} 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. 0000000016 00000 n What may be warm to you could be hot or even burn someone else. It is a medical problem that increases the risk of heart disease, diabetes and certain cancers. True allergies should be identified on an allergy ID band but sensitivities may not be reported at the time of patient admission. Liver function studies. This can cause an overall loss of plasma in the blood, and the sample could be unusable. In a way, you have to entertain a person during phlebotomy. A lot of patients have the needle phobia. 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. Try tourniquets, hot packs, gravity, and ask the patient where they usually have luck with blood draws. You need to overcome those fears by exuberating confidence and persuading a person that everything will be alright. A 3ml, 5ml or 10ml syringe will work fine. I hope you find my posts helpful. Our members represent more than 60 professional nursing specialties. While doing all of this, make sure to penetrate the skin with one quick move. Use either a syringe or the luer adapter with the butterfly system. Insert the needle at a 15 to 30-degree angle into the vessel. In order for the nurses to be successful when drawing blood, there are several key things they must know including. The patients vein may have collapsed. For hand veins, apply the tourniquet 1-2 inches above the wrist. The loss of support makes it easy for veins to roll causing difficulty in drawing blood. A doctor can access the femoral vein and others to draw blood. Over the years I have drawn blood from many older patients, learning tips and techniques along the way in dealing with them and drawing blood from them. When the last one is done, you need to remove the tourniquet. just like everyone else. 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. 0000016460 00000 n Make sure to find a vein that is properly hydrated. When you draw their blood, are you ready for them? If you are drawing from a leg, the extremity needs to be placed over the bed so that the blood can easily flow into it. trailer <<1A62135BA6734AC3B0AC4ED47D445652>]/Prev 812906/XRefStm 1512>> startxref 0 %%EOF 240 0 obj <>stream We and our partners use data for Personalised ads and content, ad and content measurement, audience insights and product development. Using heat (such as a warm towel) or placing the extremity in a dependent position (to allow gravity to fill the veins) can help, too. We strive to be the Going there is risky as you can hit a nerve or tendon. Be careful when using wet or damp washcloths. Why does blood stop flowing during blood draw? It will stop the bleeding and prevent the creation of hematoma. 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. Standard data rates may apply. Web Place the tourniquet over the patients sleeve of the patient shirt sleeve if drawing an arm vein. To avoid bruising, place the tourniquet over the patients shirt sleeve if drawing blood from an arm vein. Get a good night's sleep the night before your donation, eat healthy foods and drink extra liquids. CMAA exam 1 Flashcards | Quizlet So, get help! of water (or other nonalcoholic drink) before your appointment. Although this is something you mightve seen a lot in the movies, you should always avoid it. She hit the vein on the first try. Using alcohol or some other antiseptic, wet the site. Often, even a loose bind can help a vein to pop. Although this is a benign, temporary effect, it can be quite misleading and can lead to the bad diagnosis. The veins we have are the veins we will have for life. Dispose of contaminated materials and needles in the designated hospital-approved containers. 0000001512 00000 n Obese patients, particularly those considered to be extremely obese, have reported being treated with disrespect by physicians and other medical staff. allnurses is a Nursing Career & Support site for Nurses and Students. Finding difficult veins isnt impossible, but it can require a few different methods to be put into place. If you do otherwise, you are going to injure the patient. If you can find a vein with that desirable characteristic, youll know that youve discovered a usable vein, even if its not prominent. This is an extremely large vessel and if stuck properly can yield excellent blood results. Beaumont Laboratory GERIATRIC PHLEBOTOMY TIPS 0000011603 00000 n 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. Make sure you have one in your venipuncture equipment. The information provided should not be used for diagnosing or treating a health problem or disease. Another technique is for you to use a blood pressure cuff. Moreover, because their veins are so fragile, the elderly may receive several sticks in order to draw blood or get sufficient blood. Be careful, though. Before and after the insertion, the tube should be left in the holder. Fourthly, they are not very active, possibly causing lower blood pressure, hence slower blood flow. 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. A syringe is a great technique for blood drawing! If the person is tense, try getting them to relax. After assembling the appropriate equipment, follow the next steps to perform a proper venipuncture. Let us know if you have a preferred arm or particular vein that has been used successfully in the past to draw blood. Venipuncture tips: 50 Actionable Tips to Perform tips on starting IV, drawing blood on obese patient. Choosing a specialty can be a daunting task and we made it easier. Many times combining techniques can mean the difference between finding a vein or not. Bloating. To find out the advantages of the syringe method go here. Remove the needle from the patients arm and press down on the vessel with gauze. Excess fat around the waist can put you at an even higher risk for obesity-related health problems, including heart disease and type 2 Ask the person to lower their arm for a few minutes before applying the tourniquet. 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. Next, locate the vein you will be using for the blood draw. Avoid exaggerated hyperextension, which can be uncomfortable for the elderly. Some patients are easier than others because of the prominence of their veins. This is due largely to the fact that patient factors will vary greatly when it comes to drawing blood. Sign up to receive the latest nursing news and exclusive offers. 0000012940 00000 n How to Use a Vein Finder on Obese Patient. Obesity - Diagnosis and treatment - Mayo Clinic Next, identify the vein that you will be using. 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 Thyroid function tests. Premarital blood tests have been done away with. Patients hand should be dangling so that the blood can rush down and fill the veins. What Does Blood Draw or Venipuncture Training Involve? 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. The paramedic immedi This makes sense, as many individuals, particularly those with very low body fat in their arms, will have extremely visible veins. Someone else may be able to find something that you cannot. Also, it is the basis of diagnostics. equally, but do you know which nurses are making the most money in 2023? 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. Provide a password for the new account in both fields. Looking for a change beyond the bedside? Extend the arm. You dont have to drink tons of water the night before but the recommended daily water intake should suffice. Frail veins can pose a great problem when drawing blood. The rightvein should feel somewhat bouncy as you press on it. A close look at the site from which you will draw blood will tell you which equipment to use. Some health care settings may insert blood drawing peripheral intravenous catheters into this vessel for frequent blood draws. Anchor the vein. They already have pain, so lets make the process easier and more comfortable for them. Tips for technicians to improve phlebotomy skills - DVM 360 I once had a patient who was a VERY difficult stick - I brought in the best of the best IV starters that were working that night, but no luck. 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. In fact, most of the procedures cannot be performed if you dont have a clear head on your shoulders. For example, the veins of a middle-aged man will likely be easier to find than that of a woman, unless shes extremely active. The forearm is about the last place to look. You know all nursing jobs arent created (or paid!) That means that you can trust us to have reliable, up-to-date information While traditionally a nurse would use their hands to feel for a vein, many hospitals are now using vein finders to help reduce the amount of time it takes to find a vein and start treatment. WebPatients who are dehydrated, obese, terminally ill, or hard sticks often get their blood drawn in other locations rather than the antecubital fossa. 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. Avoid excessive probing. 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 In situations like these, you have to be patient and apply various techniques depending on the reason for the difficulty. As a phlebotomist, venipuncture is one of the main parts of your job. When you encounter such a case, make sure to use blood pressure cuff or try one of the other tricks we shared in our guidelines. 0000005129 00000 n instance: "61c9f514f13d4400095de3de", The paramedic immediately brought out a large flash light and pressed it to the patients arm. 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. Always avoid drawing blood from areas where the skin is damaged, inflamed, infected or burned. Pumping fists can lead to pseudohyperkalemia or increased level of potassium in the blood. In order to prevent hematoma, you should only puncture the uppermost wall. Massaging may help you in finding a vein if you have not already found one. Follow your institutional policy when using blood pressure cuffs. Veins will appear as a dark line. We worked with CreditCards.com to help nurses find the right card to fit their lifestyle. Only tighten it if necessary. WebIf you are drawing blood from an arm, make sure to sit near the patient, as close as possible. It used to be that all 50 states required blood tests before getting a marriage license but that is no longer the case. What about other resources that may be available? If the veins are deep and not visibly popping out, use a tourniquet and have the patient lower their arm. 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. 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? We've looked at programs nationwide and determined these are our top schools. It is also possible to apply multiple tourniquets. They should be spread distally from proximal joint to the insertion site. 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. Insertion point should be under 15 to 30 degrees angle. There are tips for making veins pop out when taking blood. Grab the patients lower arm (below the site of puncture) firmly to draw the skin taut and anchor the vein from rolling. Application of heat will cause vasodilation, making veins easier to see or palpate. 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 You may have to apply heat more than once. No matter what, always take your time to find just the right vein. Lower the patients arm for a few minutes before applying the tourniquet. Get the latest on all things nursing by joining our email newsletter. Patients Drink an extra 16 oz. Being able to find a usable vein quickly is crucial, and something you learn throughout your training. WebSome obese people are no prob, but some have deep veins, rolly pollies, etc. 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 necessary, apply the tourniquet and examine the median cubital, cephalic, and basilic veins. 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. As we mentioned, it is your duty as a medical professional to ensure the patient that everything will be ok. Most times, drawing blood is not that difficult, but there those occasions when you will get a difficult person. In 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 patients when they encounter insensitive healthcare professionals. The ability to obtain blood samples rapidly without altering cells in the sample is essential to maximize diagnostic quality. Try light exercise beforehand. On the surface, it seems as a rudimentary procedure, one that doesnt require any special training. There is a nice way to fill the tubes faster. As you get older, most of you systems tend to shrink and they become more fragile. The needle should fully penetrate it. Dismiss. There are numerous considerations when performing venipuncture or phlebotomy. Premarital blood tests have been done away with. 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. venipuncture is one of the main parts of your job. 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 A tourniquet should also never be left on for more than one minute. A medical expert should stroke them from distal to the proximal vein. Learning the anatomy of the main veins and arteries in the body is essential to becoming competent in phlebotomy. First, gather all of your supplies and discuss with your patient what you are going to be performing. Blood Test Vs Blood Donation (Comparisons). Get help from a Doctor. 0000010671 00000 n 0000014430 00000 n Venipuncture is a skill that takes time and practice to master. Medical Care for Obese Patients: Advice for Health Care - AAFP Persons must be trained to use the blood pressure cuff. So, the choice of equipment will change from patient to patient. WebInflate cuff to 30mm Hg above systolic reading and maintain pressure for about 1 to 2 minutes.
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