I was given an injection with a baby needle on my elbow pit. The nurse had to switch veins 4 times (twice in left arm, twice in right arm) and still didn’t manage to give me the injection. I was told it was because I felt nervous so it made my veins “disappeared”. How is that possible ?
In: Biology
For me, my blood pressure dropped…to the point where I actually fainted. Embarrassing as hell.
What veins are in the “back of your elbow?”
So, from a theoretical perspective:
Your body goes through something called sympathetic stimulus during stressful situations – it is colloquially called a “fight or flight” reaction. The body does several things with this, it reduces blood flow to your gut (don’t need to be digesting things when running from a tiger), activates insulin (to get glucose into your muscles, where you are gonna need it to run from a tiger), dilated the pupils (so you can see the tiger better), increases blood flow to your heart, and increases heart rate (definitely need that with tigers around), and *decreases* peripheral blood flow (to prioritise the central organs, like your heart and lungs) by constricting your veins. Smaller tubes, less blood in them, more blood for your heart. This increases your blood pressure too.
From a practical perspective, the venous constriction is actually relatively small, certainly compared to other factors affecting how easy it is to get a needle in, like hydration.
Your nervous disposition also has an effect on the person putting the needle in. I am massively needle-phobic, and I really hate cannulating other needle-phobes, cos I know what they are going through, and it makes me feel under massive pressure to get the vein first time, which inevitably makes me miss.
Nervousness causes high blood pressure. One of the causes of high blood pressure is constriction of the blood vessels thus making them smaller and hard to find. Add in the fact that not everyone has the same body make-up, I.e. some people may just have naturally smaller/less flexible veins or their veins don’t run in exactly the same way, can also contribute.
Likely to do with vasoconstriction, which is the narrowing of blood vessels. When you get nervous, your body releases adrenaline into the bloodstream. This serves several purposes but one of the effects of adrenaline is vasoconstriction. This could lead to a smaller target for the nurse to hit with a needle. Also, adrenaline can cause increased body movement which can make it more difficult to be accurate with the needle.
Generally when you’re stressed your veins get larger.. maybe she was projecting?
“High stress levels
Increased stress levels can cause vascularity due to higher levels of the stress hormone cortisol. Another hormone called aldosterone can cause water and sodium retention along with increased blood pressure. This can lead to vein swelling.”
[source](https://www.healthline.com/health/veiny-arms#how-to-achieve)
As someone who has started hundreds of IVs, this might be true, but in my experience, it’s likely the person with the needle. Some are just better at getting the veins than others. You’re essentially trying to stick a needle in a floppy noodle without seeing it. They move, and unless you can feel it, you miss.
Also, everyone is different. I have straight thick veins, and I’ve had a patient whose veins didn’t have a straight section longer than an inch or so. That was a tough stick. But theoretically, adrenaline/constriction could have something to do with it.
I was not at all aware of this, ive been a blood donor since i was 18 years old and my veins are very easy to find, they have never missed even once.
Here is a possible reason, when you feel stressed the body increases the blood pressure to increase blood flow by somewhat collapsing the veins to increase blood pressure.
The answers here are awesome but there is a other option I didn’t see explored. Nurses miss veins all the time and just like trying to perform any fine motor skill under duress, it can be significantly more difficult. It could be they missed the first time and got into their own head about it which caused them to miss. Now their having to prick you again while you’re watching. They may seem calm but in their head they could be thinking: “I’ve done this a thousand times, how did I miss? … I better get it perfect this time… oh fuck I missed again… Jesus what is wrong with me today…fucking finally”. Nurses are people, they can psych themselves out too and it may be that she fed you a line as an excuse.
Source: nurse
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