A blown or ruptured vein occurs when a vein gets punctured and it causes blood to leak outside the vein. In the majority of cases, a blown vein is not dangerous, but it should be treated right away and the vein shouldn’t be used to draw blood or start an IV.
There are many situations where people experience a blown vein, yet a nurse or doctor may still need to draw blood, inject medications, or use an IV. In these cases, another vein will be selected.
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Patients and healthcare professionals need to be aware of the signs of a blown vein. Blowing a vein can be uncomfortable and cause challenges in treatment.
Causes of blown vein
A blown vein can be due to various things. The list below covers the most common reasons that a person ends up with a ruptured vein.
- Wrong sized needle: A vein can blow if it is perforated by a needle that is too large.
- Incorrect insertion: There are cases where the needle is inserted incorrectly or implanted too deeply in the vein, causing both sides of the vein to be perforated.
- Fragile veins: Veins can rupture in people who happen to have abnormally sensitive or fragile veins. Some individuals, such as the elderly, have veins that are too thin and are prone to perforation.
- Moveable veins: Some veins are very sensitive and move easily when pressure is applied to the area. This makes it difficult to implant a needle properly and can lead to a rupture in the vein.
- Patient movement: There are situations where a needle is inserted into a patient and they are moving around a lot so the needle perforates the vein.
- Stuck bevel: The bevel is the slanted part of a needle, which creates a sharp, pointed tip. There are cases where the bevel gets stuck in a vein.
Symptoms of blown vein
Sometimes, people who experience a blown vein can quickly identify the problem on their own. The entry site will start to swell up and bruising may appear. In these cases, the area can be sensitive to touch.
Here is a short list of the typical symptoms of a blown vein:
- Swelling
- Discoloration
- Tenderness
- Hematoma
It is worth noting that hematomas tend to occur when the needle goes right through more than one vessel wall, but keep in mind that bruising can also occur when someone puts too much pressure on the entry site after an IV has been removed.
There are situations where the rupture is not obvious, but a saline flush can help determine if the vein has blown. The saline flush, which is a painless procedure, runs through the patient’s body, and if there has been a vein rupture, the site will swell up.
Detecting a blown vein
Most people who experience a vein rupture describe it in a similar way to other injuries that involve swelling and bruising. It can be sensitive to touch and the swelling can stretch the skin, making it feel hot and itchy.
Since fluids are seeping out of the vein, these fluids tend to pool just under the skin, right near the needle injection site. The puncture created by the needle can also allow blood to seep out, which can also pool under the skin to form a bruise. While it isn’t dangerous, the swelling and bruising in the area can be annoying and is an obvious sign of a blown vein.
As mentioned earlier, if there is no swelling but you experience tenderness, a saline flush just might confirm that you have a blown vein.
How to avoid a blown vein?
Before we address what to do for a blown vein, let’s look at ways to avoid a rupture in the first place.
Needle size: Before inserting a needle, make sure you are using the correct needle size, as this will help you avoid accidental ruptures. If in doubt, try the smaller needle, as long as it can get the job done and meets procedural guidelines.
Use tourniquet: A tourniquet can help identify potential veins, but they should not be too tight and they need to be released once the vein is perforated.
Use BP cuff: With elderly individuals or those who have sensitive veins, it is best to use a BP cuff.
Vein finder: If a tourniquet and BP cuff can’t help identify a vein, then try a vein finder to locate a suitable vein for needle injection.
Heating pads: A heating pad can be helpful in warming up the arm and identifying veins.
Select straight veins: If possible, choose a straight vein, since they are better for needle insertion and tend to cause fewer problems.
Proper insertion: While inserting a needle, be sure the bevel is facing up and the needle is at a proper angle.
Poke prevention: Once you see a flashback from the needle, stop and adjust by lowering the angle of the needle. This can prevent you from poking through the other side of the vein.
Don’t fish: If you insert the needle and can’t find the vein, don’t fish around. This increases the chance of blowing a surrounding vein.
Anchor vein: Stabilizing the arm to minimize movement during the needle insertion lowers the risk of blowing a vein.
Treatment for a blown vein
Blown vein treatment can be rather simple for those who have minor injuries. These individuals can use their hands to compress the blood vessel. It will minimize blood loss and reduce inflammation. Following up with an ice pack will also help with inflammation and bruising.
It does depend on how the injury occurred. In the case of infiltration—the administration of medication through a needle—compression and cold therapy can be helpful, but further treatment may be required if a large amount of fluid has pooled under the skin. In these situations, fluid does have the potential to cause damage to the nerves. Therefore, it has to be removed with a needle. In some cases, a follow-up surgical procedure is needed to repair any damage.
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If extravasation is involved, the area should be compressed and aspirated. Extravasation is when medication is still inadvertently administered into the tissue, yet it is toxic, causing any area that comes in contact with the substance to blister. Once aspiration (pulling the needle back once injected) is complete, a saline washout should be done to flush out any remaining toxic chemicals. A surgical procedure might be required to repair any damage to surrounding area.
As indicated, most cases of a blown vein are harmless and can be addressed by applying pressure to the area, cleaning the open skin with proper antibacterial materials, and applying ice to minimize swelling, inflammation, and bruising. It is important to keep a close eye on the site to make sure there are no noticeable changes. For instance, if there is an infection, a doctor should be consulted.
When a blown or ruptured vein occurs, it can’t be ignored. At the same time, those who have experienced such a rupture should not be afraid of receiving future treatment that involves the insertion of needles into the veins. An injection or IV can be life-saving. When small veins, sensitive veins, and other similar challenges are kept in mind, a blown vein is something that can be avoided.
