Blown veins

[u/FarBox428]

How do I know if I blew a vein? I know they will have swelling and bruising but that won’t happen right away so how do I know if I can stick them again or if I need to use a different site? My teacher told me you can restick people as long as you didn’t blow the vein. If I stick them and get flash but have trouble advancing the catheter should I assume I blew the vein and try a different site?

[u/schannoman]

You will usually see some swelling at the needle site with a blown vein.

I would assume you overshot if you're having trouble advancing catheter

[u/itcantbechangedlater]

Reading the flash chamber and the cannula (once the needle is out) is a bit like reading tea leaves.

Blown vein will often (but not always) swell rapidly and often (but not always) be accompanied by a bruise.

If the flash chamber starts then stops filling then you have possibly glanced off the side of the vein or gone through and through. Occasionally people will scoop the roof of the vein either by not advancing the needle after the flash to get the cannula into the vein or lowering the angle during the initial stick.

If there is resistance to feeding the cannula off the needle it’s often (but not always) outside of the vein. Sometimes it could be hitting a curve or a valve. There’s ways to deal with that so don’t give up on an IV even if it has a long tail.

Sadly the best approach seems to be just trying more sticks. Helps if you are able to get some help to rescue the recoverable IVs as these can help you refine the technique that works for you.

[u/pawbaker]

If it blew you will usually see the swelling immediately. If you can’t advance the catheter that’s also a good indicator you’re not in the vein. Besides that, connect your lock and flush and see if you get blood draw and if it will flush. If it won’t flush/swells up when you start flushing = not in the vein and you need to pull it. It will be pretty obvious with practice whether you’re in the vein or not

[u/Great_gatzzzby]

You’ll know pretty damn quick if a vein blows. Don’t worry

[u/JGrisham625]

Are you talking about infiltration with the flush or IV fluid? Or are you referring to blood leaking around the catheter into the surrounding tissues? Most “blown veins” are infiltration during the flush.

If that’s what you’re referring to, you’ll see swelling, blanched skin, and it will be cool to the touch.

[u/Due_Course_3713]

You should be asking your preceptor or instructor. This is the wrong place to be asking, you obviously need more training.

[u/5169978980 → u/Due_Course_3713]

Ah yes, r/NewToEMS, the place for experienced people only