A blown vein is a term used to describe what happens to a vein when it ruptures or gets punctured causing blood to leak outside of the vein itself.
When a vein blows the blood from the vein may spill out into the surrounding area making it useless for drawing blood, injecting medication or using an IV.
In most cases a blown vein is not dangerous, in fact it’s usually harmless, however when a vein blows it should be treated immediately and the vein should not be used to draw blood or initiate an IV until it has fully healed.
If a vein blows and medical action is required, such as drawing blood, injecting medication or implanting an IV in the arm the individual, nurse or physician must choose another vein that is not blown for the procedure.
What causes blown vein
A blown vein may caused by a number of different factors.
A vein may blow due to it being perforated by a needle that is too large or inserted incorrectly, or by a needle that is implanted too deeply into the vein causing both sides of the vein to be perforated and leading to possible blood leaking out of either end.
In some cases the vein may also become blown because the vein walls are abnormally sensitive/fragile or too thin to be perforated (sometimes seen in elderly patients or those with sensitive veins).
Lastly, some veins are prone to sensitive movement, meaning they can be easily moved around when the body part moves or when pressure is applied to the area making it difficult to successfully implant a needle or keep it in the vein.
Frequent causes of a blown vein
- Using a catheter that is too large
- Inserting a needle into a highly sensitive/fragile vein
- Accidentally perforating both sides of the vein when inserting a needle, which can cause leak out from the opposite end
- Inserting a needle into a movable vein
- Moving around while a catheter/needle is inserted into the vein
Symptoms of a blown vein
Individuals who have a blown vein may experience bruising and swelling around the vein that can appear discolored (red, purple or black).
Tenderness around the blown vein area may also be apparent.
Symptoms of a blown vein
How to treat a blown vein
The first step in treating a blown vein is to identify whether or not the vein has actually blown and if so how severe the situation is.
As mentioned previously you can often identify a blown vein by observing discoloration around the perforated area and checking for swelling and tenderness.
In most cases a blown vein is fairly harmless and can be treated by applying pressure to the area, cleaning the open skin with alcohol pads and/or proper antibacterial chemicals and using cold treatment such as an ice pack to minimize swelling.
However, if there is a large amount of swelling, significant blood leak, abnormal sensitivity, spill out of medication into the surrounding area or skin (which can be potentially toxic) and/or any concern of a possible infection you should seek immediate professional assistance from a physician, practitioner or specialist to ensure that the vein is safe from infection or significant medical complications.
Treating a blown vein
- Identify whether or not the vein is blown
- Apply pressure to the area
- Clean the open skin with the proper antibacterial materials
- Apply ice pack to minimize swelling, inflammation and bruising
- Consult a professional if there is any concern for infection, toxicity or additional damage
How to avoid getting a blown vein
When inserting a catheter/needle to draw blood, inject medication or perform an IV it is important to ensure you use the correct size needle to avoid accidentally rupturing the vein.
If you have any concerns about needle size and are able to use a smaller needle to perform the procedure then go with the smaller needle, as long as it is able to peform the job it needs to adequately and is within procedural guidelines.
If a tourniquet is applied to help identify a potential vein pay attention to how tight the tourniquet is and release it once the vein is properly perforated so that the blood can flow freely.
When dealing with elderly patients or those with sensitive veins it may be better to use a BP cuff in order to control the pressure more precisely.
In situations where a tourniquet or BP cuff is inadequate for identifying a vein a visual aid such as a vein finder can help you locate a suitable vein.
A heat pad can also be used on patients that have a cold arm to help warm and identify a vein.
As you look for an adequate vein try to identify one that isn’t too small or sensitive to be punctured and search for a vein that is straight as this will provide you with a better insertion and minimize your chances of an error.
During insertion slowly insert the needle, make sure the bevel is facing up and insert the needle at the proper angle in order to avoid pushing through both sides of the vein.
Once you see flashback from the needle STOP and adjust the approach by lowering the angle of your needle to prevent poking through the other side of the venous wall.
Lastly, if you insert a needle and are unable to find the vein avoid fishing for the vein as this can cause unnecessary injury and potentially blow a surrounding vein.
Instead pull the needle back and adjust the angle of the vein you are looking to perforate.
Steps to prevent a blown vein during needle insertion
- Identify the correct catheter/needle size prior to perforating the vein
- Choose the best vein for the situation (avoid small, sensitive veins, look for straight veins)
- Make sure you insert the needle at the correct angle (avoid inserting the needle at an angle that is too shallow or deep)
- Insert the catheter/needle slowly and stop once you’ve hit the vein to assess the situation (look for flashback or adequate blood flow)
- Improve the veins visibility using the appropriate methods (gravity, tourniquet, BP cuff for elderly patients
- Use visual aids if available (vein finder device, etc…)
- Avoid fishing for a vein
- Anchor the vein and arm to minimize movement during insertion or procedure