Drawing blood/phlebotomy tips and tricks

  1. 0
    Ok, so I took my class last february, got some tips here, and now have done at least 70 draws. I am decent, but now I want to be better than that.

    My problems are those women (they are all post menopausal women in my study) with those skinny itsy bitsy torturous veins that you really cannot hardly feel, but can see a little. And then the other problem are those women you just cannot palpate or see anything.

    Advanced tricks and tips please! Actually, basic ones are great too.

    I am using butterflies.

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  3. 26 Comments so far...

  4. 3
    Try using double tourniquits, one up near the axilla, one mid forearm.
    When anchoring, pull down hard with your thumb, just one finger so you don't flatten vein.
    Try to avoid going by veins you see, not saying if you see a big night crawler, avoid if, just FEEL those veins!!!
    Veins bounce (as you probably know) so bounce em up as far as you can till you feel a "fat" entry point.
    Flabby skin can be pulled back for the illusion of tautness.....

    Practice, practice, practice. Each poke is a learning experience!!
  5. 3
    Hi,
    I've been a phleb for 20 years now; just graduated from nursing school!!
    Almost everyone has a decent vein in their wrist-turn their hand so the thumb is on top and the pinkie finger is on the bottom (their hand will be "sideways"), and use a hot pack or wrap hand/wrist in a hot towel. These veins must be anchored properly or they will move away from the needle. Also, I don't know what your facility's policy is (some do not allow this), but in extreme cases I will draw from the inside wrist-palm side- after warming up the area with a hot pack. I use the smallest gauge needle I can get away with as this is a tender spot for the pt. Don't be afrain to check for surface veins on the upper arm or on the back of the upper arm; most elders have veins in some strange places you can access. Take your time whenever you can-better to take your time looking for decent access than to stick people numerous times.
    Good luck and remember-no one gets everyone-at times we all have a difficult day trying to get blood from these patients no matter how much experience we have!
    Hang in there:spin:
    PurpleLVN, PhoenixTech, and martinb216 like this.
  6. 0
    Thanks so much Hystericka and Sunflower!

    I am way too much of a weeny to go for those wrist veins

    Keep them coming all!
  7. 0
    The inside wrist veins almost always work for me! They terrified me at first but I have never had any problems using them. I have seen people stick patients between the fingers! I feel so bad for the pt because that really seems to hurt them.
  8. 0
    Quote from buckdropper
    The inside wrist veins almost always work for me! They terrified me at first but I have never had any problems using them. I have seen people stick patients between the fingers! I feel so bad for the pt because that really seems to hurt them.
    Come teach me!
  9. 0
    Find out which wrist the pt wears her watch on, usually the "snuff cuff" the radial aspect just below the thumb has a nice fat vein. The arm the pt wears her watch on will have more engorged hand and wrist veins. Don't know the mechanism, just 15 years of experience stickin' em!
  10. 1
    There are some people on whom I get better results with a Blood pressure cuff instead of a tourniquet. Inflate the Bp cuff as though you were taking a Bp and leave it pumped up until you draw blood.
    Adri_RN likes this.
  11. 0
    Thanks for the tips!
  12. 0
    BP cuff inflated to about 100 works great.

    I always liked those plump wrist veins too but you must be very careful to avoid the many nerves in this area. I had a tech hit a nerve once and it was very painful, and gave me problems for weeks.


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