%PDF-1.3 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. 26. 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 var d = document.getElementById("zf_div_SBGg-3DTNCwt65i9A6n_zU3SneyGD89SSqM_7F_nCas"); This cookie is set by GDPR Cookie Consent plugin. Readers may purchase the authors Ten Commandments of Phlebotmy poster through the Center for Phlebotomy Education. PhlebotomyU is dedicated to providing our students an engaging and rewarding educational experience. The phlebotomist should warn the patient when the needle will be inserted so that they are not surprised. Clean the area for at least a half minute. window.ClickTable.mount(options); Even though most hospitals do have phlebotomy teams, it is still critical for nurses to learn these skills in order to provide the best patient care. Keep the basilic vein (located on the medial or inside aspect of the antecubital area) as a last resort. Garza, D., & Becan-McBride, K. (1999). There are four common sites phlebotomists use for blood draws: median antecubital, cephalic, basilic and dorsal hand. For adult patients, the most common and first choice is the median cubital vein in the antecubital fossa. endobj << /ProcSet [ /PDF /Text /ImageB /ImageC /ImageI ] /ColorSpace << /Cs2 8 0 R Insert the needle only about 1/4 in., with the entire bevel under the skin. This means referring to an identifying bracelet affixed to the patient or asking the patient to state his or her name. What does it mean to anchor the vein? At the end of this activity, the students should be able to: 1.locate the ideal vein in drawing blood; 2.choose a suitable site in drawing blood; and. Apply PPE. % All Rights Reserved. Divide the distance the solvent moved by the distance the individual spot moved. Anchor 2 is most important to the phlebotomist during the blood draw. Web Explore the problems in identifying suitable veins for venipuncture. Needlesticks: Who pays the price when costs are cut on safety? mount_type: "" Anchoring the vein is particularly important when drawing from the cephalic or basilic veins. 6 0 obj ", things I did not know. 7 How to calculate the Rf value in chromatography? An important benefit of using vein location aids is their potential to preserve veins. As the object falls towards the Earth again, the vertical velocity increases again in magnitude but points in the opposite direction to the initial vertical velocity. Single use materials such as needles should never be reused. Sign up for wikiHow's weekly email newsletter. All of the following may be used to enhance the vein from an artery. Bob, Gary, and Bob, who share profits and losses in the ratio of 4:4:2, respectively, decide to liquidate their partnership on December 31, 2019. I have a tip to add: I always had trouble giving blood until a nurse taught me this trick. % of people told us that this article helped them. When positive identification is not possible by either of these methods, have the patients nurse or other caregiver identify the patient and document the name of the person who verified the patients identity for you. The angular vein is a vein located between the top of the nose and the eye. However, it does BECOME easier with practice. WebOne of the steps requires thephlebotomist to locate and anchor the patient's vein while inserting theneedle. The anchoring system is composed of two parts: Anchor 1 and Anchor 2. element: document.getElementById("fbctb96d8be2"), Functional cookies help to perform certain functionalities like sharing the content of the website on social media platforms, collect feedbacks, and other third-party features. Whether your veins are narrow or dilated, it is very important to know some tips and tricks to locate difficult veins. How far away should your wheels be from the curb when parallel parking? Enjoy! Venous System window.addEventListener('message', function (){ Depending on the healthcare facility, there may be protocols in which other medical personnel must assist. If no veins can be accessed, find the metacarpal veins on the back of the hands. His/Her fingers should support the back of the arm slightly below the elbow. Proper safety standards to avoid a needle stick, standards for quality care for patients and health workers, including, availability of appropriate supplies and protective equipment, availability of post-exposure prophylaxis (PEP), avoidance of contaminated phlebotomy equipment. Not everyone can draw blood from every patient. [1] }, false); There are several important steps a phlebotomist must use to successfully collect a blood specimen. Stretching the skin is the single most effective way to minimize the pain To do this the phlebotomist will hold the needle in his dominant hand. If one is not prominent enough to instill confidence, default to the cephalic vein on the lateral or thumb side of the arm as a second choice. No other methods are acceptable. This cookie is set by GDPR Cookie Consent plugin. It is more likely to roll away from the needle than the cephalic vein because it is not held as tightly in place by the tissues around it. }); 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. The information provided should not be used for diagnosing or treating a health problem or disease. WebLocating and anchoring the vein or any blood vessel, is required to appropriately puncture the vein without slicing or severing it while trying to start an IV or draw blood. } Straighten out the arm that they're taking blood from and stick your other fist under that elbow, it pops the vein up. Lower the patients arm for a few minutes before applying the tourniquet. 12 0 obj But opting out of some of these cookies may affect your browsing experience. Do not apply the warm pack or water bottle directly to the skin. Veins are part of your circulatory system. Allow the disinfectant to dry before inserting the needle. Which of the following actions should the nurse take? } Anchoring veins To fix the issue of rolling veins, it is important to learn how to anchor a vein during a vein . a. Phlebotomy teams generally only make rounds at specific times in hospital settings, therefore, if a lab test is ordered immediately it could be the responsibility of the nursing staff to draw the specimen. Change the angle of the needle while it is still under the skin so that it can be inserted into the vein. Here are the basic steps to drawing blood: The first step in drawing blood correctly is to identify the appropriate veins to puncture. Massage the area where you want to cannulate. When you place a cannula in your vein, it causes tension that tightens your veins even more making injection much more challenging. 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. A high percentage of specimens rejected by laboratories are due to clots in lavender- or blue-stoppered tubes. 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. The skin should be pulled toward the wrist and stretched taut. If you cannot successfully locate a vein on a hard stick patient, dont hesitate to ask for help. To secure firmly, as in holding a vein in place by pulling the skin taunt with the thumb. The proximity of underlying nerves and the brachial artery make punctures in the area of this vein highly risky. Once the vein is anchored on the arm or hand, the needle can be inserted. Before withdrawing the needle, loosen the tourniquet after 1 minute. f.style.height="352px"; By using our site, you agree to our. However, when it is not visible and/or the initial puncture is unsuccessful, probing the area subjects the patient to the potential for excruciating pain and permanent injury more so than probing in the area of the cephalic or medial veins. These veins may also be visible through the skin. That purpose is to make the blood draw less painful for the patient and easier for the phlebotomist. Identify suitable veins for venipuncture. What happens if you dont use a tourniquet when drawing blood? A blood pressure cuff that is inflated to 4060 mm Hg also works well. Intermittent IV bolus, 200 mL. When tying the tourniquet, it is better to start loose then get tighter if need be. One report in August showed that they are even lower than the beginning of the. Similar to a workout, the veins will become more visible and are often easier to access. [dropcap]10[/dropcap] Thou shalt treat all patients as if they are family. Some people are generally inclined to have troublesome veins genetically. Locating Proper Site and Anchoring Vein in Venipuncture.pdf Procedure 2. Looking for a change beyond the bedside? Perform good hand hygiene and don appropriate PPE. If not inverted immediately upon filling, invert the tubes as soon as possible after the puncture. d.appendChild(f); The phlebotomist may find a vein from the direct lighting of a flashlight rather than a standard ceiling light. 4 0 obj var zf_perma = zf_ifrm_data[0]; Geriatric Patients: Best Tips For Drawing How much does a English bull terrier cost? 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. var evntData = event.data; To do this, position your non-dominant thumb slightly inferior to the vein and pull the skin and subcutaneous tissue downwards Because sedated or semi-conscious patients can respond affirmatively to any question, go beyond seeking an affirmation of their identity and request they state their name in full. The 1620 four-color graphic can be viewed and ordered at http://www.phlebotomy.com/poster.htm. How to calculate the Rf value in chromatography? It forms from a junction of the supratrochlear vein and the supraorbital vein. Drawing blood from this area does pose a greater likelihood of the vein rolling or collapsing because it is difficult to anchor. Deliver blood specimens to the laboratory promptly. Insert the needle in at a 15 to 30 degree angle and then hold it still while collecting blood. Anchor the vein by pulling the skin below the vein taut. Carlsen, W., & Holding, R. (1998, April 13). f.style.width="100%"; All valid questions, especially for a phlebotomist. Sanitize your hands with soap and water or 70% alcohol. [dropcap]4[/dropcap] Thou shalt glorify the medial vein. If it cannot be seen it can usually be felt. Sometimes it becomes a tough row to hoe to locate veins in some people. try{ Some patients are easier than others because of the prominence of their veins. This can cause bleeding beneath the skin. ~TmSCv l4cK'[d dH1R_wg@42IiI4j-%dp{l>c^~/~^/[J%%,yXVt&y{&e)smiDjult_Ioq_n836NlaOIPqRQS+-9CI`pV4Mhh>K|=C|Yb;:{P?+!A0Xu-pJjgg[G=/;{f]NXU? 6,j*Y(c.&o9^u:Rnr@-@^ ]xj[6(4AKHf8Y+,U!&-miYOsrM! "This article is very helpful because it is clearly mentioned how to draw the blood from the patients, explaining, "I am a nurse and found the article to be very good. This article was medically reviewed by Shari Forschen, NP, MA. }, false); Even those who elevate phlebotomy to an art form can have difficulty from time to time. Have the patient lower their arm and make a fist to make the veins more obvious. With a vein finder, venipuncture becomes so convenient. stream Make it a habit to drink more water on a regular basis. Sign up to receive the latest nursing news and exclusive offers. If you have narrow or difficult veins, you should hydrate your body before inoculation. Thanks to all authors for creating a page that has been read 689,873 times. In this way, the vein dilates for a short time, making it simpler to locate. If these three steps did not work, finding a new draw site may be necessary. Going too tight at the beginning can result in the loss of plasma in the blood, impacting the test results. It is also relatively easy to access because the tissue around it prevents it from rolling away from the needle. Dont be discouraged if at first, you dont access the vein. Some people are genetically predisposed to having problematic veins, or their age causes the veins to be smaller or hidden. His/Her fingers should support the back of the arm slightly below the elbow. Many venipunctures are routine, but you may occasionally encounter some difficult veins. Anchor 2 maintains the device as steady as possible, which allows the phlebotomist to exchange one tube with another without the needle being inadvertently pulled from the arm.