Butterflies?

[LNDis4ME]

Hi all!

For those of you out there who draw your own labs, do you use butterflies? We are now being told not to use them when possible b/c they supposedly cause hemolysis. Generally in L & D, we try to draw labs when starting our IV's, but there's always patients that need labs drawn later, and I always use a butterfly. I LIKE butterflies, they are what I learned on, and it's my preference. I'm having trouble buying into the whole hemolysis thing, b/c I can't remember the last time I had a draw of mine come back hemolyzed. I meant to check with our phleb this am to see what she uses, but didn't get a chance. Every other place I have worked where they have techs drawing labs, they have used butterflies. Any thoughts?

Thanks!

[Dixiecup]

I like butterflies also esp on older adults, but it is a bit more challenging to see if you can obtain the speciman with a vacutainer.

The main reason I was always told to veer away from butterflies was the cost factor (of course!)

[TazziRN, RN]

"butterfly" refers to the wings, not the needle. the needles come in different gauges just like any other needle. the needle gauge can be responsible for hemolysis, but i can pretty much guarantee the wings have absolutely nothing to do with it!

[SaderNurse05, BSN, RN]

As a former medical technologist and phlebotomist deluxe;) I know they do cost more and generally come in smaller gauges. Sometimes when people use them to get a hard stick it takes the blood so long to make it up the tubing and into the tube that it does damage the cells, hence hemolysis.

[TazziRN, RN]

when i've seen labs drawn by a phlebo with a needle and syringe, the gauge was usually a 22. butterflies come in 22's. and the vac needle can be removed from the other end and a syringe attached, which i have done often.

[loricatus]

I think that some labs like to blame the hemolysis on the butterfly needle [name used for the needle with the wings and tubing attached]. I have heard the same thing as you and rarely get anything hemolyzed (unless it just one of those nights that every specimen that goes to the lab by anyone is supposedly hemolyzed). Even when we were told to switch to the 'harpoon' to draw blood, I continued hiding my use of the butterfly to do my draws without any difference in my hemolysis rate. Funny thing, those that switched to that 'harpoon' needle didn't see a reduction in the lab's hemolysis rate.

The only thing that I am careful to avoid with the butterfly draw, is to never draw the anticoags first (since the tube has to be filled and the air in the tubing can interfere with the complete filling of the tube).

PS: I use 23 through 16 gauge butterflies & even have used a butterfly IV (saf-t-intima)

[nursemary9, BSN, RN]

We were told to limit our use if butterflies because they are VERY expensive; this was in Home Health. When I asked one of our Phlebotomists at the Hosp--he did verify that.

[barbyann]

:twocents::twocents: Cha ching!!!

[RheatherN, ASN, RN, EMT-P]

I agree with everyone else, they are much easier to draw with most of time, but we are also told to "veer away". esp when i did phleb, we had some girls that is all they would use, and got "talked" to about it. COST... but i feel that we need to just learn to use the other ones, hell if you can do an IV, you can do this.. not trying to be rude or mean, but heck,,, we can do it.. SUPER NURSE!!!!

-H-