tips for drawing blood on obese patients

A tourniquet should also never be left on for more than one minute. This will give you more stability and it will relax you. Ask the patient to make a fist and not pump the hand. Slapping can lead to contraction which can further decrease the veins, producing an adverse result. We are a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com. For an experienced professional, this is typically a relatively easy job. Finding difficult veins isnt impossible, but it can require a few different methods to be put into place. If using wet or damp washcloths, do so with caution. Be sure that youre doing everything in your power to keep a level mindset before and during the blood drawing process. Unfortunately, some people have difficult veins to work with due to obesity, dehydration, and a variety of other issues. The first area for venipuncture is in the antecubital fossa. If nothing works, try with vein locator. Without proper specimens, unhelpful or even harmful medical treatment could happen. When you draw their blood, are you ready for them? This will lead to a better compression that will properly regulate the pressure. 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 If no blood flows, pull out the needle and repeat the draw. I am a full time phlebotomist and I enjoy my job. Sometimes you won't be able to see the veins at all, but you will be able to palpate them. Check between the knuckles. Blood Test Vs Blood Donation (Comparisons). Firstly, they are sick. Standard data rates may apply. Sometimes, you may see a tendon thinking that it is a vein. Drink an extra 16 oz. It can be easy, especially when youre conducting multiple blood drawing procedures on a daily basis, to become somewhat detached from the patient that youre drawing blood from. With the foot- some places require a specific order r/t other dx that can increase DVT risk :) Thirdly, they may lose their appetite and drink less fluids. Let us know if you have a preferred arm or particular vein that has been used successfully in the past to draw blood. This technique is especially helpful with hand veins. Nursing schools do not teach this skill due to legality issues. Re: the 2 tourniquet trick (above and below). ARe there any tips on how to be more successful? Massage the arm from the wrist to the elbow if using arm veins. First, remember where to look. Use alcohol to stimulate the site to make the vein more visible. If you cant find one, consider the third option, the forearm. Should RaDonda Vaught Have Her Nursing License Reinstated? Veins will appear as a dark line. 0000012097 00000 n 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. Dont do any heavy lifting or vigorous exercise for the rest of the day. These devices are good at locating superficial veins, however, their ability is limited for deeper veins. A trick I use sometimes is putting a second tourniquet 2 inches above the first tourniquet. 2023 Carrington College. 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. Blood tests are no longer Hi! 0000015433 00000 n These can include: Learning about your 0000011603 00000 n When you are retaining water, it increases the total volume of fluid that is being pushed through your blood vessels by your heart. The first step is to discuss with the patient what you will be doing and why as well as gather all the needed supplies. 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. To use a tourniquet to draw blood correctly, you should tie it three or four inches directly above the puncture site. 0000019017 00000 n As a phlebotomist, venipuncture is one of the main parts of your job. Before you start injecting needles into people, make sure to get a proper training and get used to the entire process. Follow your institutions policy when using heat. just like everyone else. Usually, the antecubital area has the best veins for drawing blood. 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 Follow your institutional policy when using blood pressure cuffs. In situations like these, you have to be patient and apply various techniques depending on the reason for the difficulty. mount_type: "" If a vein is not prominent enough to see easily, you can feel around for it. Being able to find a usable vein quickly is crucial, and something you learn throughout your training. Patients hand should be dangling so that the blood can rush down and fill the veins. For bigger and stronger veins you can use a 22 or 21 gauge needle. Continue with Recommended Cookies. trailer <<1A62135BA6734AC3B0AC4ED47D445652>]/Prev 812906/XRefStm 1512>> startxref 0 %%EOF 240 0 obj <>stream The needle may also not be in a vein. As the body ages, the skin becomes thinner and blood vessels become weaker. WebSome obese people are no prob, but some have deep veins, rolly pollies, etc. Instead, make sure to remove tourniquet first and then remove the needle followed by instant pressure on the insertion point. If you continue to use this site, we will assume that you are happy to continue. Inflate cuff to 30mm Hg above systolic reading and maintain pressure for about 1 to 2 minutes. There are two main ways to find a vein to draw blood. Our mission is to Empower, Unite, and Advance every nurse, student, and educator. Do not massage down as doing so will defeat the purpose. Has 1 years experience. If youre still experiencing difficulties, placing a warm washcloth over the puncture site can also increase blood flow and make a vein more prominent than was previously the case. What if I cant find a vein? It allows the phlebotomist to control the vacuum, which is good because it is much less traumatic on a patient's vein. Grab the patients lower arm (below the site of puncture) firmly to draw the skin taut and anchor the vein from rolling. This will fill them up much quicker which is a great way to finish procedure faster if you have a troublesome patient. Enjoy :). I Feel Stuck - Like My Options Are Limited, Ethical Arguments Against Mandatory Vaccination, Nursing Student on Spring Break Saves Collapsed Man's Life, Candida Auris: Dangerous Fungus Spreading in US Health Care Facilities, Nurses Week 2023 | Best Discounts, Freebies, and More. (Immediate download. Veins become more visible when blood is forced into them. However, for the elderly, it may be difficult. 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. But sometimes, it can find a vein you didnt see or feel. This forces blood up and fills the vein. This can be a real time saver and it is also the best way of finding the right insertion point. If you are going to start an IV in the hand always have the patient pump their fist. Sometimes, you will need another person or two to help you with difficult patients. In fact, the majority of intensive care units require their nurses to possess these skills. Doctors usually mistake if for hyperkalemia when assessing the results. 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. Pump the fists! All rights reserved. I was in a patients home a few days ago and had to call EMS, the patient was obese and her spouse said she had terrible veins. The paramedic immedi In order to prevent hematoma, you should only puncture the uppermost wall. Is there an IV team, anesthesiologist, or other trained personnel that could be of assistance? However, in addition to our natural vein anatomy, here are several reasons why your veins may pose some difficulty when doing a blood test. link to Blood Test Vs Blood Donation (Comparisons), link to No More Blood Tests For Marriage License. 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 0000001196 00000 n 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!). Furthermore, it has a low risk of damaging surrounding nerves, arteries, and tendons versus other veins in the hands. 0000000016 00000 n Try tourniquets, hot packs, gravity, and ask the patient where they usually have luck with blood draws. The three most commonly used veins for drawing blood are the median cubital, the cephalic, and the basilic veins. Similarly to insertion, removal of the needle should also be swift and efficient. Apply a heat compress to the area for 3-5 minutes. Sometimes you can find a good one there, though be careful as you insert the needle. They will be much easier to spot and throbbing. It is crucial to use needle and cannula that is smaller than the patients vein. Also, it is the basis of diagnostics. The ability to obtain blood samples rapidly without altering cells in the sample is essential to maximize diagnostic quality. If a person doesnt have enough experience, he might make a mistake by not removing the tourniquet before the needle. 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. Subscribe for the latest nursing news, offers, education resources and so much more! Many times, you will have to resort there to draw blood. Heightening awareness of healthcare workers to the problem and consequences of leaving a tourniquet on too long. Talk about pressure! It is also possible to apply multiple tourniquets. If you experience dizziness or lightheadedness, stop what youre doing and sit down or lie down until you feel better; avoid performing any activity where fainting may lead to injury for at least 24 hours.

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