A blown vein means that the vein has ruptured and is leaking blood. It happens when a nurse or other healthcare professional tries to insert a blood draw or intravenous (IV) needle, and things don’t go quite right.
When the vein starts to leak, you’ll notice your skin darkening around the insertion site. Once that happens, the needle must be removed.
Here, we’ll look into the causes and symptoms of a blown vein, as well as how it can be prevented.
Once you have a blown vein, you’re likely to notice discoloration fairly quickly. Other symptoms include:
Blown vein vs. collapsed vein
A collapsed vein is a blown vein that has caved in, which means that blood can no longer flow freely through that vein. Blood flow will resume once the swelling goes down. In the meantime, that vein can’t be used.
If the damage is severe enough, a collapsed vein can be permanent.
A vein gets blown when a needle goes into the vein and out through the other side. There are several reasons this can happen.
Using the wrong size needle
Veins come in all sizes, and so do needles. It’s important for a nurse to choose the best vein available and to identify the correct size of needle for that vein.
Tell your nurse if you’ve had problems with particular veins in the past and how they were ultimately resolved.
Wrong angle or ‘fishing’
A needle must be slowly inserted at the proper angle, not too shallow or too deep. Being off the mark can result in a blown vein.
If a vein can’t be entered on the first try, it’s important not to move the needle around in search of another vein. The needle should be pulled out and reinserted in a better location.
Some veins are a bit thicker and tougher than others. As the healthcare provider attempts to insert the needle, this type of vein can bounce, or roll away.
The needle might puncture the vein, but not get all the way in before the vein rolls, causing the vein to blow.
Moving during insertion
If you move, even a little while the needle is going in, you run the risk of a blown vein. That’s why it’s important to relax your arm and stay as still as you can until the needle is all the way in and the healthcare provider has loosened the tourniquet.
Long-term IV drug use
IV drug use can damage veins and cause scar tissue to form, which can be permanent. This can happen if you have a health problem that requires frequent use of IV drugs (for example, if you’re receiving chemotherapy for cancer and you don’t have a chemo port).
It can also happen if you have a substance abuse problem and use needles. In addition to the repeated needle insertion that can blow veins, the substance you’re injecting can contribute to blown veins. For example,
In time, accessing functioning veins can become problematic.
As we age, we start losing tissue beneath our skin, and our veins become more fragile and less stable. They can roll around under the skin during IV insertion, increasing the risk of blowing a vein.
If needle insertion results in swelling and bruising, you’ve got a blown vein. It may sting and can be uncomfortable, but it’s harmless.
The healthcare provider typically applies a little pressure to the injection site to minimize blood loss and swelling. After a few minutes, they clean the area to prevent infection.
If there’s a lot of swelling, an ice pack can help ease symptoms.
You may have slight discomfort for a day or two. Bruising should start to lighten within a few days and disappear completely within 10 to 12 days.
It’s easier to find a good vein if you’re well hydrated. Unless advised not to, as would be the case before surgery, drink plenty of water before going for blood work or IV insertion. Inform your healthcare provider of any previous problems with your veins.
If your healthcare provider is taking a long time to prepare for needle insertion, it’s because they’re taking care not to blow a vein. You can help by remaining as still as you can during needle insertion.
If needles make you uncomfortable, face the other direction and focus on taking long, deep breaths until it’s over.
Your healthcare provider should take time to:
- Choose the best vein for the procedure: one that is a good size, straight, and visible.
- Avoid the area where veins divert. If it’s hard to find a vein, they should ask you to make a fist.
- Use a tourniquet or other device to make the vein more visible. For older adults, a blood pressure cuff may be preferable to the tourniquet. If a tourniquet is used, it shouldn’t be too tight.
- Choose the correct needle size for the vein.
- Insert the needle at a 30-degree angle or less.
- Stabilize the vein by applying a thumb below the puncture site.
- Take a slow, steady approach.
- Release the tourniquet before withdrawing the needle.
- Carefully withdraw the needle and apply gentle pressure to the site.
When finding the right vein is very difficult, ultrasound or other visualization devices are useful. Despite best efforts, a blown vein can still happen.
Most of the time, a blown vein is a minor injury, not a serious problem. But it’s important that the vein not be used again until it’s healed.
Sometimes, a blown vein can collapse and prevent blood from flowing. Collapsed veins can heal, but some never bounce back. Depending on the location of the vein, this can lead to circulation problems. New blood vessels will develop to bypass the collapsed vein.
In some cases, medication that was to be delivered intravenously can be potentially harmful when spilled into the skin. When that happens, further treatment may be required.
A blown vein occurs when a needle punctures through the vein and causes it to rupture. It may sting and bruise, but it’s generally a minor injury that clears up within a few days.