tips for drawing blood on obese patients tips for drawing blood on obese patients

Then, deflate blood pressure cuff and apply tourniquet. Closely monitor the arm to ensure that is is not applied to tight or for more than 2 minutes. 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. Then, massage from the wrist to the elbow. Although this is not a necessity, it is pretty much recommended. Improve knowledge and awareness of the risks associated with phlebotomy among all health workers involved in the practice, Increase safe practices and reduce blood borne virus exposure and transmission, Availability of appropriate supplies and protective equipment, Availability of post-exposure prophylaxis (PEP), Avoidance of contaminated phlebotomy equipment, Recapping and disassembling vacuum-containing tubes and holders, Reusing tourniquets and vacuum-tube holders that may be contaminated with bacteria and sometimes blood, Working alone with confused or disoriented patients who may move unexpectedly, contributing to needle-sticks, 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. WebTips for Drawing Blood Always feel the vein rather than see it! If you encounter such a person, make sure to draw blood from larger veins instead of the smaller ones. This makes sense, as many individuals, particularly those with very low body fat in their arms, will have extremely visible veins. element: document.getElementById("fbct7c991c3d"), Eat a healthy meal, avoiding fatty foods like hamburgers, fries or ice cream. This allowed him to see the vein and was able to get the IV in. If you're drawing blood cultures, be sure to follow the policy and procedure at your facility. WebDrink an extra 16 oz. I'm Kadia. Gravity will often reveal hand veins you didnt see earlier. When you are retaining water, it increases the total volume of fluid that is being pushed through your blood vessels by your heart. With the foot- some places require a specific order r/t other dx that can increase DVT risk :). Applied 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 fainting, stays low. Some patients have hypovolemia or reduced volume of circulating blood. Remove the needle, take care of the site and repeat the procedure. These can include: Learning about your If a person is overweight, it might be harder for a professional to find the vein. The three most commonly used veins for drawing blood are the median cubital, the cephalic, and the basilic veins. This can pose a real problem as their veins collapse quicker. At some time in life, every person will do a blood test, and not only one but multiple as life goes on. Its important to speak to your supervisor to learn the steps in order to become certified in your hospital. A 3ml, 5ml or 10ml syringe will work fine. Make sure you check with the nurse first for permission. Scar tissue can especially be problematic as it is hard to penetrate. 0000017785 00000 n Please enter a valid e-mail address. What may be warm to you could be hot or even burn someone else. We strive to be the This illuminated the veins that he could not palpate. WebBy using a syringe and needle to draw the patient's blood, you can control the pressure and speed at which the blood is removed by varying the rate that you pull back on the Lower the patients arm for a few minutes before applying the tourniquet. Some veins can be deep in the antecubital fossa area, especially, if there is a lot of fat tissue. Pumping fists can lead to pseudohyperkalemia or increased level of potassium in the blood. Subscribe for the latest nursing news, offers, education resources and so much more! Someone else may be able to find something that you cannot. Enjoy :). For example, in a case of a patient with fragile veins, it is much better to skip a tourniquet as it may cause the vein to blow out. The needle should fully penetrate it. 0000031034 00000 n 1-917-426-3524, By using the site you agree to our Privacy, Cookies, and Terms of Service Policies. 0000260220 00000 n Insert the needle into the vein. A trick I use sometimes is putting a second tourniquet 2 inches above the first tourniquet. 0000014430 00000 n Before you start injecting needles into people, make sure to get a proper training and get used to the entire process. 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. Also, avoid cotton as fibers may stay in the wound and reopen it later on. Other times, they dont want to pop out or raise for the phlebotomist to be able to draw successfully. Then, push down with the flat of the finger over the area. WebOnce veins have been located, return the patients arm to the horizontal position for the blood draw. Your veins will be easier to find and palpate when you are well relaxed, as tension can constrict veins. We and our partners use data for Personalised ads and content, ad and content measurement, audience insights and product development. Afterward, you can easily go upwards. 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 instance: "61c9f514f13d4400095de3de", 0000011603 00000 n However, thats not always a luxury most phlebotomists are afforded. On average, it is much harder to find veins in people with darker skin tone. Please wait while we send your information. }()); Drawing blood from a patient can be a daunting task, but it also is a necessity for nurses. It is crucial to use needle and cannula that is smaller than the patients vein. Spaces are not allowed; punctuation is not allowed except for periods, hyphens, apostrophes, and underscores. The needle has passed through the vein. In the end, they can only lead to injuries. In the case of children or uncooperative individuals, restraints are an option but they should be avoided at all costs. Bloating. Then, apply heat to the lowered arm. Sometimes, its even hard to feel them with your finger. WebObesity isn't just a cosmetic concern. I have had patients tell me nurses are more successful in one arm than the other, etc. Phlebotomy Pages advises that individuals use touch as their primary indicatorwhen looking for the vein from which to draw blood.1 Veins will often feel as though they are slightly risen beneath the skin. Medicine is a very serious profession. Do it by performing a quick backward motion. Edematous sites (swollen sites filled with serous fluid), From an IV cannula (unless permitted by your institution), Sites above an IV cannula in the same vessel, Arm with a preexisting or current blood clot, Evacuated Collection Tubes (tubes specific to labs ordered), Personal Protective Equipment (ie gloves), Bio-hazard leak-proof transportation bags. Like most medical procedures, phlebotomy can be really easy or really hard. By placing a warm towel over the veins, you are increasing the blood vessels which will make them more visible. 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!). Place it at the chin and lightly draw a straight line. Finally, an ER tech came up and he used a venoscope, which is basically a fancy flashlight - basically the same thing that bruali described in their post. 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. How to Use a Vein Finder on Obese Patient. Sure, its easier said than done when a needle is about to enter a persons vein, but tension can constrict veins. Finding difficult veins isnt impossible, but it can require a few different methods to be put into place. To make a basic grid for your female body proportions, turn your ruler so its perpendicular to the vertical line you drew. I have to say, I started off doing venipuncture for lab draws prior to IVs and found that a good way to learn. Over the years I have drawn blood from many older patients, learning tips and techniques along the way in dealing with them and drawing blood from them. The practice of phlebotomy is not something that can strictly be learned from watching videos or reading a how-to guide but something that must be practiced repeatedly in a controlled environment with other trained professionals. Relax, listen to music, talk to other donors or read while you donate. Phlebotomy, the practice of drawing blood from a vein, is a proficiency that all nurses need to learn. (Immediate download. Another way that prednisone can increase blood pressure is weight gain. Once again, please be aware that these are only guidelines for blood draws and nurses should consult with the appropriate hospital personnel regarding performing this procedure on patients. Once the vein is located, the individual arm can be returned to horizontal position for blood collection. 0000027834 00000 n 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. Password must have upper and lower case letters. Rolling up gown sleeves (rather than pushing sleeves up) to enhance tourniquet visibility. 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. Apply the tourniquet one to two inches above the wrist if drawing a hand vein. Invert a BP cuff so that the blood can go to the lower regions of the limb. As a result, this will lead to the release of histamine increasing the vein. Some institutions have kits with all of the needed supplies while others will require the nurses to gather them individually. Spend a decent amount of time looking for good veins. Try tourniquets, hot packs, gravity, and ask the patient where they usually have luck with bl Contact should be limited and you shouldnt place the locator on burned skin. 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. What about other resources that may be available? 0000005419 00000 n As the body ages, the skin becomes thinner and blood vessels become weaker. When the blood draw is complete, gently release the tourniquet. 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. By submitting this form, I authorize and agree that a representative of Carrington College can contact me about educational services and future offers by email, phone and/or text messaging at the email and telephone number provided above using an automated telephone dialing system, and/or an artificial or pre-recorded voice or text message. Talk about pressure! Here, I share with you all the tips and tricks I have learned doing phlebotomy over the years. Follow us and never miss out on the best in nursing news. If the person is dehydrated or hasnt been drinking a lot of fluids, get them to drink some and see if that helps. Doctors have access to deep veins like the femoral and subclavian vein that other phlebotomists dont have. To expedite your donation, start your RapidPass on the day of your appointment. While traditionally a nurse would use their hands to feel for a vein, many hospitals are now using vein finders to help reduce the amount of time it takes to find a vein and start treatment. In certain cases, the patient may move a bit which may result in you sticking the needle in your own finger. This can be a real time saver and it is also the best way of finding the right insertion point. 0000022045 00000 n So, if youre working with a patient who has small veins, or veins that are hard to find, practice some of the techniques discussed in this guide to make life easier for you. Make sure that tourniquet is removed before the needle. 0000031735 00000 n The veins we have are the veins we will have for life. 0000029232 00000 n In order for the nurses to be successful when drawing blood, there are several key things they must know including. Most people have normal looking serum. They should be spread distally from proximal joint to the insertion site. This will fill them up much quicker which is a great way to finish procedure faster if you have a troublesome patient. What constitutes a difficult vein? Get the patient to lower his or her arm. 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. Sometimes, the patient may experience hemoconcentration. 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. 2. Just my opinion. They dont harm the patient in any way and can be used regularly to make your job easier and safer. Position the patient and hyperextend the patients arm. They are popular because they are so useful. Use left/right arrows to navigate the slideshow or swipe left/right if using a mobile device. The bevel of the needle should go upwards. of water (or other nonalcoholic drink) before your appointment. 0000008998 00000 n If a person doesnt have enough experience, he might make a mistake by not removing the tourniquet before the needle. Utilize the combination of massage, heat, and gravity. 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. Luckily, got it on the first stick. A transilluminator is a cool way of finding or confirming veins. Venipuncture or drawing blood is one of the most common procedures performed in any medical center. Find a convenient blood drive near you and schedule an appointment to donate today. Maybe the number one thing that a person can do is to make sure they are well hydrated. This For example, the veins of a middle-aged man will likely be easier to find than that of a woman, unless shes extremely active. Is there an IV team, anesthesiologist, or other trained personnel that could be of assistance? 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 This can cause an overall loss of plasma in the blood, and the sample could be unusable. Here, I share with you all the tips and tricks I have learned doing phlebotomy over the years. Do not snap it against the patients skin as doing so could cause bruising in the area.if(typeof ez_ad_units!='undefined'){ez_ad_units.push([[468,60],'phlebotomistreport_com-banner-1','ezslot_5',168,'0','0'])};__ez_fad_position('div-gpt-ad-phlebotomistreport_com-banner-1-0'); The 3 main areas to find veins include the antecubital fossa, the forearm, and hand veins. When the body is properly hydrated, veins become more dilated. You could get help from them. Although this is something you mightve seen a lot in the movies, you should always avoid it. If you cant find one, consider the third option, the forearm. As a result, it can be difficult at times to find a vein to draw blood from. If the needle site starts to bleed, apply pressure and raise your arm straight up for 5-10 minutes or until bleeding stops. 0000000016 00000 n 3,377 Posts. 0000001689 00000 n Some patients are easier than others because of the prominence of their veins. The patients vein may have collapsed. Label appropriate tubes at the bedside and place them into transport bags. You know all nursing jobs arent created (or paid!) Always try to draw blood from veins that are lowest. Sign up to receive the latest nursing news and exclusive offers. Continuous interaction can help distract a person during this time. Next, locate the vein you will be using for the blood draw. This one goes without saying but is still something that needs to be emphasized. Re: the 2 tourniquet trick (above and below). Veins will appear as a dark line. 0000013386 00000 n WebIn this module, you'll learn why the right approach is critical when drawing from overweight patients, and you'll have a newfound appreciation for what it's like for too many Make sure bleeding at the puncture site has stopped and the site is cared for.