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What Causes Itchy Hives On The Chest And Stomach After Vacutainer Needle Injection?
Question: Hello,
Yesterday afternoon I had gone for a blood test at metropolis labs mumbai, The phlebotomist used a vacutainer instead of a normal needle-syringe. The vacutainer was opened in front of me...but I did not really pay attention to whether its seal was intact or not. After getting home post blood draw...I washed the area near the site of the poke with quite a bit of hand sanitizer (ethyl alcohol) and some of it probably entered the poke site which was bruised a bit and not well covered.
A couple of hours after this, I started getting itchy hives on the chest and stomach and general itchiness all over the body. The hives came and went but the itchiness has persisted and ive spent most of the night itching myself. The hives were medium to large sized red patches in a straight line. While I do not see any hives right now..the itchiness is still there.
My concern is as follows.
1. Is this an allergic reaction? and if so, does it indicate that the vacutainer needle was non-sterile??? http://www.micglobal.co.uk/blood-sampling-vacutainer-needles-i7259.html Pls check this link to see an image of what was used to draw blood. If a reused or non-sterile needle could cause such hives...should I be worried about blood borne infections? If yes, Should I get prophylaxis? The lab in question is among the best in India and it is not very likely that they reuse needles. Also, since the plastic tube containing the needle was opened in front of me( I did not check whether the seal was already broken or not)...the only way it could have been reused is by deliberately recapping it and putting it back into the plastic tube shown in the picture.
2. Is it possible that the hand sanitizer getting into the poke (it had bruised a bit and hence the wound wasn't fully covered) could also cause such an allergic reaction? I have since read that it should not be used on open wounds.
3. I have never experienced this kind of reaction after a blood test draw and it is quite scary. PLS advise ASAP.
Yesterday afternoon I had gone for a blood test at metropolis labs mumbai, The phlebotomist used a vacutainer instead of a normal needle-syringe. The vacutainer was opened in front of me...but I did not really pay attention to whether its seal was intact or not. After getting home post blood draw...I washed the area near the site of the poke with quite a bit of hand sanitizer (ethyl alcohol) and some of it probably entered the poke site which was bruised a bit and not well covered.
A couple of hours after this, I started getting itchy hives on the chest and stomach and general itchiness all over the body. The hives came and went but the itchiness has persisted and ive spent most of the night itching myself. The hives were medium to large sized red patches in a straight line. While I do not see any hives right now..the itchiness is still there.
My concern is as follows.
1. Is this an allergic reaction? and if so, does it indicate that the vacutainer needle was non-sterile??? http://www.micglobal.co.uk/blood-sampling-vacutainer-needles-i7259.html Pls check this link to see an image of what was used to draw blood. If a reused or non-sterile needle could cause such hives...should I be worried about blood borne infections? If yes, Should I get prophylaxis? The lab in question is among the best in India and it is not very likely that they reuse needles. Also, since the plastic tube containing the needle was opened in front of me( I did not check whether the seal was already broken or not)...the only way it could have been reused is by deliberately recapping it and putting it back into the plastic tube shown in the picture.
2. Is it possible that the hand sanitizer getting into the poke (it had bruised a bit and hence the wound wasn't fully covered) could also cause such an allergic reaction? I have since read that it should not be used on open wounds.
3. I have never experienced this kind of reaction after a blood test draw and it is quite scary. PLS advise ASAP.
Brief Answer:
Hypersensitivity & urticarial reaction; No worries
Detailed Answer:
Hi there.
Yes it appears to have been an allergic or more accurately a hypersensitivity reaction. But NO it does not indicate the vacutainer needle was non-sterile & No you need not worry about blood-borne infections in this case. No need for any prophylaxis.
It is very possible the sanitiser could cause the reaction you suffered from. Yes it is indeed correct that it should not be used on open wounds & I suspect that this was the 'trigger' in your case.
While I understand & empathise with you, it is not such a rare occurrence & I have encountered patients' having such reactions both during blood donations & during the administration of some special IV medications used in my line of work as a dermatologist. It could also very well be a 'vascular' hypersensitivity reaction that is 'idiosyncratic' (this means occurs sans reason).
In either case, there is nothing you really need to be scared or ponder over. Treat the hives if not already done so with a shot of antihistamine & a shot of 100mg IV hydrocortisone if still persisting & rest assured there is no infection.
Good Luck & Godspeed!
Dr Praveen Rodrigues MD
Hypersensitivity & urticarial reaction; No worries
Detailed Answer:
Hi there.
Yes it appears to have been an allergic or more accurately a hypersensitivity reaction. But NO it does not indicate the vacutainer needle was non-sterile & No you need not worry about blood-borne infections in this case. No need for any prophylaxis.
It is very possible the sanitiser could cause the reaction you suffered from. Yes it is indeed correct that it should not be used on open wounds & I suspect that this was the 'trigger' in your case.
While I understand & empathise with you, it is not such a rare occurrence & I have encountered patients' having such reactions both during blood donations & during the administration of some special IV medications used in my line of work as a dermatologist. It could also very well be a 'vascular' hypersensitivity reaction that is 'idiosyncratic' (this means occurs sans reason).
In either case, there is nothing you really need to be scared or ponder over. Treat the hives if not already done so with a shot of antihistamine & a shot of 100mg IV hydrocortisone if still persisting & rest assured there is no infection.
Good Luck & Godspeed!
Dr Praveen Rodrigues MD
Above answer was peer-reviewed by :
Dr. Yogesh D
Thank you for the prompt reply Dr Rodrigues.
Have you ever come across instances of needles being recapped and used again. Is it even possible with a vacutainer? The phlebotomist burnt the needle in front of me and when i called back told me it is standard practice and that the vacutainer needle was new and opened in front of me.
Also currently I have no hives but im still feeling a bit itchy...can you recommend an oral anti allergy medication as it is Sunday and I cannot access my GP or any local skin doctor today
Lastly, even if you feel that there is a 1% need for prophylaxis pls let me know
Regards
Have you ever come across instances of needles being recapped and used again. Is it even possible with a vacutainer? The phlebotomist burnt the needle in front of me and when i called back told me it is standard practice and that the vacutainer needle was new and opened in front of me.
Also currently I have no hives but im still feeling a bit itchy...can you recommend an oral anti allergy medication as it is Sunday and I cannot access my GP or any local skin doctor today
Lastly, even if you feel that there is a 1% need for prophylaxis pls let me know
Regards
Brief Answer:
It is all good; wish you continued good health
Detailed Answer:
Hi there.
No I cant say I have come across recapped needles in vaccutainer cases..highly improbable in a large & recognized laboratory set-up..they have too much to loose. He may have burnt the needle to pacify you once you asked. Else, I don't see that as standard practice but you will have to go check with his manager or the manager of another such establishment for most accurate info on this front. In either case, it will not have caused your reaction.
Please try Xyzal 5mg (levocetrizine) 2 tabs once/day or if you prefer a non-sedative antihistamine, Fexofenadine 180mg (Allegra or Telfast)...the latter single tablet should suffice.
No I don't feel there is even a 1% chance for requirement of prophylaxis as this is a hypersensitivity reaction.
I do hope I have been factual, clear & allayed all your fears. The tiny doubts can & will keep popping up in your mind on account of anxiety & I suggest to get some sort of closure, you pick up the antihistamine, put this behind you & carry on..to achieve a sense of closure, please do close this query..it may help.
Good luck & once again rest assured, there appears no need for prophylaxis or worry. These reactions are more common than you think. Godspeed!
Dr Praveen Rodrigues MD
It is all good; wish you continued good health
Detailed Answer:
Hi there.
No I cant say I have come across recapped needles in vaccutainer cases..highly improbable in a large & recognized laboratory set-up..they have too much to loose. He may have burnt the needle to pacify you once you asked. Else, I don't see that as standard practice but you will have to go check with his manager or the manager of another such establishment for most accurate info on this front. In either case, it will not have caused your reaction.
Please try Xyzal 5mg (levocetrizine) 2 tabs once/day or if you prefer a non-sedative antihistamine, Fexofenadine 180mg (Allegra or Telfast)...the latter single tablet should suffice.
No I don't feel there is even a 1% chance for requirement of prophylaxis as this is a hypersensitivity reaction.
I do hope I have been factual, clear & allayed all your fears. The tiny doubts can & will keep popping up in your mind on account of anxiety & I suggest to get some sort of closure, you pick up the antihistamine, put this behind you & carry on..to achieve a sense of closure, please do close this query..it may help.
Good luck & once again rest assured, there appears no need for prophylaxis or worry. These reactions are more common than you think. Godspeed!
Dr Praveen Rodrigues MD
Above answer was peer-reviewed by :
Dr. Yogesh D
By "burnt" I meant he put the needle in the incinerator machine after the blood draw was done (Ive seen it done before). Anyways Dr Rodrigues thank you for your reassuring reply. I will get the Allegra right away. Finally, is there a way to contact you via this site or otherwise in the future...pls let me know
I will keep this convo open for a few more days...just to keep my anxiety in check. Though I promise I will not bother you unless required.
have taken allegra as recommended
Regards
I will keep this convo open for a few more days...just to keep my anxiety in check. Though I promise I will not bother you unless required.
have taken allegra as recommended
Regards
Brief Answer:
No worries!
Detailed Answer:
Hi there.
I love your honesty. Don't worry you wont be bothering me.
However, please do bear with me if sometimes I take awhile to answer.
I wish I could provide you with my mobile number but the rules on this site prevent me from doing so.
I do consult at XXXXXXX Hospital in Bangalore & you are most welcome to drop in or get creative :)
Once again, you don't seem to have anything to worry about. As I said these type of transient urticarial reactions are common-place.
Good Luck & Godspeed!
Dr Praveen Rodrigues MD
No worries!
Detailed Answer:
Hi there.
I love your honesty. Don't worry you wont be bothering me.
However, please do bear with me if sometimes I take awhile to answer.
I wish I could provide you with my mobile number but the rules on this site prevent me from doing so.
I do consult at XXXXXXX Hospital in Bangalore & you are most welcome to drop in or get creative :)
Once again, you don't seem to have anything to worry about. As I said these type of transient urticarial reactions are common-place.
Good Luck & Godspeed!
Dr Praveen Rodrigues MD
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Above answer was peer-reviewed by :
Dr. Prasad
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