Butterfly Vs. 22 gage. What do u use prefer to use?

[Anagray, BSN]

In my hospital use of butterflies is very much discouraged. My neighbour works in another hospital close by and she says butterflies is what they most commonly use.

I have no problem using 22 gage, however, most patients on my floor are elderly, bruised and are on blood thinners.

I am still drawing blood under supervision of the nurse.

One night, my very expereinced co-worker was drawing a blood on an elderly woman with a butterfly in front of me. The vein collapsed. They had to stick her again.

2 days later, I was assigned to draw blood on the same patient.

Explained to the nurse what happened previously, the nurse advised me to go with 22 gage anyway. Of course, I misssed.

The same tech who worked on this patient 2 days ago came in, had to find another site on the pateint's bruised arm (hands were already out of the question) and stick her again.

My first question is what do u prefer to use and what is your hospital's policy?

Second question is should I debate with the nurse who is supervising if i don't feel comfortable using the large needle?

I usually do what i'm told, but in the case I described, I am looking out for the patient, not for my personal comfort. I felt horrible that night. what would u do?

[ageless]

For known "bad sticks", I use a 22 jelco with a small (3-5cc) syringe. puts less pressure on the vein and less chance of collapse. I have had many successes with this technique after others have previously failed in their attempts.

[Nurse Ratched, RN]

I work psych and have three types of patients: addicts (usually with bad veins); mentally unbalanced (uncooperative and/or combative; and confused elderly (generally uncooperative an/or combative with the bonus of bad veins :). I know the butterflies are pricier, but when I may only have one shot, I'll go with what will most likely get results which is the butterflies.

[Nurse Ratched, RN]

Forgot to add that lab does blood draws for the rest of the hospital - our unit is the only one who draws our own labs. If they want something else used, they can send up someone to do it .

[sunnygirl272]

i do home care, and do the majority of our blood draws...and our wound care ...and our cath changes...lol..just call me scut monkey..anyhooo....i used to only use the straight vacutaineer needles...no only use butterflies...and if you are the one doing the draw..you have the right to choose what needle to use..supervisor can suggest..but i don;t feel they can force you to use soemthing different, unless there is a policy

[jayna, RN]

Once drawing blood on babies and elderly, I like to use butterfly. But once for IVI I will rather use 22G.

[SharonH, RN]

I prefer to use the # 21 vacutainer needles. I know they are large but they work faster. I use to swear by the butterflies but they are so slow and I can almost always hit a vein with the #21. Only for the most difficult of patients(and the most anxious) do I use the butterflies.

[Ted]

I use a 23 guage Vacutainer butterfly (what's supplied on the unit).

Ted

[crispix]

I prefer to use butterflies,they are easier to handle than the 21g vacutainer needles(IMHO)and,if it is a slow draw you can attach a small syringe.

I have worked on floors where they tell the staff not to use them due to the cost.But,if you are unable to get the blood using a vacutainer,rather than stick the patient several times,why not use a butterfly and do it once?I never could understand their logic,especially since the majority of the patients were ederly with fragile veins.Butterflies just work better,I think.

Christine:p

[Huganurse]

I use the butterfly/vacutainer system as well most of the time.

[arbley]

Most nurses have equipment that they prefer, and it varies from one nurse to the next. Personally, I find butterflies a little bit awkward and slow.

I first learned to draw blood using a vacutainer with a 21g needle. These work ok if you are used to them, but they can collapse some of those puny veins because they can exert too much suction. For cases like that, I prefer a syringe w/22g needle. I shy away from the 23g needles, whether butterfly or not, because the lab folks have drilled into my head that the smalled the needle, the greater the possibilities of hemolysis. If that happens you just have to draw it again anyway. And, think about this. Do you give blood through a small bore IV? Why not? Because small bore IV's can beat up the red blood cells pretty badly sometimes.

[Christian Nurse]

I was patient care tech in a hospital in Michigan. I did blood draws as well as IV starts. I also worked a predominantly geriatric population and with them I use the "One Stick" rule. If I can't get it on he first try I'll ask someone else to try. So I loved using the butteflies. They seemed easier to use and the "wings" helped guide you. But cost was the main concern on our unit. That's why we had to stop using them so much.