What Causes a Blown Vein & How is it Treated?

A blown vein means a ruptured or punctured vein. If you have a blown vein, then this means that the vein has ruptured and is leaking blood into the surrounding area. This typically happens when a nurse or any healthcare professional fails to insert a needle into a vein properly.⁽¹⁾

When a vein starts to leak blood, you will notice your skin begin to darken around the spot where the needle had been inserted. Once the site begins to darken, the needle should be removed immediately.

Until the vein has had time to heal, it cannot be used for drawing blood, for inserting an intravenous (IV) line, or for injecting the medication.⁽²⁾

In most cases, a blown vein is not a dangerous condition and is, in fact, harmless. However, when a vein blows, it needs to be treated immediately, and the vein should not be used until it heals completely.

If you have a blown vein and some medical action still needs to be done, such as injecting medication or drawing blood, then the nurse or doctor will choose another vein for the procedure.

The most common reason for a blown vein is when a needle enters into the vein and goes out through the other side of the vein. There are many reasons why this happens, including:

Veins in the body are in all sizes and so are needles. A nurse must choose the best possible vein available and at the same time, also identify the correct size of the needle to be used in that vein.

If you have experienced problems with some particular veins in the past, then you must inform the nurse before they insert the needle and also let them know how the issue was ultimately resolved.

The healthcare professional must be aware of inserting the needle slowly at the proper angle. The needle should not be inserted too deep or too shallow. When the needle is off the mark, then it can result in a blown vein.

If the nurse is not able to enter the vein on the first try, then also it is important not to move the needle around while searching for another vein. They should pull out the needle and reinsert it in a better location to enter the vein.

If the patient is moving, even a little, while the needle is being inserted, there is a high risk of having a blown vein. This is why it is important for people to keep the arm relaxed and to stay as still as possible until the needle is inserted all the way in, and the nurse has loosened the tourniquet.

Some veins in the body are a bit tougher and thicker than others. As the nurse tries to put in the needle, such type of a vein can roll away, or bounce away.

In this case, the needle might have punctured the vein, but not gone all the way in before the vein rolls, which can cause the vein to rupture or blow.

As we age, we start to lose tissue under our skin, and the veins also start becoming less stable and more fragile. This increases the chances of the vein rolling around under the skin during the insertion of an IV line. This greatly increases the risk of having a blown vein.

People who use drugs intravenously for an extended period of time can have a buildup of scar tissue and damage to their veins. This scar tissue can often be permanent. Long-term IV drug use can happen due to a health problem that requires you to frequently administer your medication intravenously. For example, if you are undergoing chemotherapy for treating cancer, and there is no chemo port.

Long term IV drug use can also happen when you have a substance abuse problem and are using needles to deliver the drugs. Apart from the long term IV use, repeated insertion of needles can also lead to blown veins, and even the drug you are injecting can contribute to blown veins. For example, studies carried out by the London School of Hygiene and Tropical Medicine have found that high acidity of heroin can cause permanent damage to your veins.⁽³⁾

Once you have a blown vein, the first symptom you will notice is the discoloration on your skin. Other symptoms of a blown vein include:

• Stinging
• Bruising
• Swelling
• Hematoma
• Tenderness or mild pain at the injection site

You may also experience bruising and swelling around that vein that has started to become discolored. This discoloration can appear to be red, purple, or black.

If you notice swelling and bruising immediately after needle insertion, then it is an indication that you have got a blown vein. It may sting, and you will feel some discomfort, but it is still harmless.

Your nurse will apply a little bit of pressure on the injection site to reduce blood loss and to bring down the swelling. After a couple of minutes, they will also clean the area to prevent any infection.

If you experience a lot of swelling, then using an ice pack will help alleviate the swelling.

You are likely to experience minor discomfort for a day or two. The bruising will start to get lighter within a couple of days and disappear altogether within 10 to 12 days.

In some cases, though if there is a lot of swelling, significant blood leak into the surrounding area, abnormal sensitivity in that region, spill out of medication into the skin or the surrounding area, and a high concern of a possible infection, then you will need immediate medical assistance to ensure that the vein is safe from any major medical complications or from infection.

Remember that it is easier for your healthcare provider to find a suitable vein if you are well hydrated. Unless you are advised against drinking water, as is the case before undergoing surgery, you should drink plenty of water before you go to get your blood taken or for IV insertion. It would help if you also informed the nurse about any previous problems you have had with your veins.

If your nurse is taking a long time to prepare for inserting the needle, then this is to ensure that they do not blow a vein. You can help during this situation by remaining as still as you can while the nurse inserts the needle.

If you are a healthcare provider, then remember that while inserting a needle for drawing blood, injecting medication, or performing an IV, it is essential to make sure that you are using the right sized needle to avoid rupturing a vein.

If you are concerned about the size of the needle and are able to use a smaller needle for performing the procedure, then it is best to go ahead with the smaller needle. But, this should be only as long as the smaller needle is able to perform the procedure adequately and within the procedural guidelines.

If a tourniquet is being applied for identifying a good vein, then it is important for the healthcare provider to pay attention to how tight the tourniquet is and to immediately release it once the vein has been correctly perforated to allow the blood to flow freely again.

In the case of elderly patients or people who have sensitive veins, it is recommended for health providers to use a blood pressure cuff so that they are able to control the pressure more accurately.

To avoid having a blown vein, your healthcare provider should pay attention to the following:

• Take the time to choose the best possible vein for the procedure. The vein should be visible, straight, and of a good size.
• Avoid the area where the veins divert. If it is challenging to locate a good vein, then they should ask you to make a tight fist.
• It is a good idea to use a tourniquet or any other device such as a blood pressure cuff to make the vein more visible or stand out. In older patients, a blood pressure cuff is recommended over the tourniquet. If a tourniquet is being used, then it should not be tied too tight.
• In patients who have a cold arm, a heating pad can be used to help warm up the hand and identify a vein.
• They should take the time to choose the correct size of the needle for the vein.
• The needle should be inserted at a 30-degree angle or less.
• They should take the time to stabilize the vein by placing a thumb below the puncture site.
• They should take a slow and steady approach instead of rushing through the procedure.
• They should release the tourniquet before they withdraw the needle.
• The needle should be withdrawn carefully and slowly while also applying gentle pressure to the injection site.
• When it becomes quite difficult to find the right vein, then an ultrasound or other visualization methods are used.
• Under no circumstances should they be fishing for a vein.

However, in spite of all the precautions and the best efforts of the healthcare provider, a blown vein may still occur.

The majority of times, a blown vein is harmless and just a minor injury. However, it is important, though, that the vein is not used again until a time it is healed completely.
In some cases, a blown vein may collapse, preventing blood from flowing. This can be a complication s collapsed veins can heal, but they are never able to bounce back to being healthy again. Depending on the location of the collapsed vein, circulation problems can occur. Over time, though, new blood vessels will develop to bypass this collapsed vein.

Sometimes, a medication that is being delivered intravenously can spill onto the skin and cause harmful side effects. In such cases, further treatment may be required.

A blown vein is not a medical emergency and is considered to be a harmless injury. A blown vein occurs when a needle is inserted wrongly and punctures through the vein, causing it to rupture. Blown veins can cause stinging and bruising, but it is not a serious health problem and tends to clear up by itself within a couple of days. If you are worried about having a blown vein, then discuss your concerns before you have blood drawn or before you have an IV line put in.

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