Collapsed vein

Collapsed veins are a common result of chronic use of intravenous injections. They are particularly common where injecting conditions are less than ideal, such as in the context of drug abuse.

Veins carry blood back to the heart and lungs from around the body. They have thinner walls than arteries; they lie closer to the surface and do not pulsate. The veins closest to the skin’s surface are used to get blood during a blood test or to put medication into the body.

Veins may become temporarily blocked if the internal lining of the vein swells in response to repeated injury or irritation. This may be caused by the needle, the substance injected, or both. Once the swelling subsides the circulation will often become re-established.

Permanent vein collapse occurs as a consequence of:

• Long-term injecting
• Repeated injections, especially with blunt needles
• Poor technique
• Injection of substances which irritate the veins.

Collapsed veins are a common problem among intravenous (IV) drug users. Nearly every habitual IV drug user develops one or more collapsed veins as a result of repeated injury from intravenous injection. Although recovery is possible, often the damage to the veins is permanent and may lead to serious health complications.

Smaller veins may collapse as a consequence of too much suction being used when pulling back against the plunger of the syringe to check that the needle is in the vein. This will pull the sides of the vein together and, especially if they are inflamed, they may stick together causing the vein to block. Removing the needle too quickly after injecting can have a similar effect.

Treatment for collapsed veins is often simply a matter of using a little common sense. Stop injecting into the same vein; this allows time for the vein to heal and helps prevent further damage.

The following are tips and tricks which may help you:

• Clean – Always wash your hands before you start and have a clean area to make up and give your factor.
• Drink plenty of fluids – make sure you have enough to drink before you try to give your factor so that your veins are plump and bouncy.
• Keep warm – if you are cold, your veins will shrink and will be much more difficult to find. This is sometimes a problem in winter so it helps to put on a jacket to keep warm. Have a warm shower or bath. A warm breakfast or cup of hot chocolate/milo will warm you from the inside. If you are still having problems then a heat pack over the vein you are using is a great way to warm you up and help make it easier to find your veins.
• Environment – makes sure there is good lighting where you are sitting and you are comfortable and relaxed. If you are stressed or scared then your veins know this and make it more difficult to find them. Sit somewhere comfortable and if you need to be distracted, turn on music or the TV. Take a few deep breaths before you start if you need to calm yourself.
• Exercise – being fit and healthy means you will have better veins. A healthy weight range also makes it easier to find and feel your veins. Just before you have your factor, doing a quick round of exercise such as running on the spot or star jumps will help get your blood pumping and make finding your veins easier.
• It is better to use a plump bouncy vein that you can feel than a vein you can only see. If a vein is plump and bouncy it will be easier to access than a vein that is visible but flat. Take your time to feel and get to know your veins and the direction they are running.
• Position – make sure you have your arm below the level of your heart. Dangling your arm over the edge of the bed/chair before you access your veins will allow gravity to increase blood flow to the area and the vein. After applying the tourniquet squeeze a rubber ball or make a fist or flap your arms up and down to help increase blood flow.
• Use distraction for small children – TV, DVDs, iPad, toys, bubbles, Buzzy Bee, another person. Anything your child likes is helpful.
• Pain relief – using anaesthetic ‘numbing’ creams. Remember to remove and clean the area well. Finding the veins is easier if the cream has been removed for around 10 mins before trying to use the vein.
• Avoid pressure on the needle insertion site during an infusion or when taking the needle out. Remember to release the tourniquet before you start infusing your factor.
• Apply pressure after the needle is removed to make sure the bleeding has stopped. If you do not apply adequate pressure for long enough then you may get a bruise over the vein making it difficult to feel when you next need to use it. Using a pressure band aid will help prevent bruising. Looking after your vein makes it much easier to find the next time you need treatment.
• Rotate vein sites as needed – you may not need to do this but if you are having problems with the vein, it is always good to have an alternative to use.
• If you need a blood test – ask the health professional you are seeing if you can access your vein yourself or if they could use a different vein to your regular vein.
• Ask for help – sometimes you will have problems despite your best efforts. Remember, it is ok to ask for help if you are having problems.

Collapsed vein causes

Collapsed veins are often due to chronic injury and are most commonly associated with repeated intravenous injections into a specific vein or specific portion of a vein. While sometimes a collapse can be temporary (caused by minor irritation), other times the collapse can be permanent, which means blood will no longer be able to flow through that vein.

After injecting into the same vein for weeks or months, the internal lining of the vein becomes swollen and collapses; blood flow through the vein ceases. In many instances, the vein recovers once the swelling subsides and blood flow returns to normal. However, permanent collapse is a possibility.

The causes of permanently collapsed veins include:

• using a vein repeatedly for multiple intravenous injections
• using a needle with a blunt tip
• medications or drugs that irritate the veins and cause inflammation
• improper injection technique
• removal of the needle too quickly after injection.

Having weak or fragile veins or varicose veins can also increase the risk of having a vein collapse.

Collapsed vein prevention

Since there is very little that can be done to treat a permanently collapsed vein, it’s important to know how to avoid them. The ultimate way to avoid collapsed veins is to stop using IV drugs. This is the best step for overall health and wellness.

If quitting isn’t an option right now, take every precaution possible to reduce some of the harm caused by using IV drugs. Here are a few tips and techniques to avoid collapsed veins:

• Make use of needle exchange programs. Blunt needles are a common cause of collapsed veins.
• Take care not to hit an artery. Arteries and veins sit very close together so it can be easy to make a mistake. If an artery is hit, take the needle out immediately and apply firm pressure at the injection site.
• Do not inject into the veins in the hands, as they are too small and collapse easily. Also, avoid injecting into the groin as this can cause serious circulation problems.
• Do not inject into swollen or bruised sites.
• Always swab the area before injection to prevent dirt and debris from entering into the vein and causing irritation.
• When using a tourniquet, never tie it too tight.
• Choose subcutaneous or intramuscular injection methods. Just remember, this method has its own health complications associated with it.

Collapsed vein signs and symptoms

The most common symptoms of collapsed veins are cold hands and feet from impaired blood flow, sharp pain at the injection site, and bruising and discoloration of the skin. There may also be itching, tingling or numbness at the injection site as the vein starts to heal.

Collapsed vein treatment

A vein that collapses temporarily following an injection or blood draw may heal once the inflammation subsides. But permanently collapsed veins can’t recover. Sometimes, the body forms new, tiny veins to help restore circulation in the area; however, these tiny veins are smaller and weaker than “normal” veins, and they cannot be used for future injections.

While there is no vein treatment designed to cure or heal collapsed veins, there are steps you can take to make sure your other veins stay as healthy as possible. By improving your overall vein health, you may be able to compensate for the loss of circulation caused by the collapsed vein, and you may also be able to prevent future vein problems. Seeing a doctor who’s skilled in varicose vein treatment and other vein treatment options is an important part of preventing serious circulation problems, whether you have collapsed veins or not. And it’s especially important if you have spider veins, varicose veins, or symptoms associated with collapsed veins.

Exercises for veins

1. Squeeze a sponge ball in your hand. Start with ten squeezes daily and build up to 50 squeezes per hand daily. This exercise helps to develop the supporting muscles.
2. Place a tourniquet around your upper arm. It should be tight enough so that your veins stand out in a few minutes, but not so tight that you can’t feel a pulse at the inside elbow. Squeeze your fingers in and out with/without a sponge ball until your arm gets tired. Loosen the tourniquet and rest a little, then repeat this exercise again. If you do this frequently, at least twice a day, it will improve your veins.

When you do these exercises, your muscles tighten, clamping off veins that run through them. This makes all the blood that flows into the arm return through surface veins. This causes veins to become larger and stronger, making them easier to find and use.

Remember, it’s like any other exercise. It only works if you do it regularly, and it will certainly help with your infusions.

Vein rotation

Medicines that are given through veins can irritate the walls of the veins. Changing which veins you use can help decrease irritation and scarring.

When you put a needle in your skin, it leaves a small hole that needs to heal. The same is true with your veins. You can keep your veins in good shape if you let them heal before you use them again. If you don’t let your veins heal, you may be at risk of collapsed veins or infections.

Rotating your vein is often recommended, where you let one spot heal while you use another. A vein usually takes a couple of days to heal. It is also useful to have a backup vein that is used to being injected in case you have issues with your regular vein.