When a vein ruptures, the vein is no longer usable for blood draws, IV line insertion or medication injection until it has healed.
Blown veins can lead to darkening of the skin around the insertion site, caused by the blood pooling to cause a bruise.
This article will discuss the causes and symptoms of a blown vein, as well as strategies to prevent it from happening.
What are the main symptoms of a blown vein?
The main symptom of a blown vein is pain or discomfort at the site where the needle was inserted. The skin around the area may also become swollen, bruised, or discoloured.
In some cases, the vein may also start to leak blood or fluid, which can cause further swelling or discomfort.
If you experience any of these symptoms after a needle insertion, it is important to seek medical attention to ensure proper treatment and healing.
Blown vein vs. collapsed vein
A blown vein refers to a vein that has ruptured and caused blood to leak out.
While a collapsed vein is a vein that has become flattened or closed due to external pressure. This may happen during the process of blood drawing or IV insertion, or from other factors such as dehydration or poor circulation.
The symptoms of a collapsed vein may include:
- Swelling
- Pain
- Difficulty drawing blood
While blown and collapsed veins may have some similar symptoms, they have different underlying causes and require different treatment approaches.
What causes a blown vein?
Many things can cause a blown vein. Some of the most common causes are as follows:
Using the wrong needle size
If a nurse uses a needle that is too big for the vein, the vein may rupture. If the needle is too small, the vein may not be able to hold the blood.
Nurses need to be aware of the different sizes of needles and veins so that they can choose the best option for each patient.
Make sure to let your nurse know of any previous issues you have experienced with drawing blood from a particular vein in the past and how it was resolved.
Wrong angle or 'fishing'
A needle must be inserted slowly and at the proper angle. If the needle is inserted too shallow or too deep, it can result in a blown vein.
It is important to avoid moving the needle around when a vein cannot be accessed on the first attempt. Instead, the needle should be removed and reinserted in a more suitable location.
Rolling veins
Certain veins may be thicker than others, making it challenging for healthcare providers to insert the needle successfully.
When attempting to insert the needle, the vein might shift or roll, causing the needle to puncture the vein without entering it completely, leading to the vein rupturing.
Moving during insertion
To avoid a blown vein, it is crucial to remain still while the needle is being inserted. Even slight movements can increase the risk of the vein rupturing.
Therefore, it's recommended to keep the arm relaxed and steady until the needle is inserted fully and the healthcare provider loosens the tourniquet.
Long-term IV drug use
IV drug use can be damaging to veins, causing scar tissue to form which can be permanent. This is more likely to happen if you have a health condition requiring regular IV drug use, or if you have a substance abuse problem and use needles.
The kind of substance being injected can also contribute to blown veins. For example, research [2] shows that heroin's acidity can damage veins.
Age
As we age, our skin loses tissue and our veins become less stable and more delicate. They can move around under the skin during IV insertion [3], which increases the risk of blowing a vein.
How is a blown vein treated?
If you have a blown vein from needle insertion, it is not harmful but may be uncomfortable.
Your healthcare provider will typically apply pressure to the injection site and then clean the area.
If there is a lot of swelling, you can use an ice pack to help ease the symptoms, which usually disappear without a trace within 12 days.
How to prevent a blown vein
Being well-hydrated can make it easier to find a suitable vein for blood work or IV insertions. Unless there are specific instructions not to drink water, such as before surgery, it's recommended to drink plenty of water before the procedure.
To avoid blowing a vein, healthcare providers may take their time preparing for needle insertion. To assist them, it's essential to remain as still as possible during the procedure.
To ease discomfort from needles, you can turn your face away and focus on taking slow, deep breaths until the procedure is completed.
Your healthcare provider should [4]:
- Select an appropriate vein that is visible, straight, and a good size for the procedure.
- Avoid areas where veins diverge. The patient may be asked to make a fist if a suitable vein is not found.
- Use a device such as a tourniquet or blood pressure cuff to increase the visibility of the vein. For older patients, a blood pressure cuff may be more suitable. If using a tourniquet, ensure it is not too tight.
- Select a needle size that is suitable for the chosen vein.
- Insert the needle at an angle of 30 degrees or less.
- Place a thumb below the puncture site to stabilize the vein.
- Take a slow and steady approach when inserting the needle.
- Release the tourniquet before removing the needle.
- Carefully withdraw the needle and apply gentle pressure to the puncture site.
Although healthcare professionals try their best to locate the right vein, they may still encounter difficulty, in which case ultrasound or other visualization devices may be helpful. However, even with these aids, there is still a possibility of a blown vein occurring.
What are the potential complications of a blown vein?
Blown veins are typically minor injuries and are not considered a major problem.
Some blown veins are at risk of collapsing. When they do, circulation problems can occur due to restricted blood flow. Collapsed veins usually heal, but it is possible that some blown veins will not recover. When this happens, new blood vessels can develop to bypass it.
When medication intended for intravenous delivery spills into the skin due to a blown vein, it can be harmful, and further treatment may be necessary.
Main takeaways
A blown vein is a minor injury that occurs when a needle punctures through the vein causing it to rupture, resulting in stinging and bruising. However, it usually clears up within a few days by itself.
