Because the nerves and veins in the arm are closely connected, a venipuncture can accidentally injure the nerves. Nerve damage can be mild or temporary, but some are more serious. Severe nerve damage can lead to chronic problems. By knowing the safest location for venipunctures and following other tips in this article, you can reduce your patient's risk of nerve damage.
Types of nerve injury
- Severe acute pain
- Sharp stabbing pain up and down her arm
- The sensation of varying the degree of pain according to the position of the needle
- A "needle prick" or "electric shock" sensation runs down the arm from the venipuncture
- Pain or tingling discomfort in the hands or fingertips
- The pain persisted after the needle was pulled out
- Patients may experience retraction or report pain during needle insertion or needle movement.
A patient may exhibit signs such as pain or discomfort during needle entry and movement. This is likely caused by a subcutaneous hematoma pressing on the nerve, I.V fluid infiltration, or tightness of tourniquet application. Symptoms like arm numbness and radiating limb pain tend to manifest within 24-96 hours after venipuncture (intravenous catheter insertion).
If, at any time during the procedure, you feel something weird or pain comes over your arms stop immediately and get out of there. This could result in a nerve being cut off which would be very uncomfortable and dangerous to live so stay safe! Let your boss know what happened right away so they can go fix it while keeping pressure on the site for bleeding.
The nurse should document the incident, which includes recording who was notified and what interventions were made. Attempt venipuncture at an alternate site, preferably in the opposite arm. Reapplying a tourniquet to the same arm for a repeat venipuncture can cause previously punctured veins to bleed into tissue and compress nerves below it.
If you suspect compression injury, stop the infusion and notify your health care provider immediately. If the solution has infiltrated, apply a compress—warm for isotonic solutions with normal pH; a cold for medications such as potassium chloride.
Fasciotomy is a procedure commonly used to treat nerve compression injuries. This involves making small incisions around the affected area and draining fluid or blood from it, or manually expressing fluid if needed (document findings and interventions in an event report).
Reducing the risk of nerve injury
Follow these steps to reduce your patient's risk of nerve injury during venipuncture:
●When choosing the most prominent vein, avoid the inner or volar surface of your wrist and forearm. Veins on this part of a person's arm are close to arteries, nerves, ligaments, and tendons while being closer to other veins that you could possibly choose from for I.V access later in case it is necessary.
●The nurse or assistant should properly position the patient and anchor the vein securely.
●If you're having a hard time finding the vein, try using a smaller needle angle or use a vein finder to help you find a difficult vein. The smallest possible needle angles are about 15 degrees when veins can be found near your skin’s surface and up to 30 degrees for deeper ones.
●Advance the needle into the vein lumen in a direction that follows the contour of veins.
●To reduce the risk of compression injury, avoid probing. You may nick the vein and cause subcutaneous bleeding. Take care to avoid transfixing (advancing a needle past) veins on purpose as well by going around them or redirecting it in another direction first if you need to probe deeper into the skin tissue.
●Don't try more than two venipuncture attempts. If you haven't succeeded after the second attempt, ask a colleague with advanced I.V skills to give it a go instead!
●The doctor must apply pressure to the patient's arm for 3 minutes or until bleeding stops, then elevate their arms and press again. This is because anticoagulant therapy makes blood clots at a slower rate than normal that could lead to excess loss of blood if the vein puncture isn't stopped immediately.
●Teach the patient to report signs and symptoms of nerve compression injury, such as pain at the I.V. insertion site or infiltration (elevated skin temperature).
The AIMVEIN Vein Finder is a breakthrough technology that has the potential to quickly identify veins, preventing nerve damage or minimizing its consequences for patients.
