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IV insertion GONE WRONG 💀 Perforation & Hematoma 💉

Intravenous (IV) therapy is a standard medical procedure to administer fluids, medications, and nutrients directly into a patient's bloodstream. Although generally safe, complications can arise during IV insertion. One such complication occurs when the needle perforates the vein, leading to the formation of a hematoma.

Understanding this incident is crucial for healthcare professionals and patients as it helps manage and prevent further complications.

What Happens When a Vein is Perforated?

During IV insertion, a needle punctures the skin and enters a vein. Ideally, the needle enters the vein without causing significant damage, allowing for the smooth flow of blood into the catheter. However, if the needle accidentally perforates (punctures through) the vein, several issues can occur:

1. No Blood Return in the Needle:
Typically, once the needle is correctly placed within the vein, blood will return to the needle hub or catheter, indicating successful venous access. However, blood may not return as expected if the needle perforates the vein. This lack of blood return can be misleading, suggesting that the needle is not in the vein when, in fact, it has passed through the vein entirely.

2. Formation of a Hematoma:
A hematoma is a collection of blood outside the blood vessels, usually resulting from a vessel injury. When the vein is perforated, blood may leak into the surrounding tissue rather than flow into the catheter. This leakage causes swelling, discoloration (bruising), and pain at the insertion site—a condition known as a hematoma.

The hematoma may appear as a raised, firm, and often painful area around the needle's insertion site.

Causes of Vein Perforation During IV Insertion

Several factors can contribute to vein perforation during IV insertion, including:

Vein Fragility:
Elderly patients, patients with certain medical conditions requiring medications such chemotherapy, or those who have undergone multiple IV insertions may have fragile veins that are more prone to injury.

Inadequate Technique:
The angle of insertion, depth of needle penetration, and the type of needle used all play a role. A needle inserted at an angle that is too steep or pushed too far can easily perforate the vein.

Inappropriate Vein Selection:
Attempting to cannulate a vein that is too small, mobile, or near a joint can increase the risk of perforation.

Immediate Actions and Management

If a healthcare provider suspects that the vein has been perforated during IV insertion, prompt action is necessary:

1. Stop the Insertion:
Immediately halt the procedure and loosen the tourniquet if there is no blood return and signs of a hematoma appear. Continuing the insertion could cause further damage to the vein and surrounding tissue.

2. Apply Pressure:
Remove the needle or catheter and apply direct pressure to the site to minimize bleeding and hematoma formation. Pressure should be maintained for several minutes until the bleeding subsides.

3. Elevation:
Elevating the affected limb can help reduce blood flow to the area, limiting the size of the hematoma.

4. Cold Compress:
Applying a cold compress to the site can help vasoconstrict, reducing swelling and discomfort. Cold therapy is most effective when applied immediately after the incident.

5. Assess for Complications:
Monitor the patient for signs of complications, such as increased swelling, severe pain, or numbness, which could indicate a more severe injury or infection.

6. Document the Incident:
Documenting the event accurately, including the steps taken and the patient's response to the intervention, is essential.


Prevention Strategies

To reduce the likelihood of vein perforation and hematoma formation during IV insertion, healthcare professionals should adhere to best practices:

Proper Training and Technique:
Ensure that all staff performing IV insertions are well-trained in proper technique, including correct needle angle and depth of insertion; otherwise, have the guidance of an instructor.

Vein Assessment:
Thoroughly assess the patient's veins before IV insertion, selecting the most suitable vein based on size, location, and condition.

Use of Ultrasound Guidance

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Keywords:
Perforation
IV insertion
perforated vein
Hematoma
intravenous
insertion intraveineuse


This video is for entertainment and educational purposes only!!
Medical Arts Official, 2024
‪@MedicalArts‬