Arterial injection occurs when the individual hits an artery, not a vein.  Hitting an artery can be painful and dangerous. Arterial blood travels away from the heart so whatever is injected goes straight to body limbs and extremities.  Injection particles get stuck in blood capillaries and cut off circulation.  This can result in a lack of blood flow, eventually causing the tissue to die.  Furthermore, there is no “stone” resulting from arterial injection.  Rather the muscle tissues towards which the arterial blood is flowing will become swollen and painful.

Avoid risky areas
The young person is less likely to hit an artery if they avoid risky anatomical points where arteries are more accessible – especially points such as over joints (elbow, behind knee, armpit, neck, groin).

Feel for a pulse
Encourage the young person to feel for a pulse. The presence of a pulse means that area has a large artery and should be avoided. An arterial pulse around the groin is hard to detect if the person is seated, as are small arteries around the fingers and toes. Advise the young person to find another injection site.

Place needle slowly and carefully
There may be warning signs before the needle actually touches the artery, for example, increased nerve sensations such as electrical shocks as the needle gets close to the artery, and cramps as the needle touched the artery wall. Going slowly gives the user time to avert the needle form the artery.

Arterial cramp? Pull out!
If the needle scratches or starts to pierce the artery, the thick muscular wall might go into spasm.  Circulation may then be cut off.  The person will experience a sharp, painful jolting cramp, followed by coldness and numbness in the area or limb.  The needle needs to be removed and hopefully circulation will resume.  Tissues deprived of blood will otherwise start to die off.

Blood pressure/colour
If an artery is pierced, the blood pressure will be great enough to force blood into the syringe.  This may not be the case with a smaller artery.  Whether it spurts or needs to be drawn in, the arterial blood will be bright red.

What to do if you hit an artery

  • Give up trying to inject on this occasion.  Don’t try to go to a different injection site.  If you use and go to sleep you may continue to bleed out and could lose a great deal of blood or die.
  • Remove the needle from the injection site
  • If possible, you or a friend apply pressure to the site and try to elevate the wound if possible.
  • Always seek medical help.  Even a small arterial wound can drip for a long time.

Regular injecting can lead to damage of the veins and surrounding tissue as well as a number of other associated infections:

  • Thrombosis
  • DVT – Deep Vein Thrombosis
  • Vein blockage and collapse
  • Ulcers
  • Local infections
  • Abscesses
  • Phlebitis
  • Cellulitis
  • Gangrene
  • Gangrene and artery damage
  • ‘Missed hits’
  • “Lumps and bumps”
  • Bruising
  • Scar tissue
  • Sterile abscess
  • Granulomas
  • Endocarditis
  • Septicaemia
  • Eye infections