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. The three most commonly used veins for drawing blood are the median cubital, the cephalic, and the basilic veins. That is usually the last resort. 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. In order to prevent it, professional will have to avoid phlebotomy from a hematoma and to avoid drawing plunger forcefully. Blood of water (or other nonalcoholic drink) before your appointment. 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. To find out the advantages of the syringe method go here. However, in addition to our natural vein anatomy, here are several reasons why your veins may pose some difficulty when doing a blood test. In the case of children or uncooperative individuals, restraints are an option but they should be avoided at all costs. The most common vein is the antecubital fossa; however, the median cephalic and median basilic veins are also used. Massage the arm from the wrist to the elbow if using arm veins. Press enter to open the dropdown list, then press tab and enter to choose the language. Most times, drawing blood is not that difficult, but there those occasions when you will get a difficult person. Avoid exaggerated hyperextension, which can be uncomfortable for the elderly. Tips For A Successful Blood Donation | Red Cross Blood Services 8, 9 Even You need to keep their attention and make sure they do not notice the needle. Is there an IV team, anesthesiologist, or other trained personnel that could be of assistance? 2. WebPatients who are dehydrated, obese, terminally ill, or hard sticks often get their blood drawn in other locations rather than the antecubital fossa. Below are several tips and tricks that you can use when you are faced with a difficult blood draw. Dismiss. If at the hospital, get nursing staff to assist you. 0000014430 00000 n Weight gain. 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. Pull it back slightly and blood should flow. You can try several approaches mentioned earlier in our venipuncture guidelines that will increase the vein. *This website is provided for educational and informational purposes only and does not constitute providing medical advice or professional services. Password must have at least 1 special character(s). I'm having a hard time finding veins then starting IV or drawing blood on obese patients. Approach Considerations. Nitroglycerine is yet another substance that can help you out during phlebotomy. Liver function studies. 196 0 obj <> endobj xref What constitutes a difficult vein? During phlebotomy, the doctor is the one that needs to ensure everything goes well. obese Ask the person to lower their arm for a few minutes before applying the tourniquet. This helps you build trust with a patient even further. It allows the phlebotomist to control the vacuum, which is good because it is much less traumatic on a patient's vein. First, gather all of your supplies and discuss with your patient what you are going to be performing. In order to reduce the risk of thrombosis, lines need to be flushed with a solution of heap in. Sometimes theyre very small, or hard to see. Some will come on wheelchairs, using a cane, needing help to walk, move, sit and stand. Use a transilluminator to find or confirm vein A transilluminator is a cool way of finding or confirming veins. To use a tourniquet to draw blood correctly, you should tie it three or four inches directly above the puncture site. Specializes in RN-BC, CCRN, TCRN, CEN. Password must have at least 8 character(s). 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. If you cant find a good vein, move to the back of the hand. An elderly persons veins are prone to collapsing, which could mean, you may have to try several times at drawing blood. However, this article will take you through the basics of drawing blood so you can understand the steps and guidelines. 0000005419 00000 n When the body is properly hydrated, veins become more dilated. Try tourniquets, hot packs, gravity, and ask the patient where they usually have luck with blood draws. This will help force blood up and fills the veins making a vein pop up. 0000031034 00000 n Veins become more visible when blood is forced into them. Phlebotomy basics The gratification of giving blood is a feeling you'll want to share. When performing venipuncture, he needs to convince a person that he is capable of drawing blood safely. Continuous interaction can help distract a person during this time. The heat will help dilate the veins and gravity will assist in filling those veins. 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. There is a nice way to fill the tubes faster. window.addEventListener('click-table-loaded', function(){ Your veins will be easier to find and palpate when you are well relaxed, as tension can constrict veins. There is no easy way to draw blood. If the blood is not delivered in a timely manner it can cause hemolysis and skew the lab results. After that, pressure needs to be applied on insertion point. It used to be that all 50 states required blood tests before getting a marriage license but that is no longer the case. Using alcohol or some other antiseptic, wet the site. 0000016846 00000 n 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 Password must have upper and lower case letters. Get the latest on all things nursing by joining our email newsletter. But sometimes, it can find a vein you didnt see or feel. 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. How To Draw Blood | A Step-by-Step Guide - Nurse.org It used to be that all 50 states required blood tests before getting a marriage license but that is no longer the case. window.ClickTable.mount(options); She hit the vein on the first try. Utilize the combination of massage, heat, and gravity. Please wait while we send your information. Phlebotomy basics : Nursing made Incredibly Easy - LWW They may be in a confused, agitated, or combative state of mind. This allowed him to see the vein and was able to get the IV in. 0000008110 00000 n Sometimes, the patient may experience hemoconcentration. This can be a real time saver and it is also the best way of finding the right insertion point. 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. It uses high intensity light that is directed down through the skin. They will be much easier to spot and throbbing. Confirm the ordered tests and fill out the appropriate forms and labels. go-to source for nursing news, trending topics, and educational resources. I'm not sure I understand how this works, as the valves are already in place to prevent backflow. Veins may collapse in the process and failed attempts at blood draws lead to hematomas which bring about pain. I'm Kadia. Insertion point should be under 15 to 30 degrees angle. So, before attempting to draw blood, look at the 3 areas mentioned above for the best veins to access and draw a blood sample. No matter how a patient looks like, it is necessary for a medical professional to protect himself. It all depends on your preparation and equipment. Like most medical procedures, phlebotomy can be really easy or really hard. Specializes in PICU, Sedation/Radiology, PACU. Please bring your donor card, driver's license or two other forms of identification. 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. 0000005243 00000 n Press the space key then arrow keys to make a selection. Depending on whether it is for transfusion or simple blood analysis, your cannula size will vary. Blood pressure cuff is a great method of extracting blood in case that the veins are not visible enough. Furthermore, it has a low risk of damaging surrounding nerves, arteries, and tendons versus other veins in the hands. 0000012940 00000 n Specializes in OBGYN, Urogynecology. window.ClickTable.mount(options); Has 12 years experience. For bigger and stronger veins you can use a 22 or 21 gauge needle. It will easily increase the smaller veins. This will lead to a better compression that will properly regulate the pressure. You can support each other and do twice as much good! We strive to be the Here, I share with you all the tips and tricks I have learned doing phlebotomy over the years. After a few minutes, gently tap the site of the puncture with your fingers to make the vein pop out. To make a basic grid for your female body proportions, turn your ruler so its perpendicular to the vertical line you drew. Similarly to insertion, removal of the needle should also be swift and efficient. 0000019017 00000 n We and our partners share information on your use of this website to help improve your experience. If you're drawing blood cultures, be sure to follow the policy and procedure at your facility. 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. You need to overcome those fears by exuberating confidence and persuading a person that everything will be alright. The information provided should not be used for diagnosing or treating a health problem or disease. Do not massage down as doing so will defeat the purpose. With the foot- some places require a specific order r/t other dx that can increase DVT risk :). Afterward, you can easily go upwards. One of our Enrollment Services Representatives will be contacting you shortly. Follow us and never miss out on the best in nursing news. For the elderly, using a syringe or the butterfly system is recommended. ), 2023 Center for Phlebotomy Education All Rights Reserved, Phlebotomy Continuing Education Exercise (ATM): Phlebotomy and the Obese Patient. Massage the arm from the wrist to the elbow if using arm veins. The worst thing you can do is to continue stabbing the patient. Don't take aspirin for 2 days before your appointment. The World Health Organizations (WHO) best practice guidelines for blood draws include the following: The overall purpose of establishing the guidelines is to. In most cases, simply following best practices and knowing how to find a difficult vein is the best way to carry out a successful draw. Obese patients, particularly those considered to be extremely obese, have reported being treated with disrespect by physicians and other medical staff. If a person is overweight, it might be harder for a professional to find the vein. A syringe is a great technique for blood drawing! Can You Get an Associate Degree in Nursing Online? This, in turn, can cause increases in your blood pressure. Make sure to perform venipuncture from patients non-dominant arm (which is usually the left one) as it will allow him to use his dominant arm afterwards. Always try to draw blood from veins that are lowest. 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. Its your job to make sure the patient is as comfortable as possible as you take blood, and that can be difficult to do when you cant find a usable vein. Use either a syringe or the luer adapter with the butterfly system. In the end, they can only lead to injuries. Blood 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. We've looked at programs nationwide and determined these are our top schools. 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. Then, deflate blood pressure cuff and apply tourniquet. 0000185079 00000 n 3,377 Posts. ARe there any tips on how to be more successful? 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. Although this is not a necessity, it is pretty much recommended. If a patient is reluctant or fearful, it can interfere with drawing blood. Top Vein Sites Used in Phlebotomy | PhlebotomyU | CPT1 Course Contact Us | Work @ Carrington | Privacy Policy | Terms of Service | Do Not Share My Personal Information | Sitemap | Student Consumer Information. Click here for a previous article I wrote about rolling veins. Insert the needle through the skin at a 30-degree angle or less, with the bevel facing upwards. Doctors usually mistake if for hyperkalemia when assessing the results. Scar tissue can especially be problematic as it is hard to penetrate. The elderly lose fat tissue as well as muscle mass, making their skin saggy. Next, identify the vein that you will be using. We and our partners use cookies to Store and/or access information on a device. With this in mind, you should be sure that youre getting any requisite or helpful information from your patient before beginning to draw blood. Obesity Screening: MedlinePlus Medical Test 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. Gloves are a must. Some jumping jacks or push-ups can make your veins pop out. 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. In doing so, this will enable students to learn basics prior to graduation. 4. Also, it is the basis of diagnostics. 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 Furthermore, they protect the nurse or healthcare professional from a potential needle stick. Continue with Recommended Cookies. Also, by palpation, you can sometimes feel valves in people and learn to avoid them. After that, you need to see if the patient has any medical condition, if he is using drugs or if he is fasting. Obesity - Diagnosis and treatment - Mayo Clinic Lab gives us an 8 minute window (+/- 4 minutes from exactly one hour from when they finish their glucose) to get the draw. Web Place the tourniquet over the patients sleeve of the patient shirt sleeve if drawing an arm vein. I will say a fair amount of Obesity If you encounter such a person, make sure to draw blood from larger veins instead of the smaller ones. On the surface, it seems as a rudimentary procedure, one that doesnt require any special training. 6. 0000001512 00000 n Having years of experience in laboratory work and phlebotomy, Kadia Constant enjoys sharing what he has learned. Avoid excessive probing. element: document.getElementById("fbct7c991c3d"), Get help from another phlebotomist. Use alcohol to stimulate the site to make the vein more visible. However, you will need a doctors permission for this. 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. Improve knowledge and awareness of the risks associated with phlebotomy among all health workers involved in the practice, Increase safe practices and reduce blood borne virus exposure and transmission, Availability of appropriate supplies and protective equipment, Availability of post-exposure prophylaxis (PEP), Avoidance of contaminated phlebotomy equipment, Recapping and disassembling vacuum-containing tubes and holders, Reusing tourniquets and vacuum-tube holders that may be contaminated with bacteria and sometimes blood, Working alone with confused or disoriented patients who may move unexpectedly, contributing to needle-sticks, Proper safety standards to avoid a needle stick, standards for quality care for patients and health workers, including, availability of appropriate supplies and protective equipment, availability of post-exposure prophylaxis (PEP), avoidance of contaminated phlebotomy equipment. Common Reasons People Miss Veins When Starting IVs & Drawing 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 Beaumont Laboratory GERIATRIC PHLEBOTOMY TIPS The paramedic immediately brought out a large flash light and pressed it to the patients arm. Specializes in ER, progressive care. 3. Nursing schools do not teach this skill due to legality issues. Ask the individual to flex his or her arm a bit. The needle is in place but there is no blood flow? Going there is risky as you can hit a nerve or tendon. Additional equipment such as goggles and splash shields should also be worn in extreme situations. Increased body mass can also lead to issues during venipuncture. Some guidelines suggest 40mm Hg. Some patient-friendly advice for getting blood drawn include the following: Drink plenty of water an hour before the draw. If the veins are deep and not visibly popping out, use a tourniquet and have the patient lower their arm. Patients
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tips for drawing blood on obese patients