I hope you find my posts helpful. 196 45 This one goes without saying but is still something that needs to be emphasized. Your veins will be easier to find and palpate when you are well relaxed, as tension can constrict veins. This instructional video, from the Blood Collection series produced by Medcom, Inc., is about special precautions for drawing blood from obese patients. 0000005129 00000 n As a result, this will lead to the release of histamine increasing the vein. Excess fat around the waist can put you at an even higher risk for obesity-related health problems, including heart disease and type 2 The consent submitted will only be used for data processing originating from this website. WebWhen the patient has never had blood drawn The most important factor in controlling the spread of infection is Hand washing before and after the patient Latex sensitivity is a type of Allergic reaction The recommended vein to perform the venipuncture b/c sometimes is more superficial than other veins is called Median cubical vein 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 Make sure they are feeling well before leaving. glasses of liquids and avoid alcohol over the next 24 hours. In situations like these, you have to be patient and apply various techniques depending on the reason for the difficulty. of water (or other nonalcoholic drink) before your appointment. Choosing a specialty can be a daunting task and we made it easier. Get someone to assist if you are not trained or dont have experience. Fourthly, they are not very active, possibly causing lower blood pressure, hence slower blood flow. Nowadays, there is equipment that can help us locate the vein. WebOnce veins have been located, return the patients arm to the horizontal position for the blood draw. So, before attempting to draw blood, look at the 3 areas mentioned above for the best veins to access and draw a blood sample. Then, deflate blood pressure cuff and apply tourniquet. Explain the procedure and reason for the blood draw to the patient. 0000008644 00000 n Ask the individual to flex his or her arm a bit. It is crucial to use needle and cannula that is smaller than the patients vein. Label appropriate tubes at the bedside and place them into transport bags. If you are drawing blood from an arm, make sure to sit near the patient, as close as possible. Also, it is the basis of diagnostics. go-to source for nursing news, trending topics, and educational resources. If youre a phlebotomist who has encountered this problem before, you know how frustrating it can be. All rights reserved. In order to prevent hematoma, you should only puncture the uppermost wall. With thumb, spread the skin. What are some tips and techniques for drawing blood from an elderly person? Check for any allergies or sensitivities with the patient regarding antiseptics, adhesives, or latex. Has 1 years experience. Blood tests are no longer Hi! There are numerous situations where you should refrain from using a tourniquet as a part of your equipment. When you draw their blood, are you ready for them? Having years of experience in laboratory work and phlebotomy, Kadia Constant enjoys sharing what he has learned. tips on starting IV, drawing blood on obese patient 0000001848 00000 n That's why we rely on registered nurses and other experienced healthcare Subscribe to our newsletter to be the first to know about our daily giveaways from shoes to Patagonia gear, FIGS scrubs, cash, and more! Fasting glucose and hemoglobin A1c (HbA1c) Other tests are performed as indicated by clinical findings. WebSome obese people are no prob, but some have deep veins, rolly pollies, etc. As you get older, most of you systems tend to shrink and they become more fragile. Scar tissue can especially be problematic as it is hard to penetrate. Commercial heat packs are best. The needle may have pulled out of the vein. Specializes in RN-BC, CCRN, TCRN, CEN. For novice phlebotomists, this vein is the first choice because it is close to the skins surface and tends not to roll when punctured. This is painful and can bruise the patient. 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. 3,377 Posts. At some time in life, every person will do a blood test, and not only one but multiple as life goes on. Ask the individual to elevate his or her arm at the elbow. It will easily increase the smaller veins. If you donate frequently, be sure to take multivitamins with iron to ensure you continue to. Contact Us | Work @ Carrington | Privacy Policy | Terms of Service | Do Not Share My Personal Information | Sitemap | Student Consumer Information. Some veins can be deep in the antecubital fossa area, especially, if there is a lot of fat tissue. Make sure you check with the nurse first for permission. Thirdly, they may lose their appetite and drink less fluids. 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. The only way to make sure is by touching it yourself. Veins will appear as a dark line. I have had patients tell me nurses are more successful in one arm than the other, etc. Place them one by one in the holder and take samples. Check between the knuckles. This allowed him to see the vein and was able to get the IV in. This is the main reason why a lot of tests go array. Being able to find a usable vein quickly is crucial, and something you learn throughout your training. To expedite your donation, start your RapidPass on the day of your appointment. To find out the advantages of the syringe method go here. Perform hand hygiene and don proper PPE. Standard laboratory studies in the evaluation of obesity should include the following: Fasting lipid panel. To view the purposes they believe they have legitimate interest for, or to object to this data processing use the vendor list link below. Maybe the number one thing that a person can do is to make sure they are well hydrated. Youll be the first to know about nursing news, trending topics and educational resources. If the person is tense, try getting them to relax. However, this article will take you through the basics of drawing blood so you can understand the steps and guidelines. Phlebotomy basics A trick I use sometimes is putting a second tourniquet 2 inches above the first tourniquet. It can really make the veins pop. The other day I saw a 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. Check out our Facebook page and give it a like: http://www.redcrossblood.org/donating-blood/tips-successful-donation. Make sure that no one gets directly exposed to blood. If you cant find a good vein, move to the back of the hand. But sometimes, it can find a vein you didnt see or feel. 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. Should RaDonda Vaught Have Her Nursing License Reinstated? Approach Considerations. Phlebotomy basics : Nursing made Incredibly Easy - LWW This will fill them up much quicker which is a great way to finish procedure faster if you have a troublesome patient. just like everyone else. Just my opinion. 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. If at the hospital, get nursing staff to assist you. The veins we have are the veins we will have for life. Ask the patient where they usually get stuck. If you can see the vein clearly, then this will only help you ensure that you place the needle correctly the first time. Try light exercise beforehand. The elderly need special care and attention when doing a blood test. 3. On average, it is much harder to find veins in people with darker skin tone. Take a look at these tips for drawing blood successfully: Feel & Touch When you receive your initial instruction on how to conduct basic blood draws, your 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. At outpatient areas, ask the patient to hold their arm at their side for a few minutes. There are tips for making veins pop out when taking blood. Make sure not to press too hard! Blood Collection: Special Considerations, Obese It worries me to see so many people in this thread and others talk about seeing veins and palpating them only if you can't see one. Venous access s Top Cheap and Fast Online RN to BSN Programs, Affordable Online Nurse Practitioner Programs, Top Direct-Entry Nurse Practitioner Programs, Top Psychiatric Nurse Practitioner Programs, Top Pediatric Nurse Practitioner Programs, Top Acute Care Nurse Practitioner Programs, Top Online Family Nurse Practitioner Programs, Top RN to Psychiatric Nurse Practitioner Programs, Top Womens Health Nurse Practitioner Programs, How to Get an Associate Degree in Nursing. Sometimes the veins are deeper so therefore you will have to go deeper. Patients That is usually the last resort. For hospitalized patients, raise the head of the bed. Obese Patient professionals to write our content whenever possible. Try tourniquets, hot packs, gravity, and ask the patient where they usually have luck with blood draws. Spend a decent amount of time looking for good veins. The medical expert needs a certain amount of practice as there are many things that can go wrong. Please enter a valid e-mail address. Do not snap your fingers over the vein as doing so can be painful and can initiate clotting activity, resulting in erroneous test results. They need to be labeled in advance. It is the sharpest part and this will be the best way of insertion. For outpatient areas, ask the patient to hold their arms at their side for a few minutes. 0000007172 00000 n WebObesity isn't just a cosmetic concern. Blood Once you remove the needle, gauze should be applied for a bit. Eat a healthy meal, avoiding fatty foods like hamburgers, fries or ice cream. Spaces are not allowed; punctuation is not allowed except for periods, hyphens, apostrophes, and underscores. Position the patient and hyperextend the patients arm. Once veins have been located, return the patients arm to the horizontal position for the blood draw. In fact, most of the procedures cannot be performed if you dont have a clear head on your shoulders. Same goes with veins. It worries me to see so many people in this thread and others talk about seeing veins and palpating them only if you can't see one. Make sure that tourniquet is removed before the needle. 196 0 obj <> endobj xref It used to be that all 50 states required blood tests before getting a marriage license but that is no longer the case. When the blood draw is complete, gently release the tourniquet. Measure the distance from the top of the head to the chin. Insert the beveled needle at a 30-degree angle into the vessel. instance: "61c9f514f13d4400095de3de", The first step is to discuss with the patient what you will be doing and why as well as gather all the needed supplies. window.addEventListener('click-table-loaded', function(){ Application of heat will cause vasodilation, making veins easier to see or palpate. He got her first stick, and i will definately try this in the future if i have trouble. Then, deflate blood pressure cuff and apply tourniquet. Be careful, though. Venipuncture or drawing blood is one of the most common procedures performed in any medical center. 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. Weight gain. 0000017785 00000 n The worst thing you can do is to continue stabbing the patient. Once again, please be aware that these are only guidelines for blood draws and nurses should consult with the appropriate hospital personnel regarding performing this procedure on patients. 0000031034 00000 n 11. All these factors contribute to their veins staying low. It includes preparation of the patient, finding the right vein, insertion of the needle, disposal of waste and handling of potential hazards. They can be riskier, especially if you need to draw a lot of blood. 2023 Carrington College. Venous access should always be based on feel, not looks. Tips for drawing blood successfully | Carrington College Standard data rates may apply. A syringe is a great technique for blood drawing! 0000001689 00000 n A better vein might be available in the forearm or at the back of the hand. Below are several tips and tricks that you can use when you are faced with a difficult blood draw. Use a transilluminator to find or confirm vein A transilluminator is a cool way of finding or confirming veins. These can include: Learning about your Why does blood stop flowing during blood draw? We'll need to know about all prescription and over-the-counter medications you're taking. Enjoy :). The needle has passed through the vein. 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. 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 It allows the phlebotomist to control the vacuum, which is good because it is much less traumatic on a patient's vein. Then, massage from the wrist to the elbow. If the median cubital, cephalic, or basilic veins cant be found, then go to other sites on the arm. The elderly are prone to bruising when applying the tourniquet. Remove the needle from the patients arm and press down on the vessel with gauze. Try tourniquets, hot packs, gravity, and ask the patient where they usually have luck with blood draws. Next, identify the vein that you will be using. Please bring your donor card, driver's license or two other forms of identification. The hand and lower arm are the best places for transilluminators. 0000016846 00000 n If you are going to start an IV in the hand always have the patient pump their fist. Patients who are severely dehydrated can also make it difficult to find a vein. Students should study venipuncture in books and watch licensed nurses in clinical settings perform this task. After that, pressure needs to be applied on insertion point. To use a tourniquet to draw blood correctly, you should tie it three or four inches directly above the puncture site. Rotate the wrist while maintaining the position of the arm. However, there are numerous things that can go wrong while you draw blood. Eat a healthy meal, avoiding fatty foods like hamburgers, fries or ice cream. ), 2023 Center for Phlebotomy Education All Rights Reserved, Phlebotomy Continuing Education Exercise (ATM): Phlebotomy and the Obese Patient. Insert the beveled needle at a 30-degree angle into the vessel. Before you start injecting needles into people, make sure to get a proper training and get used to the entire process. 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. Ask a friend to donate at the same time . Some will come on wheelchairs, using a cane, needing help to walk, move, sit and stand. This is the first and crucial rule of venipuncture. 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 This illuminated the veins that he could not palpate. This will move their fluid and/or tissue out of the way so you can see a good vein. Reasons for concern would include numbness, tingling, change of color to blue or white, and extreme pain. Without further ado, here are 50 tips that will help you perform this crucial procedure. Become a Part of the Nurse.org Community! Apply heat for about 3 to 5 minutes and then assess for vein. You may need the approval of a physician or someone else. If you are a bit stiffer while rubbing the alcohol, it will prepare the hand for the procedure. Many times combining techniques can mean the difference between finding a vein or not. Increased body mass can also lead to issues during venipuncture. Has 12 years experience. Sometimes, it can still be hard to find the vein after applying the tourniquet. Its important to speak to your supervisor to learn the steps in order to become certified in your hospital. Blankets or towels from a warmer can also be used. There are numerous considerations when performing venipuncture or phlebotomy. If a person is overweight, it might be harder for a professional to find the vein. If a person doesnt have enough experience, he might make a mistake by not removing the tourniquet before the needle. If you allow the visible stress or discomfort of your patient to permeate your own mentality, then youre far more likely to make a mistake or miss the vein. obese 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. The bevel of the needle should go upwards. Check out our list of the top non-bedside nursing careers. Otherwise, it may indicate that you have missed which is when you should immediately back up. By placing a warm towel over the veins, you are increasing the blood vessels which will make them more visible. One thing that I find that helps is using two tourniquets - take them together and tie it. Ask the patient where they usually get stuck. I have had patients tell me nurses are more successful in one arm than the other, etc. One thing that Ask the patient to make a fist and not pump the hand. 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. Medical professional also has to be a salesman of the sort. If you can find a vein with that desirable characteristic, youll know that youve discovered a usable vein, even if its not prominent. The person performing venipuncture can administer 10 units of bacteriostatic saline which need to be injected intradermally. Carrington College does not recruit or enroll residents of the European Union. The rightvein should feel somewhat bouncy as you press on it. Blood tests are one of the most important diagnostic techniques available to physicians. Then, add massage to the combination. Create an account and get 24 hours access for free. For hand veins, apply the tourniquet 1-2 inches above the wrist. possible. Has 7 years experience. }()); Drawing blood from a patient can be a daunting task, but it also is a necessity for nurses. Find a convenient blood drive near you and schedule an appointment to donate today. This will lead to a better compression that will properly regulate the pressure. However, for the elderly, it may be difficult. Average delivery time is 5-10 business days. All e-mails from the system will be sent to this address. Attach the needed tubes or syringes to remove the proper volume of blood.