MAKING PHLEBOTOMY EASY- WHAT THE PHLEBOTOMIST CAN DO?
- Prof. (Dr) Usha
- 6 days ago
- 5 min read
Making the blood draw procedure less painful during every step of procedure
Less painful or discomforting blood draws is always a win-win situation for everyone in the health care field. Many people have hemophobia and needle phobia. Some patients may fear receiving infection from the procedure or may faint during or after the procedure. When a patient has any of these conditions, a phlebotomist should be vigilant about patient’s anxiety, safety and hygiene. By dealing in a friendly, convincing and professional manner, wearing protective gear and gloves, the blood draw can be made easier for the patient. Sometimes, just greeting the patient by smiling or having someone hold patient’s hand during the blood draw can make a huge difference.
The phlebotomist should always pay attention to the patient. Phlebotomist needs to know how the patient is feeling and keep talking to him/her, so the patient remains engaged and distracted. This also allows a phlebotomist the ability to monitor the patient closely. When an individual faints, one must be prepared to safely remove the tourniquet and needle from the patient’s arm, while ensuring he/she does not fall. Sometimes, men are found to faint more often than women.
Tourniquet application-Dos and don’t
When placing the tourniquet on patient’s arm, only put it on as tight as is necessary. Some people actually dread the tourniquet more than the needle!
Take the tourniquet off as soon as you get a blood return. Typically, a tourniquet should not be applied for more than 1-2 minutes and be removed once the blood started flowing in the tube.
Finding a Vein-Dos and don’t
Do not attempt to draw blood from a vein that you cannot feel
If you are having difficulty feeling a vein, close your eyes and palpate as you search. Be the feeler!
If you still have no success, you can use a warm compress or ask the patient to make fist to help the vein pop up. Vein finders are also helpful.
Drawing blood- Dos and don’t
Generally, drawing from median cubital vein is less painful than drawing from a dorsal hand vein. Butterfly needle system can be used for dorsal hand collection
In case of small, delicate veins-consider using a butterfly needle with a syringe instead of vacuum tubes
Anchor the vein from rolling away by using your thumb of the hand not being used to draw
Let the alcohol dry completely before beginning the venipuncture procedure to prevent burning sensation to patient upon needle insertion
Too much manipulation of needle while inside the vein cause more pain to patient
If you try to draw blood from a particular patient twice with no success, apologize and then ask another phlebotomist to perform the blood draw.
Use of Syringes or Evacuated Tubes-Dos and don’t
It is vital for the phlebotomist to take reasonable measures while selecting equipment and technique to use for collection. The selection of equipment will vary based on the characteristics of each patient and condition.
Evacuated/Vacutainer tube system- use of a vacutainer system is recommended for those who are healthy and exhibit veins that are elastic, of good size and steady
Avoid use of a vacutainer system for the patients with challenging, collapsible, tiny or fragile veins to prevent undesirable results such as collapsing vein, incomplete or no collection at all.
Prevention of blown vein (ruptured vein) situation-Do and don’t
A blown vein (ruptured vein) can occur when a needle pierces the vein wall during blood draws. A blown vein could result in the collection of blood in surrounding tissue leading to hematoma or may also cause hemolysis. Sometimes the pressure exerted from the vacuum of an evacuated tube can cause blown veins. This can cause a vein to collapse, hemolyze or result in hematoma
It is necessary to control the rate at which blood is collected from a patient with collapsible veins. Hence, with individuals who present challenging veins, a syringe or butterfly system may be used.
Alternative to vacutainer system for phlebotomy collections
Use of syringes and butterfly needles:
For geriatric and pediatric patients, syringes or a butterfly needle are also options available for blood draw as many elderly experience a loss of elasticity in the skin leading to the difficulty in stabilizing a rolling vein and collect the quantity of blood required. Syringe or a butterfly needle collection provides control to phlebotomist for withdrawing required quantity of blood without fear of sudden collapsing of vein. It can also help in cases with rolling veins. A syringe or a butterfly needle can also be used for pediatric draw when they have extremely thin veins requiring blood to be collected slowly and in increments.
Cancer Patients
In cancer patients and those undergoing chemotherapy, a syringe method, or a butterfly needle with a syringe attached, are often preferred methods for blood draw due to the fragility and small size of veins, preventing collapsing of vein as their veins may have weakened or lost elasticity. These methods allow for flexibility and control that can result in an easy and desired venipuncture procedure.
Burn Victims
With burn patients, it may be difficult to find a vein due to the presence and thickness of scar tissue often restricting veins. Hence, a syringe technique or a butterfly needle with a syringe attached are often preferred methods for blood draw. With the use of a syringe (controlled collection), phlebotomists can obtain blood from challenging veins found in some patients.
In selecting to use a syringe versus an evacuated tube system, an expert phlebotomist can make this decision based upon his/her own experience and prevailing situation.
TO LEARN BEST PRACTICES OF PHLEBOTOMY & VENIPUNCTURE, PLEASE READ THE FOLLOWING BOOK-AVAILABLE ON AMAZON:
This phlebotomy-practical guidebook-written by the medical author, a phlebotomy professor in Canada with over 32 years of extensive knowledge and skill expertise in fields of phlebotomy, medical and healthcare helps to prepare students to acquire necessary knowledge and skills to work as a confident and efficient phlebotomist. This book is a most useful and essential knowledge and skills provider guide focusing upon essential practical aspects of phlebotomy and venipuncture practices. It highlights best practices such as drawing blood from difficult veins, tips for easier venipuncture process/blood Draws, common problems and troubleshooting guidelines etc. The book discusses in detail various lab errors-pre-analytical, analytical, post-analytical errors, their prevention and management, common problems encountered during the blood collection and troubleshooting strategies. It also covers very informative, special section related to Canadian legislation related to phlebotomy regulations, and a chapter on Latest Advancements in Phlebotomy and Integration of New Technology- as phlebotomists must be aware of evolution in this field. The test bank provided in this book helps students in active learning and knowledge retention, encouraging them to refine their understanding of key concepts of phlebotomy, gain much needed practical skills and also help them prepare for any exams in this field.
References:
The Phlebotomy Certificate Programs- Basic/Advanced/PG- In-class/Online/Blended training/certificate/workshop at Springfield College helps prepare you get updated knowledge and skills needed for a challenging career in a Canadian Healthcare such as physician’s office, hospital, nursing homes or medical clinics. Students learn details and techniques of safe and efficient Phlebotomy, Venipuncture and Dermal puncture for children, adults and geriatric patients, blood sample collection and preparation, various techniques, best practice of phlebotomy, patient communication and preparations in healthcare.
For details of the Phlebotomy training program and best training-
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