It is important to avoid nerves while performing venipuncture. Knowing where they are located and how they differ from the vasculature can assist a clinician in identifying and avoiding nerves while performing venipuncture. Two nerves that are located in common areas for venipuncture 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” which makes it a possible mistaken target when aiming for the cephalic vein in the wrist area. The median nerve “runs inside the antecubital fossa and passes through the forearm into the palm of the hand” which can make blood draw in the area of the antecubital fossa challenging. Clinicians should avoid these areas when possible. If venipuncture must be preformed in a high risk area the clinician should palpate the chosen vessel and feel for any other structures in the area. The use of vein visualization technology can also assist the clinician in determining whether the chosen vessel is a vein by allowing them to use the wipe technique to watch the flush and fill. Even when applying these techniques it may be possible to a miss stick so it is a good idea to go slow, anchor the vein and pay close attention to any reactions from the patient.
“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.”