If nothing works, try with vein locator. Deliver blood specimens to the laboratory promptly. Elderly persons walking in to do blood tests usually have nicer veins, though, there will still be a few difficulties. Even with all these guidelines, perhaps the best approach is if you ask the patient from which vein they usually draw his blood. If you have specific questions, but don't want to wait, give us a call at. If you are having difficulty finding a vein or is unsuccessful at drawing blood, ask for assistance from another experienced phlebotomist or you can get help from a doctor. Call us at 1-866-236-3276 to report any additional health information that you forgot to tell us, if you have any problems or if you needed medical care after giving blood. 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. Kindness and helpfulness must be shown to them. In situations like these, you have to be patient and apply various techniques depending on the reason for the difficulty. Quiz and answer key included. Eat a healthy meal, avoiding fatty foods like hamburgers, fries or ice cream. 0000036112 00000 n However, for the elderly, it may be difficult. Select a donation type and find a convenient time that works best for you. However, thats not always a luxury most phlebotomists are afforded. 0000001512 00000 n In fact, the majority of intensive care units require their nurses to possess these skills. The consent submitted will only be used for data processing originating from this website. It is a medical problem that increases the risk of heart disease, diabetes and certain cancers. 0000185079 00000 n 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. 2023 Carrington College. Additional equipment such as goggles and splash shields should also be worn in extreme situations. 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. What may be warm to you could burn the elderly. 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. allnurses is a Nursing Career & Support site for Nurses and Students. Be careful, though. Remove the needle from the patients arm and press down on the vessel with gauze. Water may also be used to perform this technique but not warm water. Put ur fingers on the bottom of their arm and press the tops with your thumbs. Phlebotomy is essential for a variety of medical diagnoses, procedures, and tests. All e-mails from the system will be sent to this address. Continue with Recommended Cookies. Wear a shirt with sleeves that you can roll up above your elbows. There is no easy way to draw blood. Subscribe for the latest nursing news, offers, education resources and so much more! Blankets or towels from a warmer can also be used. Still, if you prepare yourself for any possible variable, you should be able to make drawing blood second nature. As a result, it can be difficult at times to find a vein to draw blood from. Doctors usually mistake if for hyperkalemia when assessing the results. Most people have normal looking serum. } Approach Considerations. Do it by performing a quick backward motion. Talk to your doctor or therapist about improving your coping skills and consider these tips to cope with obesity and your weight-loss efforts: Journal. 1-917-426-3524, By using the site you agree to our Privacy, Cookies, and Terms of Service Policies. equally, but do you know which nurses are making the most money in 2023? Those veinfinders are worthless. Insert the needle into the vein. Apply a heat compress to the area for 3-5 minutes. Usually, the antecubital area has the best veins for drawing blood. Its important to do everything in your power to ensure the comfort of the patient when drawing blood. Firstly, they are sick. It is the best thing for patients with low blood pressure. Dispose of contaminated materials and needles in the designated hospital-approved containers. Massage the arm. Inflate cuff to 30mm Hg above systolic reading and maintain pressure for about 1 to 2 minutes. To view the purposes they believe they have legitimate interest for, or to object to this data processing use the vendor list link below. If they come in for their appointment well-prepared, it should be easier to find a vein almost immediately. For example, in a case of a patient with fragile veins, it is much better to skip a tourniquet as it may cause the vein to blow out. Agree with other posters - ask them where they usually get stuck, heat packs, gravity, tie that tourniquet tight and give them a stress ball to squeeze. You want to lessen the number of sticks you give to the elderly. 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. In order to prevent hematoma, you should only puncture the uppermost wall. Fluid retention. While it is important to know the best veins to access its also important to know which areas to avoid. They should be spread distally from proximal joint to the insertion site. All information provided to Carrington College shall be subject to our Privacy Policy. Another technique is for you to use a blood pressure cuff. 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. Your veins will be easier to find and palpate when you are well relaxed, as tension can constrict veins. They need to be labeled in advance. Ask the patient where they usually get stuck. I have had patients tell me nurses are more successful in one arm than the other, etc. One thing that Then, add massage to the combination. Drawing blood from the elderly, young children, and infants can also be a challenge. Blood pressure cuff is a great method of extracting blood in case that the veins are not visible enough. Depending on whether it is for transfusion or simple blood analysis, your cannula size will vary. Use your index finger to palpate and trace the standard path of the vein on the arm. Nursing schools do not teach this skill due to legality issues. Once blood is seen in the tubing, connect the vacutainers or use a syringe to drawback. Make sure that no one gets directly exposed to blood. Spaces are not allowed; punctuation is not allowed except for periods, hyphens, apostrophes, and underscores. Average delivery time is 5-10 business days. Next step is explaining the procedure. 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. If you donate frequently, be sure to take multivitamins with iron to ensure you continue to. However, there are numerous things that can go wrong while you draw blood. When you are retaining water, it increases the total volume of fluid that is being pushed through your blood vessels by your heart. Go to Alexander Street homepage, Blood Collection: Special Considerations, Obese Patients. of water (or other nonalcoholic drink) before your appointment. If I can't feel it then I let SWAT come in with the ultrasound. 4. Furthermore, it has a low risk of damaging surrounding nerves, arteries, and tendons versus other veins in the hands. Patients health is your priority. Make sure to find a vein that is properly hydrated. 0000019017 00000 n A second option for finding veins and drawing blood are hand veins. Should RaDonda Vaught Have Her Nursing License Reinstated? For hospitalized patients, raise the head of the bed. Without further ado, here are 50 tips that will help you perform this crucial procedure. I'm Kadia. Has 12 years experience. Only tighten it if necessary. Blood tests are no longer Hi! If a vein is not prominent enough to see easily, you can feel around for it. Make sure you have one in your venipuncture equipment. The medical expert needs a certain amount of practice as there are many things that can go wrong. 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. We've looked at programs nationwide and determined these are our top schools. Is there an IV team, anesthesiologist, or other trained personnel that could be of assistance? Also, avoid cotton as fibers may stay in the wound and reopen it later on. They are not as healthy and strong as they once were. Standard data rates may apply. More than one-third of U.S. adults and 16% of U.S. children are obese. Doctors have access to deep veins like the femoral and subclavian vein that other phlebotomists dont have. Always try to draw blood from veins that are lowest. 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. Some individuals will have far more noticeable veins than others, some will be calm about the procedure and others will require a great deal of calming down, etc. When drawing blood, you will need several tubes for different samples in your equipment. The World Health Organizations (WHO) best practice guidelines for blood draws include the following: The overall purpose of establishing the guidelines is to. Dont go deep. The veins we have are the veins we will have for life. When done drawing blood, ask the patient if all is well. Sometimes, the patient may experience hemoconcentration. 0000006606 00000 n Warn the patient that they will experience a sharp scratch. Although this is a benign, temporary effect, it can be quite misleading and can lead to the bad diagnosis. Remove the tourniquet as the last amount of blood is drawn. This can help individuals with deep veins, who are obese, or with some edema. This is mainly due to the fact that different people have different biological systems which can make it harder to find and puncture the vein. Many times combining techniques can mean the difference between finding a vein or not. Maybe the number one thing that a person can do is to make sure they are well hydrated. just like everyone else. Then, apply heat to the lowered arm. Sometimes, it can still be hard to find the vein after applying the tourniquet. If you continue to use this site, we will assume that you are happy to continue. The paramedic immediately brought out a large flash light and pressed it to the patients arm. Re: the 2 tourniquet trick (above and below). Relax for a few minutes in our refreshment & recovery area have some cookies or other snacks youve earned it! 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. The nurse can take the persons blood pressure. How to Use a Vein Finder on Obese Patient. Specializes in PICU, Sedation/Radiology, PACU. The site should not be warmed to a temperature higher than 42 EC. Stay away from the palm of the hand, fingers and from the wrist area. Contact Us | Work @ Carrington | Privacy Policy | Terms of Service | Do Not Share My Personal Information | Sitemap | Student Consumer Information. By submitting this form, I authorize and agree that a representative of Carrington College can contact me about educational services and future offers by email, phone and/or text messaging at the email and telephone number provided above using an automated telephone dialing system, and/or an artificial or pre-recorded voice or text message. I'm having a hard time finding veins then starting IV or drawing blood on obese patients. This is a common misconception - pumping the hand does not increase venous circulation. As a phlebotomist, venipuncture is one of the main parts of your job. Choosing a selection results in a full page refresh. How Does Donating Blood Affect Your Body? Top Cheap and Fast Online RN to BSN Programs, Affordable Online Nurse Practitioner Programs, Top Direct-Entry Nurse Practitioner Programs, Top Psychiatric Nurse Practitioner Programs, Top Pediatric Nurse Practitioner Programs, Top Acute Care Nurse Practitioner Programs, Top Online Family Nurse Practitioner Programs, Top RN to Psychiatric Nurse Practitioner Programs, Top Womens Health Nurse Practitioner Programs, How to Get an Associate Degree in Nursing. Many times, you will have to resort there to draw blood. This technique is especially helpful with hand veins. Standard laboratory studies in the evaluation of obesity should include the following: Fasting lipid panel. Properly label the tubes and send them to the laboratory for analysis. glasses of liquids and avoid alcohol over the next 24 hours. Enjoy :). The device may be limited in that instance. 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. Follow your institutional policy when using blood pressure cuffs. element: document.getElementById("fbct7c991c3d"), You need to overcome those fears by exuberating confidence and persuading a person that everything will be alright. Lab gives us an 8 minute window (+/- 4 minutes from exactly one hour from when they finish their glucose) to get the draw. Big ppl are not bad to stick at all, especially the ones with edema. window.ClickTable.mount(options); Here are the basic steps to drawing blood: The first step in drawing blood correctly is to identify the appropriate veins to puncture. qG@OWdeDHj5b$Ze+QPbk8oo9uDP+GJXU'X96B@;"p4-BBR'@;Z6U`[VTk^9@(} f4qa l8pE2xr/4A-\1~},HZU!6)QH` T@C 6y@ Eh7| c"qnN n Qf3NQA(d2=d9 yN|1*XYa28YSIkefHIly `zhMs\\U@>fU^s,'/ksc>M# /jD/[7=6e*6c\u1_UL3Rll5nd;m,&!w{,`YNk 3 ]^]u>mrA- k`JM4>!Aoa0z't@l"4vl~"Frq}}]#)V1Z/8BnMs^|^x}^%0)&f3FY8I'wU\`Osd{z_b|{Q30Sck-BT[@'hJV2y )lw[;w]p39=%=N|=}|60m2}Edt/#2x!Ta}$n8x4py}` lt endstream endobj 202 0 obj <>stream Pumping fists can lead to pseudohyperkalemia or increased level of potassium in the blood. WebBy using a syringe and needle to draw the patient's blood, you can control the pressure and speed at which the blood is removed by varying the rate that you pull back on the With the foot- some places require a specific order r/t other dx that can increase DVT risk :) Before and after the insertion, the tube should be left in the holder. Having years of experience in laboratory work and phlebotomy, Kadia Constant enjoys sharing what he has learned. On the surface, it seems as a rudimentary procedure, one that doesnt require any special training. Some veins can be deep in the antecubital fossa area, especially, if there is a lot of fat tissue. A 3ml, 5ml or 10ml syringe will work fine. There is a nice way to fill the tubes faster. The gratification of giving blood is a feeling you'll want to share. Utilize the combination of massage, heat, and gravity. WebDrink an extra 16 oz. Measure the distance from the top of the head to the chin. Frail veins can pose a great problem when drawing blood. HlV7WF#J$% r!h {7@)RRXZ4J9(e??@!o]h&Do?Y[L *fIXH^ Before you can start, you need to ask the patient if he has any allergies to drugs. You could get help from them. Applied Muscle Tension (AMT) is a series of simple exercises that help your blood pressure stay up and improve blood flow, so your chance of experiencing any side effects, like fainting, stays low. Your approach is something that can vastly affect the patient, making the whole experience more or less enjoyable. Make sure you check with the nurse first for permission. The loss of support makes it easy for veins to roll causing difficulty in drawing blood. 3. 6. 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. We worked with CreditCards.com to help nurses find the right card to fit their lifestyle. Luckily, got it on the first stick. What Does VEAL CHOP Stand For in Nursing? 0000015433 00000 n Before you start injecting needles into people, make sure to get a proper training and get used to the entire process. Just ensure that you have drank some fluids before the test. Gravity alone will help reveal veins that were not visible or palpable earlier. This is due largely to the fact that patient factors will vary greatly when it comes to drawing blood. Word of caution: make sure to remove the substance before rubbing the vein with alcohol. The worst thing you can do is to continue stabbing the patient. As a result, this will lead to the release of histamine increasing the vein. If youre a phlebotomist who has encountered this problem before, you know how frustrating it can be. We and our partners use data for Personalised ads and content, ad and content measurement, audience insights and product development. Try tourniquets, hot packs, gravity, and ask the patient where they usually have luck with blood draws. So, get help! Perform good hand hygiene and don appropriate PPE. Hopefully, these 50 tips will help you establish what is ok and what is not. This makes sense, as many individuals, particularly those with very low body fat in their arms, will have extremely visible veins. ARe there any tips on how to be more successful? 11. 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. These exercises can be performed throughout your donation and afterwards in the refreshment area. You should never tie it too tightly at first. There are tips for making veins pop out when taking blood. Carrington College does not recruit or enroll residents of the European Union. Ask the person to lower their arm for a few minutes before applying the tourniquet. Then, deflate blood pressure cuff and apply tourniquet. This is painful and can bruise the patient. 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. Afterward, make sure to store them properly. allnurses, LLC, 175 Pearl St Ste 355, Brooklyn NY 11201 You need full access to the arm so you will have to sit in front of the patient, a bit to his side. Similarly to insertion, removal of the needle should also be swift and efficient. For novice phlebotomists, this vein is the first choice because it is close to the skins surface and tends not to roll when punctured. Unfortunately, some people have difficult veins to work with due to obesity, dehydration, and a variety of other issues. After a few minutes, gently tap the site of the puncture with your fingers to make the vein pop out. If you havent rested properly, this can affect your ability to perform venipuncture and can lead to critical mistakes which you, as a professional, cannot afford. At nurse.org, we believe that no one knows nurses better than, well, nurses. (Immediate download. Anchor the vein from below with your non-dominant hand by gently pulling on the skin distal to the insertion site. The three most commonly used veins for drawing blood are the median cubital, the cephalic, and the basilic veins. Syringe, vacutainer, and needle size should Fourthly, they are not very active, possibly causing lower blood pressure, hence slower blood flow. If you experience dizziness or lightheadedness, stop what youre doing and sit down or lie down until you feel better; avoid performing any activity where fainting may lead to injury for at least 24 hours. 0000001196 00000 n hbba`b``3~0 U endstream endobj 197 0 obj <>/Metadata 31 0 R/Pages 30 0 R/StructTreeRoot 33 0 R/Type/Catalog/ViewerPreferences<>>> endobj 198 0 obj >/PageTransformationMatrixList<0[1.0 0.0 0.0 1.0 -306.0 -396.0]>>/PageUIDList<0 193>>/PageWidthList<0 612.0>>>>>>/Resources<>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageC]/XObject<>>>/Rotate 0/StructParents 0/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>> endobj 199 0 obj <> endobj 200 0 obj [/Separation/Beaumont#20Blue 221 0 R<>] endobj 201 0 obj <>stream