Why Does My IV Hurt?
“Nurse, my IV is burning.” “Oh, well, sometimes the medications can feel like they are burning. But it looks okay to me.”
Sound familiar? A peripheral intravenous catheter, commonly called an IV, is a small, thin, flexible tube placed into the bloodstream. An IV is the most common invasive procedure that is performed in the hospital and is used to administer medical therapies that can include fluids, medications, and blood products.
But why does it start to hurt? And is it okay if it hurts?
What an IV Should Feel Like When getting an IV placed, there will be some discomfort. The IV starts with a needle, after all. Once the IV is in place, though, it should not be painful at all. When the IV is being accessed and flushed, you may feel a cool sensation in the vein. But any burning or pain with accessing the IV or running medications is not normal. Rather, it is a sign that something is going, or has gone, wrong with the IV.
What Can Go Wrong There are many things that can go wrong with an IV. Here are just a few.
Phlebitis Phlebitis is literally translated as inflammation of the vein. Our veins are made of very delicate tissues just like the rest of our body. Damage done to the inside of the vein can lead to phlebitis.
If the IV is placed in either the wrist or the bend of the elbow, every movement we make with our arm/hand moves the IV inside our vein. The IV then rubs or scrapes the inside of our vein. The rubbing or scraping motions cause damage and can create phlebitis.
When some medications are given through the IV, they can also affect the inside of the vein and cause damage. The veins in our arms are very small. Some medications are very harsh to the body tissues, including the inside of a vein. When we combine the small veins and the harsh medicines, we can create phlebitis.
Infiltration/Extravasation The medicine that is given through an IV is supposed to stay in the vein. Sometimes the IV comes out of the vein while the medicine is still being given. This is called catheter dislodgement. When this happens, the medicine is no longer running through the vein. Rather, it is being put into the surrounding tissues, a.k.a. your arm/hand. This is called infiltration. An extravasation is the same thing as an infiltration except that the medicine being given was harsh and can cause damage to your arm/hand tissue.
Leaking Our veins and arteries are basically pipes. These pipes run through our entire body. Our blood runs through the pipes to deliver oxygen to our organs and then to get rid of waste (carbon dioxide) through our lungs. If we try to put medicines through an IV that leads to a blocked pipe, the medicine will find the path of least resistance and the IV can then leak. When an IV is leaking, this means there is vein damage.
Advocate for Yourself Every single one of the problems listed above will create PAIN as the first symptom. An IV site should be monitored by the nurse frequently, and it should not be painful.
Forewarned is forearmed. This is an old saying from a Latin proverb meaning that if you are aware of what might happen and you are prepared for it, you are better off than those who are not aware. Become knowledgeable about how an IV works. As a patient, you have the right to know what your IV is for and what complications can come from having an IV. Be prepared to speak up if you sense that something is wrong or if you don’t understand what is happening.
Be specific about what you think might be going on. Explain exactly where it hurts and when. If you speak up and tell the nurse the IV is causing pain but they try to explain it away, don’t be afraid to ask to speak with the charge nurse. The pain can be mentioned to your doctor/provider as well.
Be firm when talking with your nurse. But also, be tactful and kind. Nurses have a lot of responsibilities piled onto them during their shift. Plus, nurses are human. As humans, we all have a right to be treated kindly. Be firm and consistent when communicating with your nurse while using tact and kindness.
Resources:
Helm, R. E., Klausner, J. D., Klemperer, J. D., Flint, L. M., & Huang, E. (2015). Accepted but unacceptable: peripheral IV catheter failure. Journal of infusion nursing : the official publication of the Infusion Nurses Society, 38(3), 189–203. https://doi.org/10.1097/NAN.0000000000000100
Nickel, B., Gorski, L., Kleidon, T., Kyes, A., DeVries, M., Keogh, S., Meyer, B., Sarver, M. J., Crickman, R., Ong, J., Clare, S., & Hagle, M. E. (2024). Infusion Therapy Standards of Practice, 9th Edition. Journal of infusion nursing: the official publication of the Infusion Nurses Society, 47(1S Suppl 1), S1–S285. https://doi.org/10.1097/NAN.0000000000000532
https://www.dictionary.com/browse/forewarned-is-forearmed Assessed and Endorsed by the MedReport Medical Review Board