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After assembling the appropriate equipment, follow the next steps to perform a proper venipuncture. Obesity }()); Drawing blood from a patient can be a daunting task, but it also is a necessity for nurses. Moreover, because their veins are so fragile, the elderly may receive several sticks in order to draw blood or get sufficient blood. If you are drawing from a leg, the extremity needs to be placed over the bed so If necessary, apply the tourniquet and examine the median cubital, cephalic, and basilic veins. Place it at the chin and lightly draw a straight line. 0000262624 00000 n Some patients are easier than others because of the prominence of their veins. It needs to remain loose. Standard data rates may apply. This can be a real time saver and it is also the best way of finding the right insertion point. Once veins have been located, return the patients arm to the horizontal position for the blood draw. Your approach is something that can vastly affect the patient, making the whole experience more or less enjoyable. Fluid retention. What are some tips and techniques for drawing blood from an elderly person? Once you remove the needle, gauze should be applied for a bit. Venipuncture tips: 50 Actionable Tips to Perform 0000279572 00000 n Genetically, we dont get to choose our veins. 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. Get a good night's sleep the night before your donation, eat healthy foods and drink extra liquids. Afterward, make sure to store them properly. 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. 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. Tips of water (or other nonalcoholic drink) before your appointment. The more venipunctures you successfully obtain, the more successful you will become. Dont go deep. Follow your institutions policy when using heat. Get the patient to lower his or her arm. Click to visit Blood Collection: Special Considerations, Obese Patients As the body ages, the skin becomes thinner and blood vessels become weaker. This can pose a real problem as their veins collapse quicker. Do not wave, fan, or blow on the area as this contaminates the area and leads to an increased risk for infection. Create an account and get 24 hours access for free. 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. This will help force blood up and fills the veins making a vein pop up. It is the best thing for patients with low blood pressure. This technique is especially helpful with hand veins. 0000031034 00000 n Also, avoid cotton as fibers may stay in the wound and reopen it later on. 2. Big ppl are not bad to stick at all, especially the ones with edema. How To Draw Blood | A Step-by-Step Guide - Nurse.org Contact should be limited and you shouldnt place the locator on burned skin. 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. Specializes in RN-BC, CCRN, TCRN, CEN. In the case of elderly patients, make sure to use smaller needles and to be extra gentle. It helps us establish if there is something wrong with the body and what to look out for. 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. 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. If the needle site starts to bleed, apply pressure and raise your arm straight up for 5-10 minutes or until bleeding stops. Explain the procedure and reason for the blood draw to the patient. Identify the patient using two patient identifiers as mandated by JCAHO. Medicine is a very serious profession. With thumb, spread the skin. This is mainly due to the fact that different people have different biological systems which can make it harder to find and puncture the vein. 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. Donating Platelets? Usually, if you cant find a vein in the antecubital fossa or at the back of the hand, you will find one in the forearm. They should be spread distally from proximal joint to the insertion site. If you encounter such a person, make sure to draw blood from larger veins instead of the smaller ones. It is crucial to use needle and cannula that is smaller than the patients vein. 0000001512 00000 n Using a tourniquet is something most people are used to seeing during difficult blood draws. WebYour effort to overcome obesity is more likely to be successful if you follow strategies at home in addition to your formal treatment plan. These devices are good at locating superficial veins, however, their ability is limited for deeper veins. By placing a warm towel over the veins, you are increasing the blood vessels which will make them more visible. On average, it is much harder to find veins in people with darker skin tone. Here are the basic steps to drawing blood: The first step in drawing blood correctly is to identify the appropriate veins to puncture. Phlebotomy basics When performing venipuncture, make sure to sit whenever you can. For routine antisepsis, you can use a standard alcohol prep pad or alcohol-impregnated swabs. glasses of liquids and avoid alcohol over the next 24 hours. After all, you want the experience to be as pleasant for them as possible. 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. Has 7 years experience. If you continue to use this site, we will assume that you are happy to continue. I have had patients tell me nurses are more successful in one arm than the other, etc. 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 This is painful and can bruise 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. As a result, it can be difficult at times to find a vein to draw blood from. Next, locate the vein you will be using for the blood draw. Instead, make sure to remove tourniquet first and then remove the needle followed by instant pressure on the insertion point. Get someone to assist if you are not trained or dont have experience. Avoid excessive probing. If you dont know what a vein feels like, practice by feeling on yourself with you index finger. The nurse can take the persons blood pressure. 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. 0000007172 00000 n This can help individuals with deep veins, who are obese, or with some edema. 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 Use either a syringe or the luer adapter with the butterfly system. This is an extremely large vessel and if stuck properly can yield excellent blood results. The information provided should not be used for diagnosing or treating a health problem or disease. The number of samples or volume of blood needed will tell you which size syringe to use. Place them one by one in the holder and take samples. Check for any allergies or sensitivities with the patient regarding antiseptics, adhesives, or latex. Agree with other posters - ask them where they usually get stuck, heat packs, gravity, tie that tourniquet tight and give them a stress ball to squeeze. Be sure that youre doing everything in your power to keep a level mindset before and during the blood drawing process. Feel out all your possible options before you decide to go for it. Specializes in PICU, Sedation/Radiology, PACU. Any time that you need blood drawn for lab work,, I'm Lou, and welcome to Phlebotomy Examiner! If you can see the vein clearly, then this will only help you ensure that you place the needle correctly the first time. So, get help! However, it does BECOME easier with practice. Another technique is for you to use a blood pressure cuff. You could get help from them. Premarital blood tests have been done away with. After that, you need to see if the patient has any medical condition, if he is using drugs or if he is fasting. Don't take aspirin for 2 days before your appointment. Talk to your doctor or therapist about improving your coping skills and consider these tips to cope with obesity and your weight-loss efforts: Journal. I had one not too long ago where I had to do a 1 hour glucose tolerance test and was having trouble finding a vein. You may have to apply heat more than once. Deliver blood specimens to the laboratory promptly. Quiz and answer key included. In order to reduce the risk of thrombosis, lines need to be flushed with a solution of heap in. Lower the patients arm for a few minutes before applying the tourniquet. In situations like these, you have to be patient and apply various techniques depending on the reason for the difficulty. Enjoy :). Here, I share with you all the tips and tricks I have learned doing phlebotomy over the years. WebSome obese people are no prob, but some have deep veins, rolly pollies, etc. If a person doesnt have enough experience, he might make a mistake by not removing the tourniquet before the needle. }); What Does Blood Draw or Venipuncture Training Involve? Extend the arm. Place a tourniquet and clean the area for 30 seconds with an alcohol wipe. We worked with CreditCards.com to help nurses find the right card to fit their lifestyle. Our mission is to Empower, Unite, and Advance every nurse, student, and educator. There are two main ways to find a vein to draw blood. This is due largely to the fact that patient factors will vary greatly when it comes to drawing blood. Occasionally, it can also be caused by the longer term IV therapy. It can really make the veins pop. Place a tourniquet and clean the area for 30 seconds with an alcohol wipe. You may need the approval of a physician or someone else. It is also possible to apply multiple tourniquets. 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. How to Use a Vein Finder on Obese Patient. If you cant find a good vein, move to the back of the hand. 0000016460 00000 n 0000036112 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. N. Cleanse the puncture site: Cleanse the site with 70% isopropyl alcohol until clean. 0000018898 00000 n In certain cases, the patient may move a bit which may result in you sticking the needle in your own finger. Inflate cuff to 30mm Hg above systolic reading and maintain pressure for about 1 to 2 minutes. You dont have to drink tons of water the night before but the recommended daily water intake should suffice. Try tourniquets, hot packs, gravity, and ask the patient where they usually have luck with blood draws. Also, by palpation, you can sometimes feel valves in people and learn to avoid them. WebDrink an extra 16 oz. Blood pressure cuff is a great method of extracting blood in case that the veins are not visible enough. Syringe, vacutainer, and needle size should WebApplied 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 The patients vein may have collapsed. Pump the fists! 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. 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!). Medical Care for Obese Patients: Advice for Health Care - AAFP 0000008644 00000 n Venipuncture or drawing blood is one of the most common procedures performed in any medical center. The ability to obtain blood samples rapidly without altering cells in the sample is essential to maximize diagnostic quality. Alternate arms if youve given blood For example, the veins of a middle-aged man will likely be easier to find than that of a woman, unless shes extremely active. Unfortunately, some veins are significantly easier to see than others. For adult patients, the most common and first choice is the median cubital vein in the antecubital fossa. At some time in life, every person will do a blood test, and not only one but multiple as life goes on. Usually, the antecubital area has the best veins for drawing blood. Maybe the number one thing that a person can do is to make sure they are well hydrated. Drawing blood from the elderly, young children, and infants can also be a challenge. Once the vein is located, the individual arm can be returned to horizontal position for blood collection. If the antecub has already been accessed there are great options for venipuncture. 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. Premarital blood tests have been done away with. Password must have upper and lower case letters. Rolling up gown sleeves (rather than pushing sleeves up) to enhance tourniquet visibility. Congratulations, you just took the first step towards a new future by furthering your education. %PDF-1.4 % Measure the distance from the top of the head to the chin. Often, even a loose bind can help a vein to pop. Perform good hand hygiene and don appropriate PPE. If the blood is not delivered in a timely manner it can cause hemolysis and skew the lab results. Then, deflate blood pressure cuff and apply tourniquet. What about other resources that may be available? The three most commonly used veins for drawing blood are the median cubital, the cephalic, and the basilic veins. Whether youre becoming a nurse, a doctor or a certified medical assistant, youll probably have to draw blood countless times over the course of your career. Remove the needle from the patients arm and press down on the vessel with gauze. The dorsal venous network is Sign up to receive the latest nursing news and exclusive offers. Insertion point should be under 15 to 30 degrees angle. Lastly, you will have to mix tubes with an anticoagulant. 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. Red light reaches a depth up to 6 mm. Specializes in ER, progressive care. In the case of children or uncooperative individuals, restraints are an option but they should be avoided at all costs. Here, I share with you all the tips and tricks I have learned doing phlebotomy over the years. Manage Settings Massaging may help you in finding a vein if you have not already found one. 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 Prep the venipuncture site by cleansing the area with an alcohol prep pad for 30 seconds and allow to air dry for 30 seconds. If no blood flows, pull out the needle and repeat the draw. WebObesity isn't just a cosmetic concern. If you would like to change your settings or withdraw consent at any time, the link to do so is in our privacy policy accessible from our home page.. With the foot- some places require a specific order r/t other dx that can increase DVT risk :) Our members represent more than 60 professional nursing specialties. More than one-third of U.S. adults and 16% of U.S. children are obese. Remove the needle, take care of the site and repeat the procedure. I am a full time phlebotomist and I enjoy my job. How Does Donating Blood Affect Your Body? Very often, drinking water will get veins to show up that were not visible or palpable before. By explaining everything, you make sure there are no surprises ahead. Unfortunately, some people have difficult veins to work with due to obesity, dehydration, and a variety of other issues. Some health care settings may insert blood drawing peripheral intravenous catheters into this vessel for frequent blood draws. What may be warm to you could burn the elderly. Use a transilluminator to find or confirm vein A transilluminator is a cool way of finding or confirming veins. Doing so can help move veins and tendons away from each other increasing the likelihood for a vein to show up. WebOnce veins have been located, return the patients arm to the horizontal position for the blood draw. Sometimes, it can still be hard to find the vein after applying the tourniquet. First, gather all of your supplies and discuss with your patient what you are going to be performing. Word of caution: make sure to remove the substance before rubbing the vein with alcohol. mount_type: "" We and our partners use cookies to Store and/or access information on a device. They need to be labeled in advance. Tips for Drawing Blood Fourthly, they are not very active, possibly causing lower blood pressure, hence slower blood flow. A 3ml, 5ml or 10ml syringe will work fine. 0000014430 00000 n If you have specific questions, but don't want to wait, give us a call at. Choosing a selection results in a full page refresh. How to Select a Right Vein Finder for an Obese Patient - Healtholine But when dealing with a particularly disruptive or difficult individual, its imperative to balance both sympathy and professionalism in this matter. It is a medical problem that increases the risk of heart disease, diabetes and certain cancers. Apply the tourniquet one to two inches above the wrist if drawing a hand 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 Depending on whether it is for transfusion or simple blood analysis, your cannula size will vary. Subscribe to our newsletter to be the first to know about our daily giveaways from shoes to Patagonia gear, FIGS scrubs, cash, and more! The forearm is about the last place to look. 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. You need to make sure there is no resistance whatsoever. Adjust it slightly. Create well-written care plans that meets your patient's health goals. 0000007667 00000 n On the surface, it seems as a rudimentary procedure, one that doesnt require any special training. HlV7WF#J$% r!h {7@)RRXZ4J9(e??@!o]h&Do?Y[L *fIXH^ Subscribe for the latest nursing news, offers, education resources and so much more! Drink plenty of water an hour before the draw. 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.