locating and anchoring the vein
Get the latest on all things nursing by joining our email newsletter. Many venipunctures are routine, but you may occasionally encounter some difficult veins. 1. To learn more about our Certified Phlebotomy Technician (CPT-1) course, Copyright 2023 - PhlebotomyU | Website Design & SEO by. If you keep the tourniquet on for more than a minute, the number of red blood cells may change, potentially affecting the test. Remember that the tourniquet shouldnt be on for more than 1 minute because it can change the blood composition. The cephalic and basilic veins have a greater tendency to roll and veinpuncture may be more painful from these sites. Alcohol is a typical sanitizer. Blood flows through the arteries in your arm and backs out from veins. [dropcap]3[/dropcap] Thou shalt puncture the skin at about a 15 degree angle. Nearby muscles also compress the deep vein to keep blood moving forward. Subscribe to our newsletter to get our newest articles instantly! Subscribe to our newsletter to be the first to know about our daily giveaways from shoes to Patagonia gear, FIGS scrubs, cash, and more! Anchor 2 is most important to the phlebotomist during the blood draw. *S`II)(wxj++G~ 0 *Md90JZcwNpd)M@aJLpJ;D|8ZM :/LGLE*Xzsi_!.w~dZ+ EqcsH|wEAq/Pn #$d@ xZ/,]rG^|4'-Sl=iPN_wnPDfqtJt3&B2l4jnU!(` ^|?O~-5P7Y1:y KZ $K6oSj1O% K`P-)d!T>Pt8Pw)SVAGS{$gG#r|l9a(2zRR h#h 9Es=4^1.Ok-2V+ If it cannot be seen it can usually be felt. Venipuncture is a skill that takes time and practice to master. 1315 Research source. Place a tourniquet and clean the area for 30 seconds with an alcohol wipe. This vein is associated with minimal pain and is the most prominent when anchored. Insert the needle through the skin at a 30-degree angle or less, with the bevel facing upwards. While the needle is still under the skin, adjust the angle so that it may be entered into the vein. Phlebotomy, the practice of drawing blood from a vein, is a proficiency that all nurses should learn in their career. Nowadays, modern technology has made life so much simpler. Today, drawing a sample of blood can potentially expose the health care worker to at least 20 communicable diseases.1 Most of them are life threatening, some of them cause incurable and fatal disease, but all of them may be preventable if health care workers use appropriate caution, technique and equipment. endobj Healthcare organizations are operating on slimmer profit margins than ever. It also may be the answer to your patients prayers. I've not had any problems since using this technique. Why is the Median Cubital Vein Used the Most? Pulling down on the skin from below the intended puncture site with the thumb of your free hand anchors the vein and stretches the skin through which the needle will pass. When conducting your survey of the antecubital area, check both arms for the medial vein before considering one of the alternatives. One of the steps requires the, phlebotomist to locate and anchor the patient's vein while inserting the. WebWhen properly anchoring a vein, the. These veins vary in size between 6 and 15 wikiHow marks an article as reader-approved once it receives enough positive feedback. The anchoring system is composed of two parts: Copyright 2023 - PhlebotomyU | Website Design & SEO by, Personal Protective Equipment (PPE) for Phlebotomist. var d = document.getElementById("zf_div_SBGg-3DTNCwt65i9A6n_zU3SneyGD89SSqM_7F_nCas"); You don't need to drink so much that you are uncomfortable, but enough that you are urinating a light straw color. Get fresh tips and insights emailed to you, This content was produced in its entirety for ADVANCE Healthcare Network (1985-2019, now Elite Healthcare) and features original contributions from a qualified and experienced editorial team or was provided to ADVANCE by credible industry experts or qualified healthcare professional(s). Make fists. If wikiHow has helped you, please consider a small contribution to support us in helping more readers like you. For additional information on this or related content, please email, Sexual Assault Nurse Examiner (SANE) Core Course, http://www.cap.org/html/lip/benchmarks/phlebotomy_toc.html, Now Available: The 2021 Holiday Guide for Healthcare Professionals, Self-Care 2021: An Elite Learning Resource Guide, Immunization Awareness and Adult Vaccinations, COVID Fatigue, FAQs, and Vaccine Hesitancy, Healthy Lifestyles and Managing Heart Disease Risk, Cardiac Rehabilitation for Therapy Professionals, Nursing Rated Most Trusted Profession in Recent Gallup Poll, Symptoms and Treatments for Major Depressive Disorder, Understanding the Risks of Heart Disease in Women, Evaluation of Safety Devices for Preventing Percutaneous Injuries Among Health Care Workers During Phlebotomy Procedures. The first step is to discuss with the patient what you will be doing and why as well as gather all the needed supplies. The proximity of underlying nerves and the brachial artery make punctures in the area of this vein highly risky. The WHO has set forth the following standards of patient care for hospitals to adhere by: They also identify dangerous and unsafe practices for blood draws including, >> Related: Arterial Blood Gases (ABGs) Explained. Make sure that the alcohol has already dried on the skin before inserting because this may become more painful for the patient. ", Unlock expert answers by supporting wikiHow, https://nurse.org/articles/how-nurses-professionally-draw-blood/, https://www.guideline.gov/content.aspx?id=37621, http://www.ncbi.nlm.nih.gov/books/NBK138665/, https://www.unitekcollege.edu/blog/stick-like-a-pro-tips-for-mastering-the-art-of-venipuncture/, Tirar Sangue de Veias Difceis de Encontrar. Anchor. window.addEventListener('message', function (){ } Even those who elevate phlebotomy to an art form can have difficulty from time to time. , such as children or geriatric patients. The cookie is set by GDPR cookie consent to record the user consent for the cookies in the category "Functional". Alcohol is better than iodine because if the iodine gets into the blood it can alter values that the lab may be looking for. Complications include pain, swelling, skin sores, varicose veins, post-thrombotic syndrome, amputation, pulmonary embolism and death. window.ClickTable.mount(options); It can be done by palpating the vessel or via transillumination with a special light. Explain the procedure and reason for the blood draw to the patient. You also have the option to opt-out of these cookies. endstream If this does not happen then the needle has either not punctured the vein or the needle went through the vessel. It is vital to follow, standard procedure for blood collection to get accurate, laboratory results. His/Her fingers should support the back of the arm slightly below the elbow. 12 0 obj Anchor 2 is most important to the phlebotomist during the blood draw. Stretching the skin is the single most effective way to minimize the pain Is there some kind of exercise to help improve your veins or make them bigger and more visible? Attach the needed tubes or syringes to remove the proper volume of blood. Phlebotomy: 5 Tips on Finding Difficult Veins | CPT1 Course The more venipunctures you successfully obtain, the more successful you will become. Here are the basic steps to drawing blood: The first step in drawing blood correctly is to identify the appropriate veins to puncture. If not inverted immediately upon filling, invert the tubes as soon as possible after the puncture. This is because there are veins intentionally placed in the antecubitals of the population at random for the sole purpose of keeping skillful collectors from becoming legends in their own minds. A quick inversion after collection prevents a second puncture. There are two main ways to find a vein to draw blood. Identify the patient using two patient identifiers as mandated by JCAHO. Most permanent nerve injuries and arterial nicks I see result from misguided punctures into this vein. Insert the needle with the bevel side up at an angle usually 15 to 30 degrees with the surface of the arm. No other methods are acceptable. Next, identify the vein that you will be using. << /Type /Page /Parent 3 0 R /Resources 6 0 R /Contents 4 0 R /MediaBox [0 0 612 792] Depending on the healthcare facility, there may be protocols in which other medical personnel must assist. Since patients are living longer, they may undergo an increasing number of medical procedures, and it is vital that vein preservation is considered a long-term goal (Chiao et al 2013). Out of these, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. Regardless of how you think your life led you to hold a position as a health care professional, consider yourself assigned by a higher authority because of the comfort you can offer to the sick and injured in your own unique and compassionate way. Going too tight at the beginning can result in the loss of plasma in the blood, impacting the test results. When you think of health care jobs, physicians and nurses may be the first workers to come to mind. Difficult veins are veins that easily collapse or roll, are too thin, or are hard to find. How many times can a phlebotomist stick a patient? Keep the basilic vein (located on the medial or inside aspect of the antecubital area) as a last resort. In fact, the majority of intensive care units require their nurses to possess these skills. All materials which have been contaminated with blood should be disposed of in a biohazard container that is puncture resistant, such as a Sharps container. Therefore, before puncturing foot and ankle veins, make sure the facility does not have a policy against such punctures and that the physician approves of the site. Obtaining blood from a point where your veins are set apart or come together is not a good idea. Since 10 is a popular number for commandments, lets comply with tradition even though the list is admittedly much longer. To secure firmly, as in holding a vein in place by pulling the skin taunt with the thumb. Locating and anchoring the vein or any blood vessel, is required to appropriately puncture the vein without slicing or severing it while trying to Anchor the vein. Anchor the vein from below with your non-dominant hand by gently pulling on the skin distal to the insertion site. Anchor the vein. Divide the distance the solvent moved by the distance the individual spot moved. [dropcap]10[/dropcap] Thou shalt treat all patients as if they are family. } When confronted with a problematic vein, ask the individual if there has been an area that has worked in the past. What if the veins are nearly finished in your arm or hand? true /ColorSpace 14 0 R /Intent /Perceptual /SMask 15 0 R /BitsPerComponent After assembling the appropriate equipment, follow the next steps to perform a proper venipuncture. Other uncategorized cookies are those that are being analyzed and have not been classified into a category as yet. mount_type: "" After identifying the site for the blood draw, gather the appropriate supplies needed. The anchoring system is composed of two parts: Anchor 1 and Anchor 2. By signing up you are agreeing to receive emails according to our privacy policy. Research at Oxford University shows that bigger, thicker needles hurt less than smaller thinner ones. Injure a patient while puncturing at a steep angle and you will have a difficult time convincing the jury that you are immune from the standards as set forth in the literature. One of the steps requires the phlebotomist to anchor the Making the skin taut allows the phlebotomist to puncture the skin with less force, thereby, reducing pain to the patient. [1] The most common vein is the antecubital fossa; however, the median cephalic and median basilic veins are also used. This will be painful if the needle is removed while the tourniquet is still on. x| D??q/{#72BH4M-P(,ziJ?sObvo[_4v's}^b&W(3n. Tourniquets can be useful in two ways. Anchor the vein by pulling the skin below the vein taut. News and Education Editor, MSN, RN, BA, CBC. The thumb should be placed a minimum of 1 to 2 inches below the and to the side of the intended venipuncture site, as the skin is pulled taut toward the wrist. I learned several tips from reading this article, also some, "The step-by-step guide is very clear to read and understand with the diagrams. All valid questions, especially for a phlebotomist. Label appropriate tubes at the bedside and place them into transport bags. } Shari Forschen is a Registered Nurse at Sanford Health in North Dakota.
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