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"Rolling veins" can be a pain—literally—for the patient and the phlebotomist or the registered nurse trying to get a blood sample or start an IV. Medical professionals sometimes use the term "rolling veins" to describe those veins that seem to move or roll away every time a needle gets close to them. This article will discuss a few techniques to help you be successful with venipuncture and starting peripheral intravenous lines for IV therapy.
Table of Contents
What are Rolling Veins?Sometimes veins roll because the surrounding tissue is not strong enough to hold it in place, and an inexperienced nurse or phlebotomist doesn't know how to anchor the vein properly. The elderly often have fragile, thin skin with minimal collagen to hold the veins in place. Collagen is a protein that provides strength and structure to your skin. It's what makes younger people have that plump, fresh, smooth-looking skin. For older adults, a lack of this strength and support under the skin will result in the vein slipping away from the phlebotomist every time the needle gets close to the vein wall.
How do Rolling Veins Happen?
Try to imagine a piece of cooked spaghetti lying under a sheet of plastic wrap. If you try to insert a needle through that plastic to puncture the side of the noodle, it will slip away from you. Now imagine gently pressing down on the noodle from above and below, where you stick it to hold it in place. If you can anchor the noodle, you'll have better luck puncturing the side. The same process will help keep a vein still. With a little bit of practice and a few tips, you can successfully access even the most slippery veins.
Risk Factors
Sometimes there is no known reason for patients who have these rolling veins. Often patients will say they have rolling veins because healthcare professionals have told them after multiple unsuccessful attempts that their veins roll. It's a good practice always to ask your patient if they have been a difficult stick in the past and if they have a vein you should avoid.
Sometimes patients have risk factors that make rolling veins more common:
Tips for Dealing with Rolling VeinsWith a few simple steps, you can be more successful with IV starts, and blood draws. Try these tips with your next attempt.
Rolling Veins vs. Blown Veins vs. Collapsed VeinsBlown veins occur when the needle punctures through the vein wall, and blood leaks out from the hole made in the vein. Sometimes, the walls of the veins are so fragile that as soon as the vein is punctured, blood leaks around the needle and appears to blow up. This occurrence makes the vein useless for a blood draw or IV insertions. A collapsed vein will sometimes occur when you put too much pressure on it, blood flow stops in that area, and the vein walls collapse. Nurses can resolve it by releasing the pressure on the vein or releasing the tourniquet.
SummaryVenipuncture and IV insertion are skills that take practice and experience. It's a good idea to practice on patients with good veins and save the "hard sticks" for after you've improved your skills. Be sure not to stick with your patients more than once or twice. If you miss the first one, getting someone you know is a good stick to try the next time. There will always be another patient you can practice on. Your confidence has a lot to do with your success; the more you miss, the less confidence you will have. Learning how venipuncture works and how veins react to it can be a significant first step in accessing even the most difficult veins.
STAFF NOTE: Original Community Post
This article was created in response to a community post. The comments and responses have been left intact, as they may be helpful. Here's the original post:
References
About Krista Vaughan, RN
Krista Vaughan has been a registered nurse for 28 years.
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