Blood tests are no longer Hi! go-to source for nursing news, trending topics, and educational resources. You may have to apply heat more than once. If the median cubital, cephalic, or basilic veins cant be found, then go to other sites on the arm. Many times, you will have to resort there to draw blood. At outpatient areas, ask the patient to hold their arm at their side for a few minutes. Nowadays, there is equipment that can help us locate the vein. It helps us establish if there is something wrong with the body and what to look out for. It can be easy, especially when youre conducting multiple blood drawing procedures on a daily basis, to become somewhat detached from the patient that youre drawing blood from. Bloating. 0000031034 00000 n On average, it is much harder to find veins in people with darker skin tone. The patients vein may have collapsed. These exercises can be performed throughout your donation and afterwards in the refreshment area. Obesity In order for the nurses to be successful when drawing blood, there are several key things they must know including. You want to lessen the number of sticks you give to the elderly. venipuncture is one of the main parts of your job. The elderly need special care and attention when doing a blood test. If all else fails, you can always use drugs. In fact, based on this, the entire procedure can be harder or easier. 0000011603 00000 n On the surface, it seems as a rudimentary procedure, one that doesnt require any special training. Doing so can help move veins and tendons away from each other increasing the likelihood for a vein to show up. Average delivery time is 5-10 business days. Sometimes the veins are deeper so therefore you will have to go deeper. I will say a fair amount of For adult patients, the most common and first choice is the median cubital vein in the antecubital fossa. Lab gives us an 8 minute window (+/- 4 minutes from exactly one hour from when they finish their glucose) to get the draw. Nursing schools do not teach this skill due to legality issues. Your veins will be easier to find and palpate when you are well relaxed, as tension can constrict veins. Just ensure that you have drank some fluids before the test. Drink plenty of water an hour before the draw. Follow the cephalic and basilic veins down the forearm. If you are drawing blood from an arm, make sure to sit near the patient, as close as possible. Unfortunately, some people have difficult veins to work with due to obesity, dehydration, and a variety of other issues. Our mission is to Empower, Unite, and Advance every nurse, student, and educator. Next, identify the vein that you will be using. Check between the knuckles. Blood pressure cuff is a great method of extracting blood in case that the veins are not visible enough. 5. Its important to remember that the patient is actually your most valuable resource during this process. Blankets or towels from a warmer can also be used. At some time in life, every person will do a blood test, and not only one but multiple as life goes on. A phlebotomist will need to find a good, strong vein from which to draw blood. The number of samples or volume of blood needed will tell you which size syringe to use. Sometimes, it can still be hard to find the vein after applying the tourniquet. For patients on wards, raise the head of the bed. If you cant find a good vein, move to the back of the hand. What constitutes a difficult vein? Even with all these guidelines, perhaps the best approach is if you ask the patient from which vein they usually draw his blood. Spend a decent amount of time looking for good veins. All e-mails from the system will be sent to this address. It is the best thing for patients with low blood pressure. Phlebotomy is essential for a variety of medical diagnoses, procedures, and tests. Edematous sites (swollen sites filled with serous fluid), From an IV cannula (unless permitted by your institution), Sites above an IV cannula in the same vessel, Arm with a preexisting or current blood clot, Evacuated Collection Tubes (tubes specific to labs ordered), Personal Protective Equipment (ie gloves), Bio-hazard leak-proof transportation bags. A second option for finding veins and drawing blood are hand veins. Any time that you need blood drawn for lab work,, I'm Lou, and welcome to Phlebotomy Examiner! Maybe the number one thing that a person can do is to make sure they are well hydrated. Youll be the first to know about nursing news, trending topics and educational resources. Check for any allergies or sensitivities with the patient regarding antiseptics, adhesives, or latex. Some patients have hypovolemia or reduced volume of circulating blood. Phlebotomy Pages advises that individuals use touch as their primary indicatorwhen looking for the vein from which to draw blood.1 Veins will often feel as though they are slightly risen beneath the skin. Massage the vein. 0000005243 00000 n Avoid exaggerated hyperextension, which can be uncomfortable for the elderly. Specializes in RN-BC, CCRN, TCRN, CEN. You need to make sure there is no resistance whatsoever. 6. Drawing blood from the elderly, young children, and infants can also be a challenge. Frail veins can pose a great problem when drawing blood. 0000008644 00000 n Take a look at these tips for drawing blood successfully: When you receive your initial instruction on how to conduct basic blood draws, your instructor will most likely tell you to locate the vein you are targeting by sight. I hope you find my posts helpful. Standard data rates may apply. However, thats not always a luxury most phlebotomists are afforded. Similarly to insertion, removal of the needle should also be swift and efficient. All rights reserved. It is also possible to apply multiple tourniquets. If you really can't see a vein they usually will have one on their hand just between the 4th and 5th finger on the top of the hand. Apply a tourniquet approximately 3-4 inches above the selected site. We are a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com. Insert the needle through the skin at a 30-degree angle or less, with the bevel facing upwards. There are tips for making veins pop out when taking blood. } Always start by thinking that a patient is infectious and that he can spread a disease. Talk about pressure! Continuous interaction can help distract a person during this time. This will cause a lot of mess. professionals to write our content whenever possible. Congratulations, you just took the first step towards a new future by furthering your education. Everyones arm anatomy is different and while one technique may work for a person, combining two or three may be the answer for another. Veins become more visible when blood is forced into them. If you are drawing from a leg, the extremity needs to be placed over the bed so Subscribe for the latest nursing news, offers, education resources and so much more! The three most commonly used veins for drawing blood are the median cubital, the cephalic, and the basilic veins. The order of venipuncture sites is vital to follow. However, for the elderly, it may be difficult. Avoid exaggerated hyperextension, which can be uncomfortable for the elderly. 0000001848 00000 n Become a Part of the Nurse.org Community! As we mentioned, it is your duty as a medical professional to ensure the patient that everything will be ok. We'll need to know about all prescription and over-the-counter medications you're taking. Luckily, got it on the first stick. Check out our list of the top non-bedside nursing careers. Get someone to assist if you are not trained or dont have experience. This is the first and crucial rule of venipuncture. Get help from a Doctor. Maybe they can listen to some relaxing music, breathe in and out calmly, and encourage them to not be hard on themselves for having difficulty. This is due largely to the fact that patient factors will vary greatly when it comes to drawing blood. I'm Kadia. Whether youre becoming a nurse, a doctor or a certified medical assistant, youll probably have to draw blood countless times over the course of your career. In the case of elderly patients, make sure to use smaller needles and to be extra gentle. She hit the vein on the first try. Please wait while we send your information. It can be done by palpating the vessel or via transillumination with a special light. Word of caution: make sure to remove the substance before rubbing the vein with alcohol. The loss of support makes it easy for veins to roll causing difficulty in drawing blood. A close look at the site from which you will draw blood will tell you which equipment to use. Then, massage from the wrist to the elbow. if (window.ClickTable) { This technique is especially helpful with hand veins. When the body is properly hydrated, veins become more dilated. Finally, an ER tech came up and he used a venoscope, which is basically a fancy flashlight - basically the same thing that bruali described in their post. Has 10 years experience. Ask the patient to make a fist and not pump the hand. You need to overcome those fears by exuberating confidence and persuading a person that everything will be alright. WebIf the finger or heel is cold to the touch, pre-warming the site for a few minutes with a warm compress or commercial heel warmer will increase the flow of blood through the capillary beds. When you are retaining water, it increases the total volume of fluid that is being pushed through your blood vessels by your heart. Learning the anatomy of the main veins and arteries in the body is essential to becoming competent in phlebotomy. While traditionally a nurse would use their hands to feel for a vein, many hospitals are now using vein finders to help reduce the amount of time it takes to find a vein and start treatment. Enjoy :). If at the hospital, get nursing staff to assist you. While not commonly taught in nursing school programs, many recommend that nursing students take extra courses in how to draw blood to learn this skill. They will be much easier to spot and throbbing. 3,377 Posts. WebIf you are drawing blood from an arm, make sure to sit near the patient, as close as possible. Position the patient and hyperextend the patients arm. The first area for venipuncture is in the antecubital fossa. Place a tourniquet and clean the area for 30 seconds with an alcohol wipe. that's continuously reviewed to ensure its as relevant and accurate as 3. After identifying the site for the blood draw, gather the appropriate supplies needed. Someone else may be able to find something that you cannot. I am a Licensed Phlebotomist and Certified Medical Assistant of 15+ years with 14+ years of clinical experience. In most cases, simply following best practices and knowing how to find a difficult vein is the best way to carry out a successful draw. To view the purposes they believe they have legitimate interest for, or to object to this data processing use the vendor list link below. Venipuncture tips: 50 Actionable Tips to Perform WebUsing consistent, proficient personnel to per-form blood draws. If you are certain that youve hit a vein and there is still no blood coming from it, this is an indication that you have hit a necrotic vein. Commonly referred to as the antecubital or the AC it can be found in the crevice of the elbow between the median cephalic and the median basilic vein. We strive to be the You could get help from them. Phlebotomy basics : Nursing made Incredibly Easy - LWW Additional equipment such as goggles and splash shields should also be worn in extreme situations. One thing that I find that helps is using two tourniquets - take them together and tie it. This will fill them up much quicker which is a great way to finish procedure faster if you have a troublesome patient. }; What Does Blood Draw or Venipuncture Training Involve? The heat will help dilate the veins and gravity will assist in filling those veins. Obese patients, particularly those considered to be extremely obese, have reported being treated with disrespect by physicians and other medical staff. Here are the basic steps to drawing blood: The first step in drawing blood correctly is to identify the appropriate veins to puncture. Once you have selected the right vein finder for an obese patient, it is important to know how to properly use the My trick is to press on their hand or arm with both of my thumbs. 0000006606 00000 n It uses high intensity light that is directed down through the skin. If you can see the vein clearly, then this will only help you ensure that you place the needle correctly the first time. Phlebotomy teams generally only make rounds at specific times in hospital settings, therefore, if a lab test is ordered immediately it could be the responsibility of the nursing staff to draw the specimen. Use these tips to reduce the level of difficulty and make your chances more successful. But lots of people swear by it, so there might be something to it! Phlebotomy basics The WHO has best practices that are key to preventing infection and being successful during blood draws. Alternate arms if youve given blood These can include: Learning about your Do not snap it against the patients skin as doing so could cause bruising in the area.if(typeof ez_ad_units!='undefined'){ez_ad_units.push([[468,60],'phlebotomistreport_com-banner-1','ezslot_5',168,'0','0'])};__ez_fad_position('div-gpt-ad-phlebotomistreport_com-banner-1-0'); The 3 main areas to find veins include the antecubital fossa, the forearm, and hand veins. Unfortunately, some veins are significantly easier to see than others. So, get help! These 5 areas include:if(typeof ez_ad_units!='undefined'){ez_ad_units.push([[300,250],'phlebotomistreport_com-medrectangle-4','ezslot_6',165,'0','0'])};__ez_fad_position('div-gpt-ad-phlebotomistreport_com-medrectangle-4-0'); From my experience elderly persons on wards are the most difficult sticks.
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