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nerve damage due to IV
I recently was in the hospital and had an IV and while they had to try a few times, one of these time it hit a nerve. The IV ended up in the other arm but a day or so after I got out of the hospital I started to have somwhat sharp pain in my wrist and down into the meaty part of my thumb.
I'm wondering if this will go away eventually or should I see someone about it?
I'm wondering if this will go away eventually or should I see someone about it?
The duration of recovery from your condition would ultimately depend on how severe the nerve damage is. Ideally, it is always best to have it looked at by a competent neurologist as early as possible. In the meantime, some OTC pain medication can be taken (assuming you don't have any ulcers/gastritis or pain medication allergies) to alleviate the pain. Just make sure you take them an hour after a meal.
Thanks for the reply. The reason I was in the hospital was for a bleeding ulcer, so Advil is out of the question. But I will try some Tylenol after a meal and see if that works.
Do you know if not using the hand will help? Or some topical medications? Any ideas?
Do you know if not using the hand will help? Or some topical medications? Any ideas?
Hi,
You can have Tablet.Ranitidine 150 mg 1/2 hr befor food and then after food you can have a OTC painkiller if pain persists.The gastrirtis will be less or completely avoided by taking T.Ranitidine .
Goodluck.
You can have Tablet.Ranitidine 150 mg 1/2 hr befor food and then after food you can have a OTC painkiller if pain persists.The gastrirtis will be less or completely avoided by taking T.Ranitidine .
Goodluck.
Thanks very much! The only other question I have is if this kind of nerve problem will normally go away in a few weeks?
You know I just looked up Ranitidine and see that this is for your stomach. I am currently taking Prolisec OCT for the after treatment of my ulcer.
What I was trying to find out was if the nerve damage in my hand due to an IV sticking in to a nerve while I was in the hospital was going to go away by itself or if I should see someone? Do you know that? :-)
What I was trying to find out was if the nerve damage in my hand due to an IV sticking in to a nerve while I was in the hospital was going to go away by itself or if I should see someone? Do you know that? :-)
As I have mentioned before, recovery from the nerve damage is dependent on how severe the injury is, which cannot be assessed from our standpoint. You could opt to observe for the moment whether the pain would decrease or resolve within a few weeks with concomitant pain medications.
If the pain is bothering you, you should go to a neurologist as soon as possible to assess your injury. He will be in the best position to answer your query on how long your pain will last and provide you with appropriate advise on treatment options.
If the pain is bothering you, you should go to a neurologist as soon as possible to assess your injury. He will be in the best position to answer your query on how long your pain will last and provide you with appropriate advise on treatment options.
I have been a nurse for over 20 years. I have probably started thousands of IV's. I have never seen anyone with permanent nerve damage from an IV. I have seen nerve injuries from arterial lines though.
Permanent damage can result when a needle point makes contact with a nerve.
“Nurse, I feel an electric shock going down my arm.” Would this patient complaint mean anything to you when you insert an IV catheter or draw blood? This feeling of shock is a classic symptom when a needle point makes contact with a nerve. It could result in permanent nerve injury — and malpractice litigation involving the nurse performing the procedure is not uncommon.
The two nerves most often injured during a venipuncture procedure are the radial and median nerves. The radial nerve passes along the thumb side of the arm, from the shoulder down into the wrist area, and is in close proximity to the cephalic vein. In a venipuncture procedure, the cephalic vein is often the vein of choice for many clinicians. The distal three inches of the radial nerve, just above the thumb, is the area most often injured during the insertion of peripheral IV devices.
The median nerve is the largest nerve in the arm. It runs inside the antecubital fossa and passes through the forearm into the palm of the hand. When nurses are drawing blood from the antecubital fossa or inserting peripheral IV devices, they could contact and injure this nerve. Insertion of IV catheters into the superficial veins of the inner aspect of the wrist above the palm of the hand can result in serious injury to the median nerve and carpal tunnel syndrome.
If a patient complains of an electric shock-type sensation radiating down into his or her hand as the needle is being inserted, the appropriate intervention is to remove the needle immediately. The outcome will be minimal nerve damage without permanent injury; however, if the nurse continues to advance the needle farther into the nerve, a permanent, progressive, and painful disability resulting in reflex sympathetic dystrophy (RSD) or complex regional pain syndrome (CRPS) can result. Patient symptoms can include a mottled and cold hand and forearm, hypersensitivity to temperature changes, excessive nail and hair growth, and the inability to lift heavy objects. CRPS is diagnosed by patient history and nerve conduction studies. Treatment options include long-term pain control with narcotics, multiple nerve blocks, and even implanted morphine pumps, as well as splints, casts, and TENS (transcutaneous electrical nerve stimulation) units.
Best practice mandates nurses avoid areas of high-risk nerve injury by using landmarking techniques. The three-inch area above the thumb and the three-inch area on the inner aspect of the wrist should always be avoided since the radial and median nerves can be superficial in these areas. The risk of permanent nerve injury outweighs the benefit of IV insertion in these areas.
Standards of Practice
The Infusion Nursing Standards of Practice can be used in court to determine whether a nurse delivered appropriate infusion care to a patient. The standards state “site selection should avoid areas of joint flexion.”1 The wrist and antecubital fossa are areas of joint flexion. Insertion of peripheral IV catheters into these areas for delivery of infusion therapies can be determined to be deviations from the standard of practice. These deviations, with documented injury to the patient, can be contributing factors in a malpractice verdict against a nurse. When necessary, the physician should be notified that an alternative vascular access device will be required to safely administer the IV medications.
Nerve compression injuries are also related to infusion therapy. These occur when a patient sustains an infiltration of a large amount of IV solution into the tissues. The IV fluid in the tissue increases the pressure within the tissues, resulting in compartment syndrome; and the duration of the high tissue pressure determines the amount of permanent nerve damage. Nerve compression is indicated when a patient’s arm is infiltrated and he or she complains of numbness and tingling within the swollen area. The appropriate nursing intervention is to stop the infusion and notify the physician immediately. An emergent fasciotomy, which consists of two surgical incisions along the entire length of the arm, is required to relieve the increased tissue pressure. The incisions are left open; and, in some cases, penrose drains are used to aid in fluid drainage. A second surgical procedure is required to close the wound, and the patient will have extensive scarring of the forearm and hand.
Permanent nerve injuries are preventable by avoiding high-risk superficial nerve areas for venipuncture and by frequently documenting IV site assessments. Nerve injury related to venipuncture is one of the most common areas of nursing malpractice in which the nurse is identified as the primary defendant. Remember — listen to the patient. Remove the IV device immediately if the patient has symptoms of nerve contact during venipuncture, and avoid high-risk nerve injury areas.
“Nurse, I feel an electric shock going down my arm.” Would this patient complaint mean anything to you when you insert an IV catheter or draw blood? This feeling of shock is a classic symptom when a needle point makes contact with a nerve. It could result in permanent nerve injury — and malpractice litigation involving the nurse performing the procedure is not uncommon.
The two nerves most often injured during a venipuncture procedure are the radial and median nerves. The radial nerve passes along the thumb side of the arm, from the shoulder down into the wrist area, and is in close proximity to the cephalic vein. In a venipuncture procedure, the cephalic vein is often the vein of choice for many clinicians. The distal three inches of the radial nerve, just above the thumb, is the area most often injured during the insertion of peripheral IV devices.
The median nerve is the largest nerve in the arm. It runs inside the antecubital fossa and passes through the forearm into the palm of the hand. When nurses are drawing blood from the antecubital fossa or inserting peripheral IV devices, they could contact and injure this nerve. Insertion of IV catheters into the superficial veins of the inner aspect of the wrist above the palm of the hand can result in serious injury to the median nerve and carpal tunnel syndrome.
If a patient complains of an electric shock-type sensation radiating down into his or her hand as the needle is being inserted, the appropriate intervention is to remove the needle immediately. The outcome will be minimal nerve damage without permanent injury; however, if the nurse continues to advance the needle farther into the nerve, a permanent, progressive, and painful disability resulting in reflex sympathetic dystrophy (RSD) or complex regional pain syndrome (CRPS) can result. Patient symptoms can include a mottled and cold hand and forearm, hypersensitivity to temperature changes, excessive nail and hair growth, and the inability to lift heavy objects. CRPS is diagnosed by patient history and nerve conduction studies. Treatment options include long-term pain control with narcotics, multiple nerve blocks, and even implanted morphine pumps, as well as splints, casts, and TENS (transcutaneous electrical nerve stimulation) units.
Best practice mandates nurses avoid areas of high-risk nerve injury by using landmarking techniques. The three-inch area above the thumb and the three-inch area on the inner aspect of the wrist should always be avoided since the radial and median nerves can be superficial in these areas. The risk of permanent nerve injury outweighs the benefit of IV insertion in these areas.
Standards of Practice
The Infusion Nursing Standards of Practice can be used in court to determine whether a nurse delivered appropriate infusion care to a patient. The standards state “site selection should avoid areas of joint flexion.”1 The wrist and antecubital fossa are areas of joint flexion. Insertion of peripheral IV catheters into these areas for delivery of infusion therapies can be determined to be deviations from the standard of practice. These deviations, with documented injury to the patient, can be contributing factors in a malpractice verdict against a nurse. When necessary, the physician should be notified that an alternative vascular access device will be required to safely administer the IV medications.
Nerve compression injuries are also related to infusion therapy. These occur when a patient sustains an infiltration of a large amount of IV solution into the tissues. The IV fluid in the tissue increases the pressure within the tissues, resulting in compartment syndrome; and the duration of the high tissue pressure determines the amount of permanent nerve damage. Nerve compression is indicated when a patient’s arm is infiltrated and he or she complains of numbness and tingling within the swollen area. The appropriate nursing intervention is to stop the infusion and notify the physician immediately. An emergent fasciotomy, which consists of two surgical incisions along the entire length of the arm, is required to relieve the increased tissue pressure. The incisions are left open; and, in some cases, penrose drains are used to aid in fluid drainage. A second surgical procedure is required to close the wound, and the patient will have extensive scarring of the forearm and hand.
Permanent nerve injuries are preventable by avoiding high-risk superficial nerve areas for venipuncture and by frequently documenting IV site assessments. Nerve injury related to venipuncture is one of the most common areas of nursing malpractice in which the nurse is identified as the primary defendant. Remember — listen to the patient. Remove the IV device immediately if the patient has symptoms of nerve contact during venipuncture, and avoid high-risk nerve injury areas.
I'm very aware of what you are saying. My point is....I have never seen this happen. It is extremely rare.
3 Comments
But you probably wouldn't know how often it does, because patients this happens to often don't realize they actually suffered any damage until the next day, and you may not know they sought urgent care for it afterward or went to their doc. Not all will notify the ER or facility where they suffered a painful IV or blood draw.
But you probably wouldn't know how often it does, because patients this happens to often don't realize they actually suffered any damage until the next day, and you may not know they sought urgent care for it afterward or went to their doc. Not all will notify the ER or facility where they suffered a painful IV or blood draw.
I have to say this sucks. I am dealing with it right now I complained the second it was put in about the pain and was ignored and brushed off. literally told "it is in your hand it will hurt" by the man putting it in and the 2 nurses afterwards. I felt the pain through the drugs I had in the hospital! I currently after a full 5 weeks have very limited right hand movement which sucks as I am a righty and very unusual because I am hyperflexiable. My right hand gets cold very easily and is still swollen. the intense shooting pain is not longer there, gone after a week or so but the dull achey stiffing pain has not subsided and it radiating down my arm and up my fingers and causing them to swell as well. I am not sure how rare this actually is but my doctor is worried and so am I! Trying to do everything with my left hand sucks. typing sucks, usuing my mouse sucks and driving I can not even grip the wheel. I can barely make a fist because the swelling is getting so bad. i hope noone has to go through this. it was my only surgery ever and go figure an IV in the hand causes me more pain than they recovery of the surgery.
What was the outcome? It is two months later.
I just had this happen to me last week. Any feedback as to length of your condition would be interesting. thanks
I just had this happen to me last week. Any feedback as to length of your condition would be interesting. thanks
I too was recently in the hospital. Male nurse put in a BIG IV (I was dehydrated & needed fluids). The insertion REALLY hurt. More than it should have. I've had IVs in the past, but the pain of putting one in didn't compare to other times. I was in the hospital 3 days. On the 3rd day, the IV started to bleed, but I was finally released. Now, a month later, I still have difficulty turning my wrist and lifting things with my hand in certain positions. It gets worse when I use my wrist/hand more. Do I have ANY recourse? The hospital I was in gave very shoddy treatment..... ~lisa
I had surgery on Feb 6th, with the IV on My right wrist. My thumb and fingers whent numb right away but I did not know any better so I did not say anything. The IV was in for 3 days and my thumb and forefiinger are still numb to this day. As I use my hand to work on the computer I find that I get shooting pains throughout the hand that be the end of the day are shooting up to my forearm. The viegn is swollen and I am not sure what to do. My orthepedic surgion says to just wait and when I tried to get to a neaurologist he said he could do no more that whe my surgeion was doing. I am getting scared as this is effecting my work out put.
Thanks Karen
Thanks Karen
I know it's hindsite now but you really should have said something. It's standard practice to immediately remove any IV that causes pain or other symptoms. I know you didn't know any better. I'm very sorry for your problem.
I can relate to how you feel the reason is a simular sitution happened to me. On the 24th of this past Febuary I had an ovarian cyst repture and the nurse needed to draw some blood and start an iv of course she tried several attempts before she found a spot on my left hand not to far from my nuckles and until this day it is very hard for me to use this hand it feels like pins and needles with numbness also cold all the time and my veins start to swell and boy does this hurt thats why I like to talk about this problem so i can get a feed back on what to do with this promblem. I'm sorry you had to experience this too.
I went to the ER for allergy issues. I had an benedril IV drip started in my left arm on the inside of my elbow. placing the IV was not a problem, but when the removed it, the pain was tramendous. It has only been 6 days now sense this happened, but I am worried after reading all this info. I have pain in my shoulder, and above and below the insertion point of the IV. My left arm is very weak.
just curious to everyone who posted on here about nerve injuries from needle sticks. did you get better?
Thanks
Thanks
Yep...it took about 6 months...but at this point...I no longer have the electric shock feelings coursing down my hand and fingers when I move my wrist.
I went for a routine blood draw to get my semi annual check up. the venipuncturist has been doing this for years. she could not have been quicker but the when the needle came out of the arm from the blood draw I was white as a sheet and crying from the pain radiating from the inside of the elbow to the thumb. After reading the posting, i guess the medial nerve was hit. there is about a 5 inch area just above my wrist going toward my elbow. i get spasms like someone is drawing up the nerves on a spool. then, it passes. I sure hope this goes away soon. I thought i might be crazy until i read eveyone's comments. it has only been 5 days. thanks pat
1 Comments
Has anyone had or gone for a ct scan iv catheter insertion on wrist under thumb where they insert liquid for ct scan ??
I've been in IV nurse for 22 years. I have never had one patient mention any of the problems that have been mentioned above. It would have to be EXTREMELY rare to have any form of injury that not only is long lasting, but permanent. If an IV becomes sore due to inflammation of the vein from irritation from the cannula against the vein wall or the strength of the drug being given, it can be painful but is usually short lived (maybe a week or so). Sometimes the inside of the vein becomes inflammed and causes a clot to form (thrombophlebitis) but the clot is superficial and while painful should not cause permanent damage.
On the flip side. I also have a chronic serious illness which requires constant IVs. My veins have become difficult to access (I now have a permanent access implanted under my skin) and sometimes it took many attempts to insert an IV. Uncomfortable... most certainly, agony...definitely not, sore for days after...yes, permanent pain or damage...no.
I did hear one story once of someone having a blood test and getting nerve damage. It was immediate, obvious and apparently permanent. (story was also told to prevent phlebotomy staff from practising on each other.
Hope this helps
Chirley
On the flip side. I also have a chronic serious illness which requires constant IVs. My veins have become difficult to access (I now have a permanent access implanted under my skin) and sometimes it took many attempts to insert an IV. Uncomfortable... most certainly, agony...definitely not, sore for days after...yes, permanent pain or damage...no.
I did hear one story once of someone having a blood test and getting nerve damage. It was immediate, obvious and apparently permanent. (story was also told to prevent phlebotomy staff from practising on each other.
Hope this helps
Chirley
1 Comments
I'm not sure why you are minimizing people's comments here.
Mine healed after 4-5 weeks total time from injury. The most pain was the second week. The neurologist I saw said that was normal. The inflammation was putting pressure on the nerve. Advil and vitamin B were the recommendations, but time was the only thing that healed all.
I had neurosurgery on October 6, 2008 and apparently a needlestick (not sure what it was for...maybe an IV) on my left wrist, about one inch above my hand (on the thumb side) caused similar problems to the ones described on this board. You can still see where the needle went in...there's a round swollen spot, about the size of a dime. I had a large 3 inch bruise next to it, traveling up my forearm. My thumb, index finger, middle finger and the tip of my ring finger are "tingly" and extremely sensitive to the touch. When I woke from surgery, I told the doctors about it, but they didn't seem concerned so I assumed it would go away. Five weeks later and there's no improvement. When I saw my doctor on Wednesday, he suggested I see a hand surgeon to determine the extent of the damage. After reading Travana's post, I am really worried...again, how are all of you doing and how long did it take for your symptoms to go away? How do you know if the damage could be permanent?
I think it was an arterial puncture...the neuro otologist thinks it nicked or pinched the radial nerve, since it is affecting my thumb and first two fingers. He wants me to see a hand surgeon but I can't get an appt. till the end of the month and the neuro otologist is on vacation this week. It seems to be getting worse and the palm just below my index finger is now swollen...I was thinking about making an appt. with a neurologist instead...I am starting to really worry....
Hi, Years ago I used to have to take arterial blood samples as part of my job. I was always very wary of doing it because of the risk to the artery (spasm) and nerve that run in the radial area. There was a test we were supposed to do to make sure there was an alternative blood supply to the hand just in case the artery was damaged. This was called the Allens test. I only learned of this AFTER I stopped working for that organisation. I still shudder at my total naivete and lack of training I was given. I was very lucky that no one (to the best of my knowledge) suffered any ill effects. On the plus side, if this was your problem I think the effect would have been immediate and devastating, so perhaps you have some nerve damage that requires a little bit more time to mend. Best of luck to you.
Chirley
Chirley
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