If you are drawing blood from an arm, make sure to sit near the patient, as close as possible. Always remember to ask for help from seasoned nurses and seize opportunities to practice your skills. I once had a patient who was a VERY difficult stick - I brought in the best of the best IV starters that were working that night, but no luck. This is especially important for babies and small children that have the natural aversion to needles. 0000029232 00000 n 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. Inflate cuff to 30mm Hg above systolic reading and maintain pressure for about 1 to 2 minutes. (function() { Pumping fists can lead to pseudohyperkalemia or increased level of potassium in the blood. Spaces are not allowed; punctuation is not allowed except for periods, hyphens, apostrophes, and underscores. Wear a shirt with sleeves that you can roll up above your elbows. This can help individuals with deep veins, who are obese, or with some edema. Fasting glucose and hemoglobin A1c (HbA1c) Other tests are performed as indicated by clinical findings. Let us know if you have a preferred arm or particular vein that has been used successfully in the past to draw blood. 196 0 obj <> endobj xref Otherwise, it may indicate that you have missed which is when you should immediately back up. Relax for a few minutes in our refreshment & recovery area have some cookies or other snacks youve earned it! Some patients are easier than others because of the prominence of their veins. Massage the arm from the wrist to the elbow if using arm veins. ), 2023 Center for Phlebotomy Education All Rights Reserved, Phlebotomy Continuing Education Exercise (ATM): Phlebotomy and the Obese Patient. They need to be labeled in advance. This is also called the practice of venipuncture. What about other resources that may be available? I have to say, I started off doing venipuncture for lab draws prior to IVs and found that a good way to learn. However, there are numerous things that can go wrong while you draw blood. Webwhy might it be difficult to draw blood from an elderly patient The skin becomes thin and blood vessels become weaker how much whole blood is needed to yield 5 mL of serum WebIn this module, you'll learn why the right approach is critical when drawing from overweight patients, and you'll have a newfound appreciation for what it's like for too many If nothing works, try with vein locator. obese patient If you donate frequently, be sure to take multivitamins with iron to ensure you continue to. If you have an issue finding the vein, do not hesitate and call for a senior, more proficient colleague. Orange light highlights veins as deep as 3 mm. Apply the tourniquet one to two inches above the wrist if drawing a hand vein. Just ensure that you have drank some fluids before the test. While doing all of this, make sure to penetrate the skin with one quick move. 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. My trick is to press on their hand or arm with both of my thumbs. Although this is a benign, temporary effect, it can be quite misleading and can lead to the bad diagnosis. Using alcohol or some other antiseptic, wet the site. Avoid exaggerated hyperextension, which can be uncomfortable for the elderly. If youre a phlebotomist who has encountered this problem before, you know how frustrating it can be. 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. As the body ages, the skin becomes thinner and blood vessels become weaker. Instead, make sure to remove tourniquet first and then remove the needle followed by instant pressure on the insertion point. Spend a decent amount of time looking for good veins. Try tourniquets, hot packs, gravity, and ask the patient where they usually have luck with bl You can support each other and do twice as much good! It used to be that all 50 states required blood tests before getting a marriage license but that is no longer the case. In the end, if other medical experts managed to draw blood from a particular vein, you can do the exact same thing. 5. Be careful when using wet or damp washcloths. 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. Still, if you prepare yourself for any possible variable, you should be able to make drawing blood second nature. Below are 5 key areas of importance with tips. 0000008110 00000 n It can help veins to pop up, making them probably visible and easier to find. At outpatient areas, ask the patient to hold their arm at their side for a few minutes. I've been an RN for almost 3 years and an ED tech prior to that (which is where I learned my IV skills- nursing school sure didn't teach me much!). Choosing a selection results in a full page refresh. 0000008644 00000 n Other times, they dont want to pop out or raise for the phlebotomist to be able to draw successfully. Weight gain. A doctor can access the femoral vein and others to draw blood. Nursing schools do not teach this skill due to legality issues. No matter what, always take your time to find just the right vein. True allergies should be identified on an allergy ID band but sensitivities may not be reported at the time of patient admission. Scar tissue can especially be problematic as it is hard to penetrate. Increased body mass can also lead to issues during venipuncture. Then, push down with the flat of the finger over the area. 0000276013 00000 n Another technique is for you to use a blood pressure cuff. Obesity - Diagnosis and treatment - Mayo Clinic 2. The nurse can take the persons blood pressure. There are tips for making veins pop out when taking blood. It worries me to see so many people in this thread and others talk about seeing veins and palpating them only if you can't see one. Venous access s Here, I share with you all the tips and tricks I have learned doing phlebotomy over the years. You need to have a firm, strong grip on patients hand. Extend the arm. Get the patient to lower his or her arm. Attach the needed tubes or syringes to remove the proper volume of blood. If necessary, apply the tourniquet and examine the median cubital, cephalic, and basilic veins. possible. Once blood is seen in the tubing, connect the vacutainers or use a syringe to drawback. 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. At some time in life, every person will do a blood test, and not only one but multiple as life goes on. With this in mind, you should be sure that youre getting any requisite or helpful information from your patient before beginning to draw blood. 0000012940 00000 n Ask the patient where they usually get stuck. of water (or other nonalcoholic drink) before your appointment. Always try to draw blood from veins that are lowest. A trick I use sometimes is putting a second tourniquet 2 inches above the first tourniquet. For novice phlebotomists, this vein is the first choice because it is close to the skins surface and tends not to roll when punctured. 0000260220 00000 n go-to source for nursing news, trending topics, and educational resources. To expedite your donation, start your RapidPass on the day of your appointment. If all else fails, you can always use drugs. Be careful, though. WebYour effort to overcome obesity is more likely to be successful if you follow strategies at home in addition to your formal treatment plan. These other sites should always only be considered when there are no other viable options available to you. We've looked at programs nationwide and determined these are our top schools. If the needle site starts to bleed, apply pressure and raise your arm straight up for 5-10 minutes or until bleeding stops. The most common vein is the antecubital fossa; however, the median cephalic and median basilic veins are also used. if (window.ClickTable) { Drink an extra four (8 oz.) Perform good hand hygiene and don appropriate PPE. 0000001848 00000 n WebIf you are drawing blood from an arm, make sure to sit near the patient, as close as possible. Closely monitor the arm to ensure that is is not applied to tight or for more than 2 minutes. Wetting the area, followed by deep massaging or palpating will oftentimes reveal or confirm vein location. Use either a syringe or the luer adapter with the butterfly system. Learning the anatomy of the main veins and arteries in the body is essential to becoming competent in phlebotomy. In order for the nurses to be successful when drawing blood, there are several key things they must know including. How to Use a Vein Finder on Obese Patient. Avoid exaggerated hyperextension, which can be uncomfortable for the elderly. First, gather all of your supplies and discuss with your patient what you are going to be performing. Donating Platelets? Ask the person to lower their arm for a few minutes before applying the tourniquet. 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.
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