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 There are tips for making veins pop out when taking blood. Massaging may help you in finding a vein if you have not already found one. The most common vein is the antecubital fossa; however, the median cephalic and median basilic veins are also used. glasses of liquids and avoid alcohol over the next 24 hours. 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. This will cause a lot of mess. They are not as healthy and strong as they once were. Let us know if you have a preferred arm or particular vein that has been used successfully in the past to draw blood. This is the name displayed to others on any playlists or clips you share, Copyright 2023 by Alexander Street, part of Clarivate, Logo of Alexander Street, part of Clarivate. Enjoy :). 0000012940 00000 n
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Properly label the tubes and send them to the laboratory for analysis. Then, deflate blood pressure cuff and apply tourniquet. 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. 0000001689 00000 n
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To find out the advantages of the syringe method go here. WebA measurement around your waist. This will lead to a better compression that will properly regulate the pressure. More than one-third of U.S. adults and 16% of U.S. children are obese. Always avoid drawing blood from areas where the skin is damaged, inflamed, infected or burned. Nowadays, there is equipment that can help us locate the vein. Red light reaches a depth up to 6 mm. Blood tests are no longer Hi! Unfortunately, some people have difficult veins to work with due to obesity, dehydration, and a variety of other issues. We use cookies to ensure that we give you the best experience on our website. Our members represent more than 60 professional nursing specialties. Many times, you will have to resort there to draw blood. We worked with CreditCards.com to help nurses find the right card to fit their lifestyle. 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. Reasons for concern would include numbness, tingling, change of color to blue or white, and extreme pain. I have had patients tell me nurses are more successful in one arm than the other, etc. What constitutes a difficult vein? When done drawing blood, ask the patient if all is well. Most of the time, the visibility of the vein depends on the patient. In that case, you would use the order of Draw (venipuncture). Increased body mass can also lead to issues during venipuncture. Thank you. If a patient is reluctant or fearful, it can interfere with drawing blood. Subscribe for the latest nursing news, offers, education resources and so much more! Then, massage from the wrist to the elbow. Perform hand hygiene and don proper PPE. In order to prevent hematoma, you should only puncture the uppermost wall. Follow your institutions policy when using heat. It is a medical problem that increases the risk of heart disease, diabetes and certain cancers. This is painful and can bruise the patient. I hope you find my posts helpful. What are some tips and techniques for drawing blood from an elderly person? 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. First, remember where to look. While holding patients arm, make sure that your finger is well above the insertion point. Although this is not a necessity, it is pretty much recommended. Standard laboratory studies in the evaluation of obesity should include the following: Fasting lipid panel. Prepare by drinking enough fluids before the blood test. This will move their fluid and/or tissue out of the way so you can see a good vein. You dont have to drink tons of water the night before but the recommended daily water intake should suffice. This Then, add massage to the combination. As the body ages, the skin becomes thinner and blood vessels become weaker. Thirdly, they may lose their appetite and drink less fluids. Contact Us | Work @ Carrington | Privacy Policy | Terms of Service | Do Not Share My Personal Information | Sitemap | Student Consumer Information. Try tourniquets, hot packs, gravity, and ask the patient where they usually have luck with blood draws. Most people have normal looking serum. Going there is risky as you can hit a nerve or tendon. Insertion point should be under 15 to 30 degrees angle. After that, you need to see if the patient has any medical condition, if he is using drugs or if he is fasting. Please bring your donor card, driver's license or two other forms of identification. 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. Nitroglycerine is yet another substance that can help you out during phlebotomy. 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. 0000276013 00000 n
This will give you more stability and it will relax you. Dont do any heavy lifting or vigorous exercise for the rest of the day. If you can see the vein clearly, then this will only help you ensure that you place the needle correctly the first time. Most times, drawing blood is not that difficult, but there those occasions when you will get a difficult person. 1 Article; Use either a syringe or the luer adapter with the butterfly system. Remove the needle from the patients arm and press down on the vessel with gauze. After a few minutes, gently tap the site of the puncture with your fingers to make the vein pop out. Talk about pressure! Otherwise, it may indicate that you have missed which is when you should immediately back up. Anchor the vein. Its important to do everything in your power to ensure the comfort of the patient when drawing blood. But sometimes, it can find a vein you didnt see or feel. Avoid exaggerated hyperextension, which can be uncomfortable for the elderly. Insert the needle at a 15 to 30-degree angle into the vessel. You can try several approaches mentioned earlier in our venipuncture guidelines that will increase the vein. In order to prevent it, professional will have to avoid phlebotomy from a hematoma and to avoid drawing plunger forcefully. Approach Considerations. 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. Firstly, they are sick. If the median cubital, cephalic, or basilic veins cant be found, then go to other sites on the arm. On the surface, it seems as a rudimentary procedure, one that doesnt require any special training. Doctors have access to deep veins like the femoral and subclavian vein that other phlebotomists dont have. Continue with Recommended Cookies. 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. Wear a shirt with sleeves that you can roll up above your elbows. 0000029592 00000 n
Reflecting off the subcutaneous tissue, the light colors subcutaneous and fat tissue. A transilluminator is a cool way of finding or confirming veins. Would hate for the patient to have to come back and drink that Glucola again. With the foot- some places require a specific order r/t other dx that can increase DVT risk :) 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. Those veinfinders are worthless. mount_type: "" Drink plenty of water an hour before the draw. Sometimes you won't be able to see the veins at all, but you will be able to palpate them. Patients health is your priority. If you continue to use this site, we will assume that you are happy to continue. Try tourniquets, hot packs, gravity, and ask the patient where they usually have luck with blood draws. She hit the vein on the first try. If you encounter such a person, make sure to draw blood from larger veins instead of the smaller ones. They are springy and bouncy. The nurse can take the persons blood pressure. 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. Sometimes, it can still be hard to find the vein after applying the tourniquet. Even though most hospitals do have phlebotomy teams, it is still critical for nurses to learn these skills in order to provide the best patient care. Make sure not to press too hard! WebPatients who are dehydrated, obese, terminally ill, or hard sticks often get their blood drawn in other locations rather than the antecubital fossa. qG@OWdeDHj5b$Ze+QPbk8oo9uDP+GJXU'X96B@;"p4-BBR'@;Z6U`[VTk^9@(} f4qa l8pE2xr/4A-\1~},HZU!6)QH` T@C 6y@
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Below are several tips and tricks that you can use when you are faced with a difficult blood draw. I am a full time phlebotomist and I enjoy my job. Finding difficult veins isnt impossible, but it can require a few different methods to be put into place. For novice phlebotomists, this vein is the first choice because it is close to the skins surface and tends not to roll when punctured. It uses high intensity light that is directed down through the skin. 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 have an issue finding the vein, do not hesitate and call for a senior, more proficient colleague. 0000016846 00000 n
In fact, based on this, the entire procedure can be harder or easier. WebIf you are drawing blood from an arm, make sure to sit near the patient, as close as possible. Kindness and helpfulness must be shown to them. For routine antisepsis, you can use a standard alcohol prep pad or alcohol-impregnated swabs. I am a Licensed Phlebotomist and Certified Medical Assistant of 15+ years with 14+ years of clinical experience. The first step is to discuss with the patient what you will be doing and why as well as gather all the needed supplies. Next step is explaining the procedure. So, get help! After assembling the appropriate equipment, follow the next steps to perform a proper venipuncture. This is due largely to the fact that patient factors will vary greatly when it comes to drawing blood. Also, avoid cotton as fibers may stay in the wound and reopen it later on. 0000005129 00000 n
You have to palpate first and decide from there. 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. Avoid exaggerated hyperextension, which can be uncomfortable for the elderly. Instead of forcefully tapping the vein, it is much better if you start stroking them. The information provided should not be used for diagnosing or treating a health problem or disease. Usually, if you cant find a vein in the antecubital fossa or at the back of the hand, you will find one in the forearm. Bloating. Next, locate the vein you will be using for the blood draw. In a way, you have to entertain a person during phlebotomy. Insert along the vein. element: document.getElementById("fbct7c991c3d"), *This website is provided for educational and informational purposes only and does not constitute providing medical advice or professional services. Position the patient and hyperextend the patients arm. These can include: Learning about your Hopefully, these 50 tips will help you establish what is ok and what is not. The needle has passed through the vein. They need to be labeled in advance. ), 2023 Center for Phlebotomy Education All Rights Reserved, Phlebotomy Continuing Education Exercise (ATM): Phlebotomy and the Obese Patient. Use these tips to reduce the level of difficulty and make your chances more successful. We strive to be the They can be riskier, especially if you need to draw a lot of blood. Spend a decent amount of time looking for good veins. 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. Become a Part of the Nurse.org Community! The veins we have are the veins we will have for life. 2. 0000016460 00000 n
The worst thing you can do is to continue stabbing the patient. You want to lessen the number of sticks you give to the elderly. Sometimes you can find a good one there, though be careful as you insert the needle. They already have pain, so lets make the process easier and more comfortable for them. To view the purposes they believe they have legitimate interest for, or to object to this data processing use the vendor list link below. 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. In the case of children or uncooperative individuals, restraints are an option but they should be avoided at all costs. 0000008110 00000 n
Big ppl are not bad to stick at all, especially the ones with edema. My trick is to press on their hand or arm with both of my thumbs. Put ur finge Press enter to open the dropdown list, then press tab and enter to choose the language. Invert a BP cuff so that the blood can go to the lower regions of the limb. But lots of people swear by it, so there might be something to it! Even with all these guidelines, perhaps the best approach is if you ask the patient from which vein they usually draw his blood. Massage the arm from the wrist to the elbow if using arm veins. Pumping fists can lead to pseudohyperkalemia or increased level of potassium in the blood. Usually, it happens due to squeezing or massaging around the site or due to prolonged application of the tourniquet. 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. Also, you can gently press the needle against the venipuncture site for several seconds before insertion so that the nerves can get accustomed. To use a tourniquet to draw blood correctly, you should tie it three or four inches directly above the puncture site. Without proper specimens, unhelpful or even harmful medical treatment could happen. Some jumping jacks or push-ups can make your veins pop out. Pump the fists! Veins may collapse in the process and failed attempts at blood draws lead to hematomas which bring about pain. 0000006606 00000 n
Dont go deep. It can really make the veins pop. After identifying the site for the blood draw, gather the appropriate supplies needed. Obese patients, particularly those considered to be extremely obese, have reported being treated with disrespect by physicians and other medical staff. This helps you build trust with a patient even further. Quiz and answer key included. Press the space key then arrow keys to make a selection. of water (or other nonalcoholic drink) before your appointment. Follow your institutional policy when using blood pressure cuffs. It needs to remain loose. Is there an IV team, anesthesiologist, or other trained personnel that could be of assistance? Insert the beveled needle at a 30-degree angle into the vessel. 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 You can do that by gently massaging the arm, from the wrist to the elbow. Apply heat for about 3 to 5 minutes and then assess for vein. 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. Insert the needle through the skin at a 30-degree angle or less, with the bevel facing upwards. 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.
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