Enjoy :). All these factors contribute to their veins staying low. Drawing blood from the elderly, young children, and infants can also be a challenge. Depending on whether it is for transfusion or simple blood analysis, your cannula size will vary. There's so much that a small sample of blood can tell a doctor that you'll likely need, Giving blood is vital as it saves millions of lives every year. The veins we have are the veins we will have for life. Position the patient and hyperextend the patients arm. If you're drawing blood cultures, be sure to follow the policy and procedure at your facility. However, thats not always a luxury most phlebotomists are afforded. element: document.getElementById("fbct7c991c3d"), 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. Web Place the tourniquet over the patients sleeve of the patient shirt sleeve if drawing an arm vein. If you are going to start an IV in the hand always have the patient pump their fist. How to Use a Vein Finder on Obese Patient. We've looked at programs nationwide and determined these are our top schools. 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 First, remember where to look. In a way, you have to entertain a person during phlebotomy. Some will come on wheelchairs, using a cane, needing help to walk, move, sit and stand. Identify the patient using two patient identifiers as mandated by JCAHO. 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. Use your index finger to palpate and trace the standard path of the vein on the arm. However, in addition to our natural vein anatomy, here are several reasons why your veins may pose some difficulty when doing a blood test. For outpatient areas, ask the patient to hold their arms at their side for a few minutes. Choosing a specialty can be a daunting task and we made it easier. that's continuously reviewed to ensure its as relevant and accurate as Use a transilluminator to find or confirm vein A transilluminator is a cool way of finding or confirming veins. An elderly persons veins are prone to collapsing, which could mean, you may have to try several times at drawing blood. My trick is to press on their hand or arm with both of my thumbs. Most people have normal looking serum. When the blood draw is complete, gently release the tourniquet. They need to be labeled in advance. A close look at the site from which you will draw blood will tell you which equipment to use. The three most commonly used veins for drawing blood are the median cubital, the cephalic, and the basilic veins. The elderly need special care and attention when doing a blood test. 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. Click here for a previous article I wrote about rolling veins. The needle should fully penetrate it. Take a look at these tips for drawing blood successfully: When you receive your initial instruction on how to conduct basic blood draws, your instructor will most likely tell you to locate the vein you are targeting by sight. 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. By explaining everything, you make sure there are no surprises ahead. Slapping can lead to contraction which can further decrease the veins, producing an adverse result. Luckily, got it on the first stick. The other day I saw another nurse do a different variation of this, and she put one tourniquet above the AC (like usual), and another 2 inches below the AC. The needle has passed through the vein. This is an extremely large vessel and if stuck properly can yield excellent blood results. Utilize the combination of massage, heat, and gravity. If you can see the vein clearly, then this will only help you ensure that you place the needle correctly the first time. Relax for a few minutes in our refreshment & recovery area have some cookies or other snacks youve earned it! Let us know if you have a preferred arm or particular vein that has been used successfully in the past to draw blood. After all, you want the experience to be as pleasant for them as possible. Red light reaches a depth up to 6 mm. Place a tourniquet and clean the area for 30 seconds with an alcohol wipe. This instructional video, from the Blood Collection series produced by Medcom, Inc., is about special precautions for drawing blood from obese patients. The WHO has best practices that are key to preventing infection and being successful during blood draws. During phlebotomy, the doctor is the one that needs to ensure everything goes well. Has 7 years experience. If the person is tense, try getting them to relax. Patients who are severely dehydrated can also make it difficult to find a vein. Increased body mass can also lead to issues during venipuncture. 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. All rights reserved. Some patient-friendly advice for getting blood drawn include the following: As a phlebotomist, though, you cant expect patients always to follow perfect procedures to make drawing blood easier, and you may even find that some patients are rude. No matter what, always take your time to find just the right vein. 0000007172 00000 n Put ur fingers on the bottom of their arm and press the tops with your thumbs. She hit the vein on the first try. HlV7WF#J$% r!h {7@)RRXZ4J9(e??@!o]h&Do?Y[L *fIXH^ In the event that you cant locate the appropriate vein strictly by vision, this can be a great alternative method. In this guide, well cover how to find a standard vein and what you can do if that vein isnt proving to be a good option. Pull it back slightly and blood should flow. 0000029592 00000 n Then, apply heat to the lowered arm. A doctor can access the femoral vein and others to draw blood. Usually, it happens due to squeezing or massaging around the site or due to prolonged application of the tourniquet. Eat a healthy meal, avoiding fatty foods like hamburgers, fries or ice cream. Sign up to receive the latest nursing news and exclusive offers. Avoid snapping or tapping veins. Talk about pressure! The heat will help dilate the veins and gravity will assist in filling those veins. If the antecub has already been accessed there are great options for venipuncture. I'm not sure I understand how this works, as the valves are already in place to prevent backflow. 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. It can really make the veins pop. If youre a phlebotomist who has encountered this problem before, you know how frustrating it can be. This can help individuals with deep veins, who are obese, or with some edema. Do not snap your fingers over the vein as doing so can be painful and can initiate clotting activity, resulting in erroneous test results. A tourniquet should also never be left on for more than one minute. 0000017785 00000 n If this does not happen then the needle has either not punctured the vein or the needle went through the vessel. 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. As a result, it can be difficult at times to find a vein to draw blood from. Don't take aspirin for 2 days before your appointment. If you are drawing blood from an arm, make sure to sit near the patient, as close as possible. Then, deflate blood pressure cuff and apply tourniquet. Afterward, make sure to store them properly. More than one-third of U.S. adults and 16% of U.S. children are obese. Here, I share with you all the tips and tricks I have learned doing phlebotomy over the years. The forearm is about the last place to look. When the body is properly hydrated, veins become more dilated. I'm Kadia. Ask the patient where they usually get stuck. Going there is risky as you can hit a nerve or tendon. Get help from a Doctor. It can help veins to pop up, making them probably visible and easier to find. At some time in life, every person will do a blood test, and not only one but multiple as life goes on. We worked with CreditCards.com to help nurses find the right card to fit their lifestyle. 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!). But when dealing with a particularly disruptive or difficult individual, its imperative to balance both sympathy and professionalism in this matter. of water (or other nonalcoholic drink) before your appointment. If that is the case, the patient should bend arm upwards which will make the vein more visible. 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. This one goes without saying but is still something that needs to be emphasized. 0000028908 00000 n The most common vein is the antecubital fossa; however, the median cephalic and median basilic veins are also used. hb``g`` @16 N$00Le@L,9$)_5M2APPP*dW;b]0D&0dxAAmCfFO7008X`&` *7h_P tex4\T'# ` 1 endstream endobj 239 0 obj <>/Filter/FlateDecode/Index[33 163]/Length 27/Size 196/Type/XRef/W[1 1 1]>>stream 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 WebYour effort to overcome obesity is more likely to be successful if you follow strategies at home in addition to your formal treatment plan. 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. While doing all of this, make sure to penetrate the skin with one quick move. 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
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