var options = { Specializes in Wound Care. Another thing a person can do is to try to be relaxed as much as possible. For patients on wards, raise the head of the bed. They can help you to find a usable vein quickly, so you can get the blood draw you need, and your patient can remain comfortable throughout the experience. Ask the individual to elevate his or her arm at the elbow. 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. Very often, drinking water will get veins to show up that were not visible or palpable before. With the foot- some places require a specific order r/t other dx that can increase DVT risk :). Properly label the tubes and send them to the laboratory for analysis. Even with all these guidelines, perhaps the best approach is if you ask the patient from which vein they usually draw his blood. 0000022045 00000 n Slapping can lead to contraction which can further decrease the veins, producing an adverse result. The forearm is about the last place to look. Do not be afraid to touch your patient. When you are retaining water, it increases the total volume of fluid that is being pushed through your blood vessels by your heart. This makes sense, as many individuals, particularly those with very low body fat in their arms, will have extremely visible veins. Maybe you have the right environment, chair, and equipment to draw from them successfully, but do you give them the respect that's often lacking in healthcare? The bevel of the needle should go upwards. No matter how a patient looks like, it is necessary for a medical professional to protect himself. Before you can start, you need to ask the patient if he has any allergies to drugs. Insertion point should be under 15 to 30 degrees angle. You want to lessen the number of sticks you give to the elderly. Massaging may help you in finding a vein if you have not already found one. 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. Here are the basic steps to drawing blood: The first step in drawing blood correctly is to identify the appropriate veins to puncture. If you do otherwise, you are going to injure the patient. The paramedic immediately brought out a large flash light and pressed it to the patients arm. A transilluminator is a cool way of finding or confirming veins. Massage the arm from the wrist to the elbow if using arm veins. You should never tie it too tightly at first. Usually, the antecubital area has the best veins for drawing blood. This study guide will help you focus your time on what's most important. Youll be the first to know about nursing news, trending topics and educational resources. There is a nice way to fill the tubes faster. Nowadays, there is equipment that can help us locate the vein. To find out the advantages of the syringe method go here. What if I cant find a vein? 0000025579 00000 n Go to Alexander Street homepage, Blood Collection: Special Considerations, Obese Patients. A better vein might be available in the forearm or at the back of the hand. Become a Part of the Nurse.org Community! We've looked at programs nationwide and determined these are our top schools. Once you remove the needle, gauze should be applied for a bit. Some of our partners may process your data as a part of their legitimate business interest without asking for consent. If you donate your blood to organizations like the American Red Cross, then you can rest easy knowing, A phlebotomist is a medical professional whose main job is drawing blood. Also, by palpation, you can sometimes feel valves in people and learn to avoid them. By placing a warm towel over the veins, you are increasing the blood vessels which will make them more visible. As we mentioned, it is your duty as a medical professional to ensure the patient that everything will be ok. This will fill them up much quicker which is a great way to finish procedure faster if you have a troublesome patient. It is crucial to use needle and cannula that is smaller than the patients vein. Only tighten it if necessary. 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. 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. Students should study venipuncture in books and watch licensed nurses in clinical settings perform this task. This is painful and can bruise the patient. If you can see the vein clearly, then this will only help you ensure that you place the needle correctly the first time. Explain the procedure and reason for the blood draw to the patient. It can be done by palpating the vessel or via transillumination with a special light. After a few minutes, gently tap the site of the puncture with your fingers to make the vein pop out. 3,377 Posts. If no blood flows, pull out the needle and repeat the draw. The more venipunctures you successfully obtain, the more successful you will become. Has 10 years experience. After identifying the site for the blood draw, gather the appropriate supplies needed. 0000029232 00000 n On top of that, there are a lot of individuals who fear (or dislike) going to a doctor. We strive to be the At nurse.org, we believe that no one knows nurses better than, well, nurses. Don't take aspirin for 2 days before your appointment. For hand veins, apply the tourniquet 1-2 inches above the wrist. Click to visit Blood Collection: Special Considerations, Obese Patients 0000017785 00000 n Make sure to find a vein that is properly hydrated. These exercises can be performed throughout your donation and afterwards in the refreshment area. Secondly, they lay most of the time. In fact, most of the procedures cannot be performed if you dont have a clear head on your shoulders. A 3ml, 5ml or 10ml syringe will work fine. 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. Always avoid drawing blood from areas where the skin is damaged, inflamed, infected or burned. This is a common misconception - pumping the hand does not increase venous circulation. So, get help! Afterward, make sure to store them properly. 0000006606 00000 n Do not wave, fan, or blow on the area as this contaminates the area and leads to an increased risk for infection. instance: "61c9f514f13d4400095de3de", Subscribe for the latest nursing news, offers, education resources and so much more! Everyones arm anatomy is different and while one technique may work for a person, combining two or three may be the answer for another. Premarital blood tests have been done away with. HlV7WF#J$% r!h {7@)RRXZ4J9(e??@!o]h&Do?Y[L *fIXH^ However, this article will take you through the basics of drawing blood so you can understand the steps and guidelines. equally, but do you know which nurses are making the most money in 2023? Here, I share with you all the tips and tricks I have learned doing phlebotomy over the years. 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 its possible for you to give your patients some tips ahead of time, this can make hard-to-find veins for a blood draw so much easier. Doing so can help move veins and tendons away from each other increasing the likelihood for a vein to show up. This allowed him to see the vein and was able to get the IV in. Lab gives us an 8 minute window (+/- 4 minutes from exactly one hour from when they finish their glucose) to get the draw. If you cant find one, consider the third option, the forearm. The region from which you are drawing blood has to have a healthy tissue. For outpatient areas, ask the patient to hold their arms at their side for a few minutes. 8, 9 Even Donating Platelets? What are some tips and techniques for drawing blood from an elderly person? This can help reveal the vein. Pump the fists! Ask the person to lower their arm for a few minutes before applying the tourniquet. When you draw their blood, are you ready for them? If you encounter such a person, make sure to draw blood from larger veins instead of the smaller ones. 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. 1-917-426-3524, By using the site you agree to our Privacy, Cookies, and Terms of Service Policies. element: document.getElementById("fbct7c991c3d"), Make sure bleeding at the puncture site has stopped and the site is cared for. This is especially important for babies and small children that have the natural aversion to needles. If a vein is not prominent enough to see easily, you can feel around for it. Maybe the number one thing that a person can do is to make sure they are well hydrated. Patients hand should be dangling so that the blood can rush down and fill the veins. Pumping fists can lead to pseudohyperkalemia or increased level of potassium in the blood. link to Blood Test Vs Blood Donation (Comparisons), link to No More Blood Tests For Marriage License. The worst thing you can do is to continue stabbing the patient. Before and after the insertion, the tube should be left in the holder. Make sure they are feeling well before leaving. Rolling up gown sleeves (rather than pushing sleeves up) to enhance tourniquet visibility. They are springy and bouncy. The needle should fully penetrate it. The WHO has best practices that are key to preventing infection and being successful during blood draws. The loss of support makes it easy for veins to roll causing difficulty in drawing blood. The elderly need special care and attention when doing a blood test. Using your thumb, pull back on the skin and hold the vein down. 0000276013 00000 n 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. Thyroid function tests. I'm Kadia. Follow us and never miss out on the best in nursing news. 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. Sometimes you can find a good one there, though be careful as you insert the needle. In that case, you would use the order of Draw (venipuncture). WebPatients who are dehydrated, obese, terminally ill, or hard sticks often get their blood drawn in other locations rather than the antecubital fossa. Ask the patient where they usually get stuck. Sometimes, you may see a tendon thinking that it is a vein. Alternate arms if youve given blood recently. Gloves are a must. With vein locators, you can see where all the veins are. When done drawing blood, ask the patient if all is well. Wear a shirt with sleeves that you can roll up above your elbows. The elderly are prone to bruising when applying the tourniquet. WebSome obese people are no prob, but some have deep veins, rolly pollies, etc. 5. possible. Here, I share with you all the tips and tricks I have learned doing phlebotomy over the years. The patients vein may have collapsed. window.ClickTable.mount(options); Have iron-rich foods, such as red meat, fish, poultry, beans, spinach, iron-fortified cereals or raisins. Spend a decent amount of time looking for good veins. In the end, if other medical experts managed to draw blood from a particular vein, you can do the exact same thing. It can help veins to pop up, making them probably visible and easier to find. It helps us establish if there is something wrong with the body and what to look out for. This, in turn, can cause increases in your blood pressure. }()); Drawing blood from a patient can be a daunting task, but it also is a necessity for nurses. Manage Settings 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. Carrington College does not recruit or enroll residents of the European Union. Patients health is your priority. You need to have a firm, strong grip on patients hand. A trick I use sometimes is putting a second tourniquet 2 inches above the first tourniquet. Create an account and get 24 hours access for free. Venipuncture or drawing blood is one of the most common procedures performed in any medical center. What Does Blood Draw or Venipuncture Training Involve? With the foot- some places require a specific order r/t other dx that can increase DVT risk :) Commercial heat-packs are best for this technique as you can choose the temperature you want. 0000018898 00000 n Grab the patients lower arm (below the site of puncture) firmly to draw the skin taut and anchor the vein from rolling. Moreover, because their veins are so fragile, the elderly may receive several sticks in order to draw blood or get sufficient blood. If all else fails, you can always use drugs. Make sure you have one in your venipuncture equipment. Perform hand hygiene and don proper PPE. If this does not happen then the needle has either not punctured the vein or the needle went through the vessel. If using wet or damp washcloths, do so with caution. When the last one is done, you need to remove the tourniquet. Also, avoid cotton as fibers may stay in the wound and reopen it later on. Congratulations, you just took the first step towards a new future by furthering your education. Should RaDonda Vaught Have Her Nursing License Reinstated? Your approach is something that can vastly affect the patient, making the whole experience more or less enjoyable. If the antecub has already been accessed there are great options for venipuncture. Fat, or obese patients, have more fat around their veins which can make it difficult to find the vein for drawing blood or starting an IV. Massage the arm. 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. This can pose a real problem as their veins collapse quicker. We and our partners use cookies to Store and/or access information on a device. No matter what, always take your time to find just the right vein. In certain cases, the patient may move a bit which may result in you sticking the needle in your own finger. First, remember where to look. There are various reasons to perform a phlebotomy. Keep the strip bandage on for the next several hours; to avoid a skin rash, clean the area around the bandage with soap and water. The needle may have pulled out of the vein. 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. 4. The hand and lower arm are the best places for transilluminators. They should be spread distally from proximal joint to the insertion site. We'll need to know about all prescription and over-the-counter medications you're taking. It can really make the veins pop. I have had patients tell me nurses are more successful in one arm than the other, etc. 0000012539 00000 n I am a Licensed Phlebotomist and Certified Medical Assistant of 15+ years with 14+ years of clinical experience. Invert a BP cuff so that the blood can go to the lower regions of the limb. Drawing blood from the elderly, young children, and infants can also be a challenge. I hope you find my posts helpful. Obese patients, particularly those considered to be extremely obese, have reported being treated with disrespect by physicians and other medical staff. Big ppl are not bad to stick at all, especially the ones with edema. Select a donation type and find a convenient time that works best for you.
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