tips for drawing blood on obese patients

Then, add massage to the combination. If no blood flows, pull out the needle and repeat the draw. My trick is to press on their hand or arm with both of my thumbs. If you dont know what a vein feels like, practice by feeling on yourself with you index finger. If they come in for their appointment well-prepared, it should be easier to find a vein almost immediately. Having years of experience in laboratory work and phlebotomy, Kadia Constant enjoys sharing what he has learned. As a phlebotomist, I have been faced with situations where drawing blood from a person was quite difficult. A 3ml, 5ml or 10ml syringe will work fine. 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. This can help individuals with deep veins, who are obese, or with some edema. 0000001689 00000 n What are some tips and techniques for drawing blood from an elderly person? Sometimes, you will need another person or two to help you with difficult patients. ), 2023 Center for Phlebotomy Education All Rights Reserved, Phlebotomy Continuing Education Exercise (ATM): Phlebotomy and the Obese Patient. 0000012539 00000 n Thirdly, they may lose their appetite and drink less fluids. You are able to confuse the nerves before the insertion. If at the hospital, get nursing staff to assist you. Perform hand hygiene and don proper PPE. A syringe is a great technique for blood drawing! Extend the arm. Hemolysis is one of the most common things that interfere with the tests. 6. Dismiss. Only major veins should be used here. H\@E|E/g#0tW Y3y(N> CA}G)H6GUab/Jqk;gy>>n5%sLWorayo|zEnmn;4d~{;m/E. Some jumping jacks or push-ups can make your veins pop out. While it is important to know the best veins to access its also important to know which areas to avoid. Kindness and helpfulness must be shown to them. 0000025579 00000 n Drink an extra 16 oz. Those veinfinders are worthless. For example, Red Cross Blood has pointed out that many individuals will have had blood drawn before and may be able to point out the vein that was used in that procedure.2 If this is the case, you can streamline the process of locating the proper vein to draw from. The region from which you are drawing blood has to have a healthy tissue. Congratulations, you just took the first step towards a new future by furthering your education. 0000008110 00000 n 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. After assembling the appropriate equipment, follow the next steps to perform a proper venipuncture. Its important to do everything in your power to ensure the comfort of the patient when drawing blood. These devices are good at locating superficial veins, however, their ability is limited for deeper veins. But lots of people swear by it, so there might be something to it! Venipuncture is a skill that takes time and practice to master. Below are 5 key areas of importance with tips. glasses of liquids and avoid alcohol over the next 24 hours. Perform hand hygiene and don proper PPE. The needle should fully penetrate it. An elderly persons veins are prone to collapsing, which could mean, you may have to try several times at drawing blood. If the blood is not delivered in a timely manner it can cause hemolysis and skew the lab results. To avoid bruising, place the tourniquet over the patients shirt sleeve if drawing blood from an arm vein. Sometimes you won't be able to see the veins at all, but you will be able to palpate them. You need to make sure there is no resistance whatsoever. Average delivery time is 5-10 business days. Wear a shirt with sleeves that you can roll up above your elbows. The first area for venipuncture is in the antecubital fossa. Then, push down with the flat of the finger over the area. You know all nursing jobs arent created (or paid!) Once blood is seen in the tubing, connect the vacutainers or use a syringe to drawback. Has 7 years experience. Although this is not a necessity, it is pretty much recommended. 0000011603 00000 n Any time that you need blood drawn for lab work,, I'm Lou, and welcome to Phlebotomy Examiner! Find a convenient blood drive near you and schedule an appointment to donate today. %PDF-1.4 % 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. Try tourniquets, hot packs, gravity, and ask the patient where they usually have luck with blood draws. I hope you find my posts helpful. 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. Venipuncture or drawing blood is one of the most common procedures performed in any medical center. Use alcohol to stimulate the site to make the vein more visible. The needle is in place but there is no blood flow? 0000019017 00000 n 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. Occasionally, it can also be caused by the longer term IV therapy. Students should study venipuncture in books and watch licensed nurses in clinical settings perform this task. Slapping can lead to contraction which can further decrease the veins, producing an adverse result. WebInflate cuff to 30mm Hg above systolic reading and maintain pressure for about 1 to 2 minutes. Deliver blood specimens to the laboratory promptly. We use cookies to ensure that we give you the best experience on our website. Still, if you prepare yourself for any possible variable, you should be able to make drawing blood second nature. Specializes in RN-BC, CCRN, TCRN, CEN. However, there are numerous things that can go wrong while you draw blood. Even with all these guidelines, perhaps the best approach is if you ask the patient from which vein they usually draw his blood. This helps you build trust with a patient even further. They dont harm the patient in any way and can be used regularly to make your job easier and safer. Massage the arm from the wrist to the elbow if using arm veins. If you donate your blood to organizations like the American Red Cross, then you can rest easy knowing, A phlebotomist is a medical professional whose main job is drawing blood. Do not massage down as doing so will defeat the purpose. After identifying the site for the blood draw, gather the appropriate supplies needed. Put ur fingers on the bottom of their arm and press the tops with your thumbs. It can be done by palpating the vessel or via transillumination with a special light. By placing a warm towel over the veins, you are increasing the blood vessels which will make them more visible. The ability to obtain blood samples rapidly without altering cells in the sample is essential to maximize diagnostic quality. Persons must be trained to use the blood pressure cuff. Apply a tourniquet approximately 3-4 inches above the selected site. After all, you want the experience to be as pleasant for them as possible. 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.. For the elderly, using a syringe or the butterfly system is recommended. True allergies should be identified on an allergy ID band but sensitivities may not be reported at the time of patient admission. Many times combining techniques can mean the difference between finding a vein or not. Your approach is something that can vastly affect the patient, making the whole experience more or less enjoyable. Quiz and answer key included. This causes the veins to engorge and become visible. Firstly, they are sick. Always remember to ask for help from seasoned nurses and seize opportunities to practice your skills. You want to lessen the number of sticks you give to the elderly. It can help veins to pop up, making them probably visible and easier to find. Sign up to receive the latest nursing news and exclusive offers. Standard data rates may apply. The number of samples or volume of blood needed will tell you which size syringe to use. Remove the needle, take care of the site and repeat the procedure. A second option for finding veins and drawing blood are hand veins. 0000279572 00000 n 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 0000008998 00000 n Let us know if you have a preferred arm or particular vein that has been used successfully in the past to draw blood. Syringe, vacutainer, and needle size should You may need the approval of a physician or someone else. They should be spread distally from proximal joint to the insertion site. However, for the elderly, it may be difficult. This can pose a real problem as their veins collapse quicker. 3,377 Posts. Can You Get an Associate Degree in Nursing Online? 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. All rights reserved. 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 If a vein is not prominent enough to see easily, you can feel around for it. Learning the anatomy of the main veins and arteries in the body is essential to becoming competent in phlebotomy. Alternate arms if youve given blood This will help force blood up and fills the veins making a vein pop up. 0000027834 00000 n Nowadays, there is equipment that can help us locate the vein. When performing venipuncture, make sure to sit whenever you can. Besides proper knowledge, you will also have to have a good head on your shoulders and to make sure you follow these venipuncture guidelines closely. Veins will appear as a dark line. In fact, the majority of intensive care units require their nurses to possess these skills. Veins may collapse in the process and failed attempts at blood draws lead to hematomas which bring about pain. hb``g`` @16 N$00Le@L,9$)_5M2APPP*dW;b]0D&0dxAAmCfFO7008X`&` *7h_P tex4\T'# ` 1 endstream endobj 239 0 obj <>/Filter/FlateDecode/Index[33 163]/Length 27/Size 196/Type/XRef/W[1 1 1]>>stream Use your index finger to palpate and trace the standard path of the vein on the arm. Gloves are a must. WebPatients who are dehydrated, obese, terminally ill, or hard sticks often get their blood drawn in other locations rather than the antecubital fossa. Big ppl are not bad to stick at all, especially the ones with edema. If you have an issue finding the vein, do not hesitate and call for a senior, more proficient colleague. On top of that, there are a lot of individuals who fear (or dislike) going to a doctor. 0000016460 00000 n In that case, you would use the order of Draw (venipuncture). Pumping fists can lead to pseudohyperkalemia or increased level of potassium in the blood. The elderly lose fat tissue as well as muscle mass, making their skin saggy. Your veins will be easier to find and palpate when you are well relaxed, as tension can constrict veins. However, it does BECOME easier with practice. The device may be limited in that instance. 0000009535 00000 n You dont have to drink tons of water the night before but the recommended daily water intake should suffice. This forces blood up and fills the vein. link to Blood Test Vs Blood Donation (Comparisons), link to No More Blood Tests For Marriage License. You can support each other and do twice as much good! When the last one is done, you need to remove the tourniquet. Superficial veins often times can't handle an IV bolus or radiology contrast. Commonly referred to as the antecubital or the AC it can be found in the crevice of the elbow between the median cephalic and the median basilic vein. Everyones arm anatomy is different and while one technique may work for a person, combining two or three may be the answer for another. You know what to look for and where to look for it, so sometimes a gentle touch can make finding a usable vein easier than looking for it. Wear a shirt with sleeves that you can roll up above your elbows. It uses high intensity light that is directed down through the skin. I have had patients tell me nurses are more successful in one arm than the other, etc. It is the first area to look for veins. Warn the patient that they will experience a sharp scratch. Make sure that tourniquet is removed before the needle. Also, you can gently press the needle against the venipuncture site for several seconds before insertion so that the nerves can get accustomed. For outpatient areas, ask the patient to hold their arms at their side for a few minutes. Avoid excessive probing. 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. Its your job to make sure the patient is as comfortable as possible as you take blood, and that can be difficult to do when you cant find a usable vein. With the foot- some places require a specific order r/t other dx that can increase DVT risk :).
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