IV Shearing???

[Firewood, RN]

Hello,

Today I had a patient that I was placing an IV in. I got in, got a blood return and started to push the cannula in, but hit a valve. The needle was in the cannula but not all the way, so I pulled the cannula back over the needle and tried to maneuver it (Looking back I know that this is not appropriate practice...). Well I kind of freaked out and pulled the whole thing out of the patient. I immediately looked at the cannula and it did not appear sheared off; it was the same length as a normal one. I am still freaking out because I started thinking that maybe I scraped a sliver of the inner cannula out or cut of a miniscule amount at the end of the catheter or cut a slice off the end and didn't notice. I feel very guilty! Don't know what to do...

[MedSurgMama, BSN, RN]

“…and it did not appear sheared off; it was the same length as a normal one.” Based on what you’re describing, I don’t know what you mean. You said it did NOT appear to be sheared of, so what exactly was your concern? Do you think a piece of cannula broke off or the actual IV needle broke off? I would say you’re probably worrying over nothing, but then again freak accidents do happen. I highly doubt the end of the cannula tore off inside the vein. But if you ever have a serious concern like that, you should reach out to the physician or manager to get some guidance. If that did happen, it’s not like you intentionally did something wrong so you should never feel bad about trying to remedy the problem. It’s always better to let someone know as soon as something happens versus waiting. The physician could’ve ordered a veinous doppler to see if there was anything abnormal about the veins in the area of the IV attempt. I’ve been a nurse for 16 years. I do a lot of IVs. I’ve never seen an IV cannula or needle “shear”. 

[John Drapcho]

Thank you MedSurgMama for your thoughtful reply. As time has past I realize I was worrying over nothing as I often find stuff to obsess about. I have OCD (for real), and I generally find new things to worry about! It is frustrating for sure. Treated for OCD but I'm under stress as I started a new job and when I'm under stress the OCD flares up!