanent scarring, the need for a plastic surgery consult, and decreased ROM in the affected extremity. If a vesicant is going, it can cause pretty severe tissue damage. I don't think it's actually the hematoma that leads to lawsuits, but the other consequences of infiltration.

[ZZTopRN, BSN, RN]

Hi Guys:

Thanks for the encouragement. It seems like it is slowly, slowly resolving.

I think the reason for the lawsuits as Sharon mentioned, are not just the hematomas. I think if there is nerve damage, extravagation and some kind of lasting disfigurement. So it is getting better but still looks funny. But in the IV Cert class, they said hematomas were #1. So I guess it is the aftermath. Again, thanks. Guess it's not terminal after all.

[TiffyRN, BSN, PhD]

You asked for other's personal experience. I also had endoscopy for which I received IV Versed and I think Demerol (gosh, we still give that!). The IV was started in my hand and it hurt from the moment the nurse put it in, but I knew it wasn't infiltrated because the pain went all the way up my arm. The Versed hurt like crazy (all the way up my arm) but within seconds I wasn't aware. The IV was out when my first memories start which was my husband trying to get me dressed (that was funny). That IV site and several inches above ached so much for weeks.

I think I learned to beg my IV's be started higher if possible because I guess I'm a sensitive type.

[ZZTopRN, BSN, RN]

Gosh, Tiffany RN:

I thought mine was bad. I can't imagine the Versed hurting you. Doesn't seem right to me. That seems strange. I have had to go about 8 times for endoscopy cautery for my "watermelon" stomach (GAVE, now under control). Through all of this I have never had any kind of discomfort until now. Thanks for replying. This topic is good because it reinforces your care when you do one yourself.

[PedsER-RN, BSN, RN]

i've let residents and nursing students practice on me before and even with a good stick i still develop a bruise (sometimes with swelling) that takes a week or two to go away. when i had surgery the bruise lasted about 3 weeks (and it was a clean stick). i've also seen rather large hematomas develop with blown iv's.

[P_RN, ADN, RN]

My floor had a patient get his entire stay "on the house" because he got a really bad phlebitis on his previous stay. The big problem was no one ever documented the site WHERE his IV was placed. It was one of those not written not done things.

I just had an endo. and had the same problem. My left hand is still swollen and tender and it's been 10 days. I think all I got was Versed and was semi aware that it hurt like all get out going in.

[Tweety, BSN, RN]

After the first 24 hours use heat to facilitate reabsorption of the blood. I would expect it to start getting better, not worse, otherwise see your MD.

That's what I was going to say. At this point in time you should be using heat, not ice.

Good luck.