You are able to confuse the nerves before the insertion. The nurse can take the persons blood pressure. 0000014430 00000 n Like most medical procedures, phlebotomy can be really easy or really hard. Learning the anatomy of the main veins and arteries in the body is essential to becoming competent in phlebotomy. To avoid bruising, place the tourniquet over the patients shirt sleeve if drawing blood from an arm vein. Going there is risky as you can hit a nerve or tendon. Patients who are severely dehydrated can also make it difficult to find a vein. If you are a bit stiffer while rubbing the alcohol, it will prepare the hand for the procedure. 0000005243 00000 n 0000016460 00000 n 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 World Health Organizations (WHO) best practice guidelines for blood draws include the following: The overall purpose of establishing the guidelines is to. 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. These three together can help you find a vein. All e-mails from the system will be sent to this address. We strive to be the Stay away from the palm of the hand, fingers and from the wrist area. Once you have selected the right vein finder for an obese patient, it is important to know how to properly use the Our members represent more than 60 professional nursing specialties. So, before attempting to draw blood, look at the 3 areas mentioned above for the best veins to access and draw a blood sample. This is the first and crucial rule of venipuncture. Gravity alone will help reveal veins that were not visible or palpable earlier. Blood Collection: Special Considerations, Obese In order to prevent it, professional will have to avoid phlebotomy from a hematoma and to avoid drawing plunger forcefully. 5. Medical professional also has to be a salesman of the sort. Eat a healthy meal, avoiding fatty foods like hamburgers, fries or ice cream. 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. Thank you. Gravity will often reveal hand veins you didnt see earlier. To view the purposes they believe they have legitimate interest for, or to object to this data processing use the vendor list link below. Putting some rolled towels underneath or a pillow helps, too (just make sure to put some chux on top of them in case you make a mess!). If all else fails, you can always use drugs. The number of samples or volume of blood needed will tell you which size syringe to use. 0000028908 00000 n Blood What about other resources that may be available? Sometimes I get lucky, sometimes I get nothing. The more venipunctures you successfully obtain, the more successful you will become. WebTo clarify: The serum on the left is what normal serum looks like, but actually comes from an obese patient middle aged or older with metabolic issues (the patients I normally work with). Dont go deep. Commercial heat packs are best. Most people have normal looking serum. 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. The elderly need special care and attention when doing a blood test. 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!). Some jumping jacks or push-ups can make your veins pop out. As the body ages, the skin becomes thinner and blood vessels become weaker. Avoid excessive probing. 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 11. What Does Blood Draw or Venipuncture Training Involve? obese : phlebotomy - Reddit If possible, look at areas that tend to have less subcutaneous fat, such as the back of the hand, the thumb, the wrist, and even the top of the foot. Follow your institutions policy when using heat. Perform hand hygiene and don proper PPE. Properly label the tubes and send to the laboratory for analysis. You should draw blood in the following locations: Often, you wont know your patient personally before drawing their blood, unless you work at a smaller practice and have done it for them before. When done drawing blood, ask the patient if all is well. Someone else may be able to find something that you cannot. The ability to obtain blood samples rapidly without altering cells in the sample is essential to maximize diagnostic quality. 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. If a person is overweight, it might be harder for a professional to find the vein. Linkedin, How to Identify a Usable Vein for Blood Draws. She hit the vein on the first try. We and our partners use cookies to Store and/or access information on a device. By explaining everything, you make sure there are no surprises ahead. Invert a BP cuff so that the blood can go to the lower regions of the limb. We'll need to know about all prescription and over-the-counter medications you're taking. To find out the advantages of the syringe method go here. Kindness and helpfulness must be shown to them. Most of the time, the visibility of the vein depends on the patient. Please wait while we send your information. Ask the individual to elevate his or her arm at the elbow. The needle is in place but there is no blood flow? Check out our list of the top non-bedside nursing careers. For multiple samples use the luer adapter or a 10 ml syringe. Confirm the ordered tests and fill out the appropriate forms and labels. Difficult Blood Draws: Best Tips For Difficult Veins window.addEventListener('click-table-loaded', function(){ }()); Drawing blood from a patient can be a daunting task, but it also is a necessity for nurses. obese You can support each other and do twice as much good! Massage the arm from the wrist to the elbow if using arm veins. 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. These 5 areas include:if(typeof ez_ad_units!='undefined'){ez_ad_units.push([[300,250],'phlebotomistreport_com-medrectangle-4','ezslot_6',165,'0','0'])};__ez_fad_position('div-gpt-ad-phlebotomistreport_com-medrectangle-4-0'); From my experience elderly persons on wards are the most difficult sticks. Once you have located a vein, you can cause increase distention through massaging or exaggerated palpation (pressing repeatedly over the top of the vein). It is the first area to look for veins. Dont be discouraged if at first, you dont access the vein. Perform good hand hygiene and don appropriate PPE. When you draw their blood, are you ready for them? As we mentioned, it is your duty as a medical professional to ensure the patient that everything will be ok. Its important to do everything in your power to ensure the comfort of the patient when drawing blood. Place them one by one in the holder and take samples. glasses of liquids and avoid alcohol over the next 24 hours. Hopefully, these 50 tips will help you establish what is ok and what is not. Looking for a change beyond the bedside? 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. Prep the venipuncture site by cleansing the area with an alcohol prep pad for 30 seconds and allow to air dry for 30 seconds. (function() { Create well-written care plans that meets your patient's health goals. 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. Patients Our mission is to Empower, Unite, and Advance every nurse, student, and educator. Doctors usually mistake if for hyperkalemia when assessing the results. Reasons for concern would include numbness, tingling, change of color to blue or white, and extreme pain. Use either a syringe or the luer adapter with the butterfly system. For the elderly, using a syringe or the butterfly system is recommended. A phlebotomist will need to find a good, strong vein from which to draw blood. Then, add massage to the combination. In the end, they can only lead to injuries. This will move their fluid and/or tissue out of the way so you can see a good vein. 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. Instead of forcefully tapping the vein, it is much better if you start stroking them. Afterward, you can easily go upwards. Click to visit Blood Collection: Special Considerations, Obese Patients Use your index finger to palpate and trace the standard path of the vein on the arm. It is the best thing for patients with low blood pressure. Before and after the insertion, the tube should be left in the holder. This study guide will help you focus your time on what's most important. Then, push down with the flat of the finger over the area. Do not wave, fan, or blow on the area as this contaminates the area and leads to an increased risk for infection. Insert the needle at a 15 to 30-degree angle into the vessel. Place a tourniquet and clean the area for 30 seconds with an alcohol wipe. 196 45 link to Blood Test Vs Blood Donation (Comparisons), link to No More Blood Tests For Marriage License.