Vein injury after I.V. line

I have a sort of nagging concern. I was in the hospital about 2 weeks ago for a kidney stone. At the time, a nurse put in an I.V. line, which was relatively uneventful for me…they sometimes have trouble finding my veins and try two or three times before getting it right. I’m a fainter, btw, so this is really fun for me.

Anyway, the line was in and they administered pain medication via the port using a syringe. For some odd reason, it hurt VERY much when this was done. Enough that even over the screaming in my kidneys I said “Ouch! What’s the deal!” to the nurse. I just wasn’t expecting it to be a painful process.

So now, the vein is visibly “swollen.” It runs right across the bone on the right side of my right wrist. It’s swollen and painful not AT the I.V. puncture site on the back of my hand, but about three inches up my arm from that. The vein is very prominent, much more so than the same on on my other hand or than any other I can see on my body. It’s sore as if it’s bruise and hurts when I stretch that vein over the bone. It also hurts at other points up my arm toward my elbow.

This is minor “shut-up-and-wait-until-it-goes-away” type pain. But it’s starting to sort of concern me and it IS annoying…can’t rest my arm on anything, wrist gets quickly sore from typing, etc. Is it something I should be worried about? Having mentioned it to the hospital staff and being met with shrugs, I assume not. But then, they might not have expected it to still be a nuisance two weeks later.

I tried to do a Google search for routine, minor nonsense like this, but my search terms didn’t turn up anything appropriate (venipuncture, injury, swollen, etc.).

Phenergan/promethazine is an anti nausea medication commonly given with narcotics in the ER for kidney stone pain. It is well known to cause vein irritation because of it’s pH if given undiluted, or into a small vein, or if the catheter is right up against the vein wall, or there’s a valve right above the site which allows the medication to concentrate.

Your description of the event is consistent with phenergan irritation, but I have no idea if that’s what you received. You should be able to access your records to check on medications if you want.

google ‘phlebitis’ for lots of scary information, most of which probably doesn’t apply to you.

I can find out what I was given. And I can google phlebitis, with the caveat that if I DO have a problem it’s clearly minor. I’m just getting concerned that it’s not going away. I’d like to know what I could do to make it go away.

Actually, the initial information I found was NOT scary. Since I have none of the ‘high risk factors’ for any scary stuff and since I’m not seeing red streaks and don’t have a fever, the suggestions I’m seeing are to be active and take maybe take some ibuprofin.

It just says,

And then later:

It sounds like the fact that I was less active after being in the hospital might have prolonged the irritation.

Last year I was hospitalized for about a month total and had catheters inserted twice in my wrists. I had them for a week each.

I had all kinds of stuff injected through the catheters. I could feel the liquid flowing but it wasn’t painful or uncomfortable at all.

But the nurse doing the catheter insertion commented that I have thick veins that are easy to spot.

You still have the same catheter after two weeks? I thought they take it off after a week and insert a new one to minimize the possibility of infection.

No, I only had one I.V. line for a few hours. They took it out and two weeks later, it’s still sore and swollen. It’s annoying, and it hurts, but it’s nothing extreme. I was just a bit concerned that it was something I needed to look into so it didn’t get worse. But I don’t think that’s the case.

I’ve been turned down in attempts to donate blood because my veins are somehow difficult to locate, so maybe I just have some sort of weird quality that created this irritation.

I have miserable veins. They’re small, they hide, and they apparently move around. Nurses hate me. Unfortunately, I have to get blood drawn alot for my lupus. Any given time, I have at least 5 bruises on my arms.

I hate the nurses who insist they’re “the best”…of course they’ll be able to get a blood draw! They usually try the most times, and hurt the most.

Try ibuprofen for your pain. If it’s still bothering you in a couple of days, I would go back to the hospital and have them check it.

Last night I was getting a little paranoid. It was clearly becoming worse, not better and my whole arm was achy and sore. I took some Advil and wrapped it up in a heating pad. It seems to have improved a lot today. I’ll likely follow the same routine when I get home tonight. I’ve still got a really gross looking vein standing out across the bone in my wrist. Yuck!

I was once told to simply request someone from neonatal for this problem. The same person told me that if a person jabbed me twice without hitting a vein to make them stop and request someone else. I now refuse to sit in a chair while someone jabs me five or six times with a needle. I get vaso-vagal reaction anyway, so it’s yucky for me.

When I was in the E.R. over kidney stones my nurse looked at my arms and then got on the P.A. and announced, “We have an I.V. challenge in room 3A!” Embarrassing. But they did get someone good in. Got it on the first try.

Could be phlebitis- in which case witch-hazel liquid applied liberally will help.
Could be that the IV tissued and the drug ended up in the tissues instead of the veins- in which case try heat, topical anti-inflammatories and painkillers.
Could be an infection- if it is red, hot, swollen, and feels soft, boggy or “fluctuant” to touch you should seek medical attention.

If your whole arm, rather than just a small local area, is sore or you don’t feel well (any of: shaky, sweaty, feverish, poor appetite, diarrhoea, vomiting, headachy etc) get yourself to an ER ASAP.

IV cannulas are a relatively common source of blood infections and cellulitis- feeling generally unwell could be a warning sign of that.

Just adding a data point: I was hospitalized for four days six weeks ago, and had one clumsily-done overlarge IV for three of those days in what I think was the same position you describe. The (day) nurse who replaced that nasty initial IV tut-tutted over it and had unkind things to say about the (night) nurse who’d put it in. It took at least two weeks for the bruising to subside, and the vein and my wrist to stop hurting. The scab finally fell off last week and the vein is still slightly more prominent than the matching one on my other wrist.

I have stupid delicate shy uncooperative sneaky veins, too. In my experience, it’s the nurses who tell you “Oh, no problem, you’ll just feel a little pinch” who give me the bruises, and the ones who say “Hmmn. Not much to work with here, is there?” who get it easily. Sometimes it helps if you ask them to use a pediatric needle, but sometimes not; I think it depends on how comfortable a given nurse or phlebotomist is with using them.

Probably not helpful but the last time I donated blood, the nurse was a real hack who took multiple tries to hit the vein and sort of wiggled the needle around into there. To this day, some 15 years or so later, I still get sore there when I extend my arm with any real force (such as carrying a heavy suitcase with that hand or a 40lb bucket of cat litter). I don’t know if it’s nerve damage or internal scarring that gets stretched out or what. It’s hardly life-crippling but it is annoying and marked the last time I donated blood since I’ve only got one “good” arm left.

Thanks for your help everyone. I feel a little better, emmaliminal, knowing that someone else had a similar problem that cleared up without a hitch.

And Irishgirl, if I had to guess, I’d say it was your second possibility. That’s because the muscle around the area is sore. Except for the very prominent vein, it’s not swollen, red, or hot. No red streaks. But the entire back of my hand and up my wrist are sore to touch and it hurts to flex my wrist.

There’s no scab or wound at the actual insertion site. The pain and swollen vein are 3 inches up my arm from that. If it was right AT the site, I’d instantly think “infection.”

I have four nice Irish boys to wait on me tonight. I’ll get them to bring me tea and Advil while I sit with my arm wrapped in a heating pad. Hmm…if they’re not out on the drink.