IV start gone bad

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Specializes in acute care then Home health.

I was in pre-op starting an IV on a healthy 32 year old guy getting a knee replacement. He was in the gurney HOB elevated about 60 degrees. I asked him if he needed me to lay him down and he of course said no, even though he made it clear that he hated needles. As soon as I advanced my needle in the AC he started to say "I dont feel well, I dont feel well". I reasured him and told him to take deep breaths and it would be over in a minute. Then his eyes rolled in the back of his head and he started convulsing and gasping for air. I of course screamed for my charge and he snapped out of it seconds later and said "woah, I had a dream or something". What the heck was that? Does anyone know?

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I have had many such patients pass out on IV starts in pre-op. Only one ever had seizure like that and it was scary but she bounced right back and had her surgery. A lot of them vagal after their IV starts, I have had to give atropine only once or twice.

I usually put anyone who is afraid of needles flat for their sticks if I can, I don't ask if they want to . It is not uncommon for it to happen in male patient that age who has had little exposure to IVs etc.

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Specializes in MSP, Informatics.

had that once with a same day patient for a GB removal. She was nervouse, said she hated needles, etc... Had siezure like activity when I started her IV that lasted just a few seconds. then she woke up and was a bit dazed. They postponed her surgery--- fearing she would do the same with anestesia, or in recovery.... no Hx of siezures. but they wanted to do a full work up.

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Sometimes they feel like vomiting, so putting them flat will let them clear the airway away from your face. Get the IV in and they will feel better. On med surg, we kept an ammonia popper taped to the back of our name badge. In the event of a vagal episode, it can help. This wakes them up without any side effects. Prepare to have them push your hand away; that ammonia really stinks.

You probably need a procedure for it now.

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Specializes in Cardiac Telemetry, ED.

I've never experienced anything like that. I once saw a middle aged man turn a not so nice shade of grey when he got stuck, but that's about it.

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Specializes in Hospice, ER.

Had this happen once to a pt in the ER. Pt vagaled down and passed right out. Heart rate went down to 0 and she flatlined for a couple of seconds. It took about an hour before my heart rate went back down to normal. She was fine later on.

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Specializes in jack of all trades.

My son (now 22) still to this day has a delayed vasovagal response to any injection or blood draws. About 5-10min after he turns white as a ghost and out he goes. His breathing appears almost ceased when he does this. Scares the living heck out of not only me but the health care worker involved also. We warn them but it never fails lol. Even with my experience it still terrifies me to see my son go out like that. Took the pediatrician experiencing him go out one time from there on all injections at ER lol. Even on blood draws they have him lay down on a stretcher. Funny getting a tattoo he's fine, come at him with a needle for injection or blood draw he's down for the count.

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Specializes in home health, dialysis, others.

Many years ago, I was on an IV Team. The only pt whoever passed out on me was a young healthy male -a phys ed teacher, no less. I also had a friend - big, burly guy - who passed out after giving blood. Just recently, my own son, then 17, became completely ashen, broke out in a pouring sweat, after having blood drawn! He kept saying he didn't feel well! He knows to tell them next time to have him lay flat, keep something to revive him, before doing any procedures. I don't expect him to have any tatoos!!!!

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I started to vagal out onetime during an IV start. Everything strated to go black and I felt like vomitting and passing out. I strasted sweating and told the nurse to stop but she did not want to. I used the last of my strength to push her away before I passed out. It is the only time it has ever happened and I have had several IV's since then.

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Specializes in L&D, PACU.

Vasovagal response. Not as uncommon as I'd like...

Our Nurse Manager wants us to do all our IV starts with the patient lying down...because of that very thing.

Wikipedia's explanation of vasovagal isn't bad.

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Specializes in acute care then Home health.

Thanx. It really scared me. Ammonia popper is a good idea. Vagal response I get for passing out, but can it cause convulsions??? What do you guys think?

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Specializes in ER, education, mgmt.

The convulsion can be from the temporary lack of perfusion to the brain secondary to the bradycardia and hypotension associated with the vasovagal response. Saw it once as it happened after we suctioned some guy's trach. Said, "I don't feel so good."- passed out- verrrry long pause on monitor, and then it was over. Took the nursing student a while to recover though. hehe.

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