how do you know if you put an iv in an artery?

I have three years of nursing experience. Over the past 6 months i have been doing iv insertion.I still get anxiety about it. My patient insisted that I put the iv into her antecubital area. I felt a nice fat vein that was superficial.She said that is where they draw blood. I was in without any resistance. I put my transfer device on to draw blood and the blood flowed out so easily and fast.I think i felt a pulsation when drawing blood. I had my fingers above the sight.I thought I was just feeling the bracial artery that was close to the site. The patient had been on plavix. I usually make a mess when I draw blood when I put in an iv like i did this time The patient did not complain of any pain. Blood did not squirt. It looked the same color as always.I flushed it once and blood went back into the tubing to the point where I clamped it. I flushed it again and it was fine. I asked my charge nurse to look at it and she said that it fine. She said that she felt a pulse beside it so she doesn't think I hit an artery. After I put the iv in, I felt the pulse proximal and a tiny bit to the left. I ran in saline through a pump with no complications. I gave her morphine iv and she immediately felt the effects. How will I know if I ever put an Iv in artery. Will there be pain? Will the IV pump beep constantly beep due to the pressure. (The patient's systolic B/P was 143)This really has me worried. .I had the patient a couple of more hours and checked on her. The IV was fine with no pain. Good circulation and good radial artery.Please help!! I don't want to worry about this anymore.
The color of the blood would be different, no? Arterial blood is bright, fire-engine red, whereas venous blood -- deoxygenated -- is more of a maroon.

This blood might have been a little brighter, but it did not alarm me as being different. The patient had been on plavix, so her blood was thinner

One way to know you're in an artery is when you draw back blood with the syringe plunger let go...if the blood keeps filling the syringe and the plunger is moving back by itself you'll know it's an arterial line. Veins don't have enough pressure to push the syringe plunger back.

If memory serves, I believe that the brachial artery is much deeper and would require a bit of serious digging to access. It is very painful for the patient, and you would observe obvious pulsating spurts if you did accidentally access it, along with an immediate hematoma formation.

Hi there,Once imserted, Look for an oscillation/fluctuation in your saline lock tubing...there should be none. Ultimatelly, you can always send an ABG's (there would be a difference between arterial and venous blood).: )

You will see pulsation in the connecting piece of tubing.Also, if you flush an arterial "IV" you will likely cause an arteriospasm, resulting in immediate blanching along the path of the artery and possible pain reported by the patient.I've done it once (in a newborn) and it was very obvious.

You can also hook up some extension tubing, place a syringe on the end of it and draw back, then hold the tubing straight up in the air. If the blood flows back down, it's venous.

All helpful. Thank you.

In ICU, I just transduce the line in question . . . if there's an arterial waveform, you're in an artery. But, the other suggestions also work and are much simpler.

Trust me, you will know - the blood will spurt across the room when you remove the stylet. And accessing an artery is somewhat more painful. You will not be able to run anything through the line without a pressure system.Don't lose any sleep over this - arteries tend to be deep even though you can feel a pulse, they are not very easy to access.

Quote from JolieYou will see pulsation in the connecting piece of tubing.Also, if you flush an arterial "IV" you will likely cause an arteriospasm, resulting in immediate blanching along the path of the artery and possible pain reported by the patient.I've done it once (in a newborn) and it was very obvious.

I've had twice where I've accidentally accessed an artery...and it was ridiculously obvious every time. It's not unusual for me to make a mess by hitting a good fat vein...it is unusual to have the bright red blood spurt five feet across the room though! One of the times it didn't spurt as badly as the other, but when I drew back the syringe to check for blood return, it was the wrong color, which led me to just let go of the plunger. If the blood fills the syringe up on it's own, it's arterial. I actually called some of the newer nurses in to show them what it looks like since it happens so rarely.