drawing blood

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Ive been an LPN almost a year now. I recently switched jobs from a nursing home to a Dr's office. At my new job Im required to draw blood. I didnt even go over this in school...and in the nursing home they had a lab to come in and do it. Long story short...Im doing it...but I still dont feel I have the education I should have. If someone could pls explain some safety issues for me. Im terrified of getting stuck. We only use retractable butterfly needles. Are you supposed to retract the the needle after removing the tournequet and while its still in the arm? or do you pull it out and then do it? Pls anyone who can give me ANY safety hints, I would so appreciate it.

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Specializes in ER.

I hate those retracting butterfly needles. I don't use them, so I have no advice on those. Just be very aware of where the needle is. Do not become careless handling them. Also, watch out for patients you made need someone else to hold. I don't do venipuncture or IV starts by myself on children or confused patients. Get someone to hold the arm so you don't get stuck. The AC is the obvious place for a blood draw, but you can use other spots. I like to use above the AC in the elderly who have used up veins. Hands work too, but I don't like to use them unless there is no other option. Tie the tourniquet tight. I like to have my needle almost flat against the arm when drawing from the AC. Bevel up. Remove the tubes from the vaccutainer before you take the needle out. ALWAYS wear gloves...ALWAYS! Know which labs go in which colored tube. You can google these. Know the order of colors in which to draw.

Good luck!

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Specializes in Long Term Care; Skilled Nursing.

I'm not a registered nurse, I just took my CNA class and have to take pre-requiesettes for nursing school. But if you don't feel comfortable drawing blood, which it doesn't seem like you do, I would inform your boss and see if they can train your or you could take some sort of course to refresh this skill.

Good Luck!!!

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Specializes in LTC Family Practice.

There are some really good books on phlebotomy, I took a course last year and even though I had years of experience but was very rusty it helped. Also, there might be a weekend seminar for LPN's check the 'net.

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I hate those retracting butterfly needles. I don't use them, so I have no advice on those. Just be very aware of where the needle is. Do not become careless handling them. Also, watch out for patients you made need someone else to hold. I don't do venipuncture or IV starts by myself on children or confused patients. Get someone to hold the arm so you don't get stuck. The AC is the obvious place for a blood draw, but you can use other spots. I like to use above the AC in the elderly who have used up veins. Hands work too, but I don't like to use them unless there is no other option. Tie the tourniquet tight. I like to have my needle almost flat against the arm when drawing from the AC. Bevel up. Remove the tubes from the vaccutainer before you take the needle out. ALWAYS wear gloves...ALWAYS! Know which labs go in which colored tube. You can google these. Know the order of colors in which to draw.

Good luck!

thanks so much for the advice...I cant believe they taught us about IV's in school but not phlebotomy. ugh. I picked it up pretty well though. I just hate not knowing the equipment. first rule of nursing school..Know your equipment! and everyone Ive asked, that does it everyday...doesnt know either...I will continue to educate myself via google..lol

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Specializes in ER/ MEDICAL ICU / CCU/OB-GYN /CORRECTION.

You tube has a bunch of videos demonstrating phlebotomy techniques. Of course if you can find a local course that would be better. Look on youtube under these titles - PHLEBOTOMY AND ORDER OF DRAW and the link is

http://www.youtube.com/watch?v=HkolUCOCRNI

There are several quite good lectures and demonstrations.

Hope this is helpful

Marc

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Here's another site that breaks the steps down really well: http://www.med.uottawa.ca/procedures/iv/

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Specializes in Critical Care, Capacity/Bed Management.

Here are some tips that I have found useful:

1. hold skin taught with the the thumb of your free hand.... helps steady the vein.

2. never go in at a steep angle... veins are not that deep.

3. always hold pressure for a few minutes after finished... don't want a hematoma.

Things you should be aware of/do:

1. if your patient begins to get shaky, tell them it is important that they dont move or serious injury could result for both of you.

2. bevel of the needle should always be down.

3. keep cotton/gauze and tape ready nearby.

4. you should retract the needle while still inside the vein, its designed for that.

ALWAYS WEAR GLOVES!!!

hope that helps

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here are some tips that i have found useful:

...2. bevel of the needle should always be down. "really? i was always taught bevel up?"

3. keep cotton/gauze and tape ready nearby.

4. you should retract the needle while still inside the vein, its designed for that. "this maybe a stupid question, but with a butterfly needle you'd do this?" i do not see how this would work. thanks.

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Specializes in cardiology/oncology/MICU.
here are some tips that i have found useful:

...2. bevel of the needle should always be down. "really? i was always taught bevel up?"

3. keep cotton/gauze and tape ready nearby.

4. you should retract the needle while still inside the vein, its designed for that. "this maybe a stupid question, but with a butterfly needle you'd do this?" i do not see how this would work. thanks.

bevel is certainly up, and i do not retract the needle of any sort while it is still in the patient. it is a safety for use in disposing of sharps not to be activated while in the body, at least that is what i was taught.

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Specializes in cardiology/oncology/MICU.

Bevel is certainly up, and I do not retract the needle of any sort while it is still in the patient. It is a safety for use in disposing of sharps not to be activated while in the body, at least that is what I was taught.

I will say though that the BD website states that you can activate the needle safety while it is still in the vein.:yeah:

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here are some tips that i have found useful:

...2. bevel of the needle should always be down. "really? i was always taught bevel up?"

3. keep cotton/gauze and tape ready nearby.

4. you should retract the needle while still inside the vein, its designed for that. "this maybe a stupid question, but with a butterfly needle you'd do this?" i do not see how this would work. thanks.

whether one performs the vp bevel up or bevel down i don't know that it makes that much of a difference (i do it bevel up). however, if one retracts the needle into the safety sheath while it is still in the arm then that requires two hands (at least for me). even if one put a piece of gauze over the vp site (which would obstruct your view of retracting), then what is preventing the stream of blood pouring from the vp site and the hematoma from developing until you get a hand free to hold pressure? myself, one hand is holding the needle in place during until completion of the vp while the other hand is changing tubes, holding skin taunt, and so forth. after all, the patient can feel most every time that needle moves.then when i am finished i take a piece if gauze and gently hold over the site and remove the needle while immediately placing pressure on site. then i retract the needle.:twocents:

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