How to deal with difficult venous access

Working as a phlebotomist is not as easy as it seems, I mean, people usually think what they do is just taking blood, although I would say, it is a lot more than that.  Regretfully people only think to realize the importance of a phlebotomist if a patient has tricky veins.  So today, I would write a little about how to tackle it in these situations.

Phlebotomist usually performs venepuncture for about 50-80 patients a day, in some cases even more. Now imagine if someone has been doing this for the last couple of years, how much experience he /she would have by working all these years. So, here is the opportunity to learn from professionals.

The key is to “LOOK, LOOK and LOOK”.  Remember, every human has a blood supply, if for some reason a vein is not visible or palpable then it is a possibility that one is looking at the wrong place.  So, in order to look accurately, you should know the basics of arm anatomy or at least should have an idea of where to look for.

Usually, the most common venepuncture site is Antecubital Fossa (ACF) or simply known as the elbow joint but what about the rest of the arm. What if you can’t locate a vein in ACF, would you give up? Or would you just poke it anyway and hope for a vein to be there or would you look at other sites too?

Those who have difficult veins are already aware that it is not going to be an easy task for a phlebotomist but if you would like to be adored by patients then say “ I don’t want to insert a needle until I am a little sure” trust me this works!

Now start main judi bola livescore di Playme8! looking at the rest of the arm, if you find a suitable vein in the forearm, wrist, or back of the hand then go for it but if you are still unsure then simply seek verbal consent by explaining that you are not sure if you are going to be successful. If you are successful then ‘Hoorah’! And if you are unsuccessful then at least you have attempted to draw blood with the patient’s consent.

Your manager would not even think about raising concern about your ability because he/she should be happy that you have looked after a patient to the best of your ability.

I am going to mention here a few tricks which I have found very useful in locating a vein.

1. When a patient enters into the cubicle or a booth, they already had a preferred arm in their mind from which they want you to withdraw blood. If the patient is right-handed, he/she would prefer to be bled from the left arm and vice versa. It is your responsibility to explain that a phlebotomist should go for an arm that has the best possible vein. Please note that most of the time the dominant arm has the best veins.
2. When the patients present their arm, in a few cases it is facing sideways. You can ask the patient to rotate their arm so the ACF would face upwards.
3. If veins are still not visible or palpable ask them to open and close their fist once or twice.
4. In doing phase 3, the patient usually leaves the hand closed and clenched, ask to relax the arm.
5. If you have found a small vein, give a gentle tap once or twice with your index and middle finger
6. You have found a small vein but it keeps disappearing, use a needle cap to leave a mark on the skin. Do not twist the needle cap but apply gentle pressure only.
7. You have found a vein but it keeps moving right or left (Wobbly vein). Tap the vein and hold the skin upward or downward.
8. Sometimes, veins appear as a purple or dark blue shadow.

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REMEMBER. ANATOMICALLY THESE VEINS LIE IN ACF HOWEVER MAY DEVIATE SLIGHTLY. PLEASE NOTE PRACTICE MAKES YOU PERFECT.