Drawing Blood Question...

AC is where I go, in our facility the assistants are not allowed to take blood from the hands or wrists so if I cant get from the AC the RN has to do it.

I go where ever I see a vein first. If that's the AC, great. If that's the hand, forearm, or somewhere else, so be it.

In response to the last poster, I got blood out of a forefinger vein last week! I was pretty surprised that I was actually able to get it (it was the only vein I could find on the pt).

In response to the last poster, I got blood out of a forearm vein last week! I was pretty surprised that I was actually able to get it (it was the only vein I could find on the pt).

It's great when you can get that hard to collect specimen!

I agree with going for the AC. If the person is elderly or very thin, use a BP cuff instead of a tourniquet. Don't be afraid to ask your coworkers for help.

Don't feel embarrassed about asking for help from the RN's on the floor. I'm sure they are happy to help you. I felt like that too when I couldn't get IVs started on my older patients. I would say the best place I get them are the ACs. I try to look for good veins in the forearms, but when you deal with a lot of elderly people, it's hard to get a good vein and not blow it. I would try putting a warm wrap around the pts arms to get the veins dilated. I always find that to be helpful.

We do a lot of lab draws in my unit. If the patient doesn't have a central line, we can run out of good veins in a few days or less. So I have made it a habit to draw labs from as distal spot as I can so as not to use up the vein. Also, I try not to draw from veins that would be suitable for starting large IVs, sort of keeping those in reserve. I think it is much easier to draw blood than to start IVs. I have drawn from fingers, thumbs, feet and ankles (only with an MD order and never on a diabetic).

Lots of people here will give good advice on technique, but the best thing to do is to PRACTICE. Are you making an attempt or two to draw your labs before calling in the IV team? You should not be embarassed to tell the nurses you work with that you have trouble with blood draws. Instead of asking them for help with your draws, you should be asking if you can draw the ordered labs on their patients. The only way to get better is to keep doing it. You will get a feel for the best veins and develop your own technique over time.

Where do you go to first?

The central line.

In all seriousness, though, lack of experience makes me horrible at drawing blood. I'll usually look at the AC first, then the hand. If I don't see anything there, I'm probably not going to get it.

Ok so you have to call in the IV team. You are seeing to it that the pts needs are being met. What you need to do is go with them..and ask them if you can do the draw and will they talk you through it and that includes locating the vein for you. Try once with their help and if you do not get it..then watch them and have them explain what they are doing and thinking. The large veins in the ACF are blood drawing veins...they are suitable for the task....large with a good blood flow...they are not however,suitable for routine peripheral IV therapy as they are located at an area of flexion .

Try these steps

Apply warm pack to ACF for several min

Apply tourniquet as high as you can get it so you can trap more blood in the veins

Feel for the median cubital,cephalic and Basilic veins. Make sure you have the vein in the basilic vein area and NOT the artery...(you will feel the pulse and wall is very thick)..Feel along the course of the vein and see if it is smooth,bouncy with good volume.feel for valves

Insert bevel up (avoid the valves) at a very short angle (flush to 15 degrees) run the needle on top of the vein..if you have to stop and feel for the vein..that is OK...I like to feel it just before the poke and only once in a blue moon do I have to stop and feel for it..Once you are lined up with it and on top of it you may have to change your angle slighlty to gpop into it....you may feel a little bit of resistance as you approach the vein...keep going...pts will often say it hurts when you have the needle at the wall of the vein...once you pop in..look for the flash

You should have everything ready to draw at your fingertips

I love the those big ACs!:heartbeat I also use the forearm. I'm not of fan of drawing from hands but sometimes you got to! Don't be embarrassed, everyone has to learn and it takes time to find out what works best for you. I don't think there is a nurse alive that doesn't miss occasionally.

Also - don't forget that nice vien that runs along the back of the forearm, over the kinda fleshy part of most people's skin. It's usually easier to find on med than women, but I have placed some awesome IVs and had great blood draws if that's the only place you can go.