Tendon damage from IV or blood draw

[Nurseupnorth]

If a nurse were to poke through a tendon during a blood draw, does the patient typically feel the injury right away like with a nerve being hit? Will it always lead to tendinitis or worse? What would be the prognosis? With some people that are larger, obviously, the nurse needs to go by feel. My rule of thumb is if it swells with a tourniquet and deflates once removed and there is not a pulse...then you've got a vein. I have a fear of hitting the tendon in the AC. Which is pretty obvious where it is, but in larger folks it can sometime be tricky... I'm always really careful to not go too deep because I'm afraid of what lays behind, but I sometimes feel that I should go deeper but chicken out because of that. Any advice would be appreciated. Thanks!

[mmc51264, BSN, MSN, RN]

I am, by no means an expert at this, but wouldn't you have to go REALLY deep to damage a tendon?? Never heard of such a thing.

[Nurseupnorth]

I have never heard of it either in all honesty. My distal bicep tendons stick out far as I have a lean frame and my veins are great, but they lay right over it....so due to my anatomy I guess I theorize that a deep needle draw could go thru and hit it. For example the vein rolls to the side and in goes the needle. Unlikely....but I think that thought has created an irrational fear....crap....a nursing phobia! :) Thanks!

[brownbook]

I know exactly what you mean.

Once in a while when I use the AC the vein feels so firm....it really makes me nervous.....is it a tendon?

Your idea about the tourniquet is good. And take your time...feel....feel....feel....have them flex, extend, flex, extend their arm, turn their hand right, left, right, left...feel, feel, feel. With the AC tendon you will feel the tendon move as they turn their hand. You can feel this on your own AC.

I've never "hit" a tendon, but anything is possible in the world of IV's!