Medical professional also has to be a salesman of the sort. Use these tips to reduce the level of difficulty and make your chances more successful. They will be much easier to spot and throbbing. Once you have located a vein, you can cause increase distention through massaging or exaggerated palpation (pressing repeatedly over the top of the vein). 6. Create well-written care plans that meets your patient's health goals. 0000011603 00000 n Avoid exaggerated hyperextension, which can be uncomfortable for the elderly. However, for the elderly, it may be difficult. I understand that consent is not required to purchase any goods or services from this school and that my consent can be revoked at any time. Position the patient and hyperextend the patients arm. For an experienced professional, this is typically a relatively easy job. As the body ages, the skin becomes thinner and blood vessels become weaker. Do it by performing a quick backward motion. CMAA exam 1 Flashcards | Quizlet Take a look at these tips for drawing blood successfully: Feel & Touch When you receive your initial instruction on how to conduct basic blood draws, your If possible, look at areas that tend to have less subcutaneous fat, such as the back of the hand, the thumb, the wrist, and even the top of the foot. 0000014430 00000 n Being able to find a usable vein quickly is crucial, and something you learn throughout your training. Every so often I'll go in an area where I'm not sure whether I feel anything or not, but know there's usually a vein there. It allows the phlebotomist to control the vacuum, which is good because it is much less traumatic on a patient's vein. Kindness and helpfulness must be shown to them. They need to be labeled in advance. Do not apply the tourniquet too tightly over the arm or wrist as it could cause injury or collapse the vein. The person performing venipuncture can administer 10 units of bacteriostatic saline which need to be injected intradermally. In this guide, well cover how to find a standard vein and what you can do if that vein isnt proving to be a good option. Dont be discouraged if at first, you dont access the vein. Make sure that no one gets directly exposed to blood. Then, add massage to the combination. Press the space key then arrow keys to make a selection. 0000031735 00000 n Specializes in Wound Care. Fourthly, they are not very active, possibly causing lower blood pressure, hence slower blood flow. The only way to make sure is by touching it yourself. After that, pressure needs to be applied on insertion point. For example, the veins of a middle-aged man will likely be easier to find than that of a woman, unless shes extremely active. WebFor routine blood draws, 70% isopropyl alcohol or 70% ethyl alcohol is recommended. The needle may have pulled out of the vein. The Highest Paying Jobs For Nurses With a BSN, Types of Masters in Nursing Degrees & Specialties, Pros & Cons of Getting a Master's Degree in Nursing, Nurse Practitioner vs Physician Assistant, Highest Paid Nurse Practitioner Specialties, How to Conduct a Nursing Head-to-Toe Assessment, How to Read an Electrocardiogram (EKG/ECG), Understanding and Interpreting the Glasgow Coma Scale, Complete List of Common Nursing Certifications. Those veinfinders are worthless. First, gather all of your supplies and discuss with your patient what you are going to be performing. It uses high intensity light that is directed down through the skin. Make sure they are feeling well before leaving. Get someone to assist if you are not trained or dont have experience. Then, push down with the flat of the finger over the area. When done drawing blood, ask the patient if all is well. You have to palpate first and decide from there. This causes the veins to engorge and become visible. 0000018898 00000 n WebUsing consistent, proficient personnel to per-form blood draws. Prep the venipuncture site by cleansing the area with an alcohol prep pad for 30 seconds and allow to air dry for 30 seconds. 5. This will move their fluid and/or tissue out of the way so you can see a good vein. In a way, you have to entertain a person during phlebotomy. Has 10 years experience. So, if youre working with a patient who has small veins, or veins that are hard to find, practice some of the techniques discussed in this guide to make life easier for you. Get help from a Doctor. If I can't feel it then I let SWAT come in with the ultrasound. Its important to do everything in your power to ensure the comfort of the patient when drawing blood. 196 0 obj <> endobj xref Sometimes you won't be able to see the veins at all, but you will be able to palpate them. The forearm is about the last place to look. Obese Patient Patients Using a tourniquet is something most people are used to seeing during difficult blood draws. Lastly, you will have to mix tubes with an anticoagulant. But lots of people swear by it, so there might be something to it! HlV7WF#J$% r!h {7@)RRXZ4J9(e??@!o]h&Do?Y[L *fIXH^ Liver function studies. Go to Alexander Street homepage, Blood Collection: Special Considerations, Obese Patients. Ideally, try to work with your patient ahead of time, or give them information about what they can do to make their blood draw experience easier. Has 1 years experience. go-to source for nursing news, trending topics, and educational resources. Extend the arm. Check out our Facebook page and give it a like: http://www.redcrossblood.org/donating-blood/tips-successful-donation. He got her first stick, and i will definately try this in the future if i have trouble. WebTips for Drawing Blood Always feel the vein rather than see it! All e-mails from the system will be sent to this address. Pumping fists can lead to pseudohyperkalemia or increased level of potassium in the blood. So, the choice of equipment will change from patient to patient. Phlebotomy is essential for a variety of medical diagnoses, procedures, and tests. Instead of forcefully tapping the vein, it is much better if you start stroking them. Specializes in RN-BC, CCRN, TCRN, CEN. Massage the vein. Also, by palpation, you can sometimes feel valves in people and learn to avoid them. var options = { A phlebotomist will need to find a good, strong vein from which to draw blood. 0000001689 00000 n The first area for venipuncture is in the antecubital fossa. Without further ado, here are 50 tips that will help you perform this crucial procedure. Ask the individual to elevate his or her arm at the elbow. Frail veins can pose a great problem when drawing blood. Properly label the tubes and send them to the laboratory for analysis. If the veins are deep and not visibly popping out, use a tourniquet and have the patient lower their arm. It all depends on your preparation and equipment. Feel out all your possible options before you decide to go for it. Agree with other posters - ask them where they usually get stuck, heat packs, gr Extend the arm. Once blood is seen in the tubing, connect the vacutainers or use a syringe to drawback. This is also called the practice of venipuncture. 0000012097 00000 n The WHO has set forth the following standards of patient care for hospitals to adhere by: They also identify dangerous and unsafe practices for blood draws including, >> Related: Arterial Blood Gases (ABGs) Explained. If a vein is not prominent enough to see easily, you can feel around for it. link to Blood Test Vs Blood Donation (Comparisons), link to No More Blood Tests For Marriage License. The heat will help dilate the veins and gravity will assist in filling those veins. They are not as healthy and strong as they once were. Blankets or towels from a warmer can also be used. Avoid exaggerated hyperextension, which can be uncomfortable for the elderly. Most people have normal looking serum. 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. This can help reveal the vein. Hemolysis is one of the most common things that interfere with the tests. Using heat (such as a warm towel) or placing the extremity in a dependent position (to allow gravity to fill the veins) can help, too. In order to prevent it, professional will have to avoid phlebotomy from a hematoma and to avoid drawing plunger forcefully. of water (or other nonalcoholic drink) before your appointment. Follow the cephalic and basilic veins down the forearm. The practice of phlebotomy is not something that can strictly be learned from watching videos or reading a how-to guide but something that must be practiced repeatedly in a controlled environment with other trained professionals. Just ensure that you have drank some fluids before the test. If you dont know what a vein feels like, practice by feeling on yourself with you index finger. Quizlet Let us know if you have a preferred arm or particular vein that has been used successfully in the past to draw blood. 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. I have had patients tell me nurses are more successful in one arm than the other, etc. Grab the patients lower arm (below the site of puncture) firmly to draw the skin taut and anchor the vein from rolling. Here, I share with you all the tips and tricks I have learned doing phlebotomy over the years. You need to make sure there is no resistance whatsoever. Use left/right arrows to navigate the slideshow or swipe left/right if using a mobile device. This allowed him to see the vein and was able to get the IV in. Avoid excessive probing. If you cant find a good vein, move to the back of the hand. As a result, this will lead to the release of histamine increasing the vein. Apply heat for about 3 to 5 minutes and then assess for vein. The paramedic immediately brought out a large flash light and pressed it to the patients arm. To view the purposes they believe they have legitimate interest for, or to object to this data processing use the vendor list link below. Do not wave, fan, or blow on the area as this contaminates the area and leads to an increased risk for infection. If you do otherwise, you are going to injure the patient. The device may be limited in that instance. This forces blood up and fills the vein. Additionally, you will have to consider the reason why you are performing insertion of the needle. Dont do any heavy lifting or vigorous exercise for the rest of the day. I'm Kadia. WebInflate cuff to 30mm Hg above systolic reading and maintain pressure for about 1 to 2 minutes. That means that you can trust us to have reliable, up-to-date information Blood tests are no longer Hi! I Feel Stuck - Like My Options Are Limited, Ethical Arguments Against Mandatory Vaccination, Nursing Student on Spring Break Saves Collapsed Man's Life, Candida Auris: Dangerous Fungus Spreading in US Health Care Facilities, Nurses Week 2023 | Best Discounts, Freebies, and More. Place it at the chin and lightly draw a straight line. At some time in life, every person will do a blood test, and not only one but multiple as life goes on. Create an account and get 24 hours access for free. As a phlebotomist, venipuncture is one of the main parts of your job. In certain cases, the patient may move a bit which may result in you sticking the needle in your own finger. No matter how a patient looks like, it is necessary for a medical professional to protect himself. We strive to be the Another technique is for you to use a blood pressure cuff. Sometimes I get lucky, sometimes I get nothing. Besides proper knowledge, you will also have to have a good head on your shoulders and to make sure you follow these venipuncture guidelines closely. Veins may collapse in the process and failed attempts at blood draws lead to hematomas which bring about pain. Most of the time, the visibility of the vein depends on the patient. Drink an extra 16 oz. A close look at the site from which you will draw blood will tell you which equipment to use. 0000029232 00000 n Obese patients, particularly those considered to be extremely obese, have reported being treated with disrespect by physicians and other medical staff. Ask the individual to flex his or her arm a bit. Ask the person to lower their arm for a few minutes before applying the tourniquet. For hand veins, apply the tourniquet 1-2 inches above the wrist. Commercial heat packs are best. Rotate the wrist while maintaining the position of the arm. I'm Kadia. A lot of patients have the needle phobia. Blood pressure cuff is a great method of extracting blood in case that the veins are not visible enough. Your veins will be easier to find and palpate when you are well relaxed, as tension can constrict veins. By explaining everything, you make sure there are no surprises ahead. 0000001196 00000 n 11. Sometimes, its even hard to feel them with your finger. I will say a fair amount of Blood Collection: Special Considerations, Obese Putting some rolled towels underneath or a pillow helps, too (just make sure to put some chux on top of them in case you make a mess!). Many times combining techniques can mean the difference between finding a vein or not. Place them one by one in the holder and take samples. There are two main ways to find a vein to draw blood. I was in a patients home a few days ago and had to call EMS, the patient was obese and her spouse said she had terrible veins. Nitroglycerine is yet another substance that can help you out during phlebotomy. If they come in for their appointment well-prepared, it should be easier to find a vein almost immediately. While doing all of this, make sure to penetrate the skin with one quick move. Its important to remember that the patient is actually your most valuable resource during this process. What about other resources that may be available? WebWhen the patient has never had blood drawn The most important factor in controlling the spread of infection is Hand washing before and after the patient Latex sensitivity is a type of Allergic reaction The recommended vein to perform the venipuncture b/c sometimes is more superficial than other veins is called Median cubical vein Next step is explaining the procedure. Before you start injecting needles into people, make sure to get a proper training and get used to the entire process. With the foot- some places require a specific order r/t other dx that can increase DVT risk :) This can pose a real problem as their veins collapse quicker. Insert the needle into the vein. Make sure to find a vein that is properly hydrated. In that case, you would use the order of Draw (venipuncture). Orange light highlights veins as deep as 3 mm. I was in a patients home a few days ago and had to call EMS, the patient was obese and her spouse said she had terrible veins. The paramedic immedi If you allow the visible stress or discomfort of your patient to permeate your own mentality, then youre far more likely to make a mistake or miss the vein. If youre still experiencing difficulties, placing a warm washcloth over the puncture site can also increase blood flow and make a vein more prominent than was previously the case. If you have an issue finding the vein, do not hesitate and call for a senior, more proficient colleague. Although this is something you mightve seen a lot in the movies, you should always avoid it. 0000007172 00000 n Sometimes, the patient may experience hemoconcentration. This will fill them up much quicker which is a great way to finish procedure faster if you have a troublesome patient. You know what to look for and where to look for it, so sometimes a gentle touch can make finding a usable vein easier than looking for it. Phlebotomy basics : Nursing made Incredibly Easy - LWW If a person doesnt have enough experience, he might make a mistake by not removing the tourniquet before the needle. Select a donation type and find a convenient time that works best for you. Spaces are not allowed; punctuation is not allowed except for periods, hyphens, apostrophes, and underscores. Attach the needed tubes or syringes to remove the proper volume of blood. While holding patients arm, make sure that your finger is well above the insertion point. It will stop the bleeding and prevent the creation of hematoma. 1) Phlebotomy Pages, Words of Wisdom From and to Phlebotomists, 2014,http://www.phlebotomypages.com/expert_tips.htm, 2) The American Red Cross, Tips For A Successful Donation, 2015,http://www.redcrossblood.org/donating-blood/tips-successful-donation. Get the patient to lower his or her arm. In order to prevent hematoma, you should only puncture the uppermost wall. Always try to draw blood from veins that are lowest. It is a medical problem that increases the risk of heart disease, diabetes and certain cancers. If a person is overweight, it might be harder for a professional to find the vein. How To Draw Blood | A Step-by-Step Guide - Nurse.org We and our partners share information on your use of this website to help improve your experience. If you are a bit stiffer while rubbing the alcohol, it will prepare the hand for the procedure. Always remember to ask for help from seasoned nurses and seize opportunities to practice your skills. This can be a real time saver and it is also the best way of finding the right insertion point. There's so much that a small sample of blood can tell a doctor that you'll likely need, Giving blood is vital as it saves millions of lives every year. Top Student Loan Forgiveness Programs for Nurses, Top Nursing Interview Questions & Answers, How to Create a New Graduate Nurse Resume, Best White Shoes for Nurses and Nursing Students, Best Stethoscopes for Nurses and Nursing Students, How to Work in the US as a Foreign-Educated Nurse, Why Nursing is a Great Career Choice for Men. Dismiss. All information provided to Carrington College shall be subject to our Privacy Policy. You may need the approval of a physician or someone else. 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. However, thats not always a luxury most phlebotomists are afforded. For patients on wards, raise the head of the bed. An example of data being processed may be a unique identifier stored in a cookie. The e-mail address is not made public and will only be used if you wish to receive a new password or wish to receive certain news or notifications by e-mail. 0000007667 00000 n 0000001848 00000 n If the median cubital, cephalic, or basilic veins cant be found, then go to other sites on the arm. Have iron-rich foods, such as red meat, fish, poultry, beans, spinach, iron-fortified cereals or raisins. Place a tourniquet and clean the area for 30 seconds with an alcohol wipe. 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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