blood sample with a butterfly needle

  1. hello!
    well, so now i have a job as a nurse and i am very happy about it, no more retail!!! yeah! anyways, i start this job about 3 weeks ago and i like it, so far the nurses and ma's are very nice and really helpful, especially for a new nurse like me. during this time, in between all the different duties that i have, one is drawing blood and let me tell you i am getting better everyday, but everything is ok until the pt asks me to use a butterfly needle, either because the veins are looking so tinny or because they believe a little needle is less painful. well i do everything as i was taught, i see the flow of blood that let you now you found the vein and everything, but when i push the tube to get the blood, the blood does not run as fast as it suppose to and some times does not run at all...and i can not have my pt waiting for hours for the blood fill the 3 tubes that a need to fill for obvious i end taking out the needle and asking some body else to please get the sample for me. what am i doing wrong? i saw my co-workers do it and they do not have any problem. please help.
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    About kantuta

    Joined: Feb '09; Posts: 39; Likes: 20


  3. by   annaedRN
    You could try leveling out the needle a little - flattening it out so the bevel/needle is more "flush " with the vein if that makes sense. Also, make sure the tubes are in tight so to cause enough of a vacuum. I've had a few where I need to hold the tube in tight to make get enough blood. I usually have no problems with it being a slow flow though. Hope you figure it out. like anything practice makes perfect!!
  4. by   meluhn
    You are probably just used to seeing the way the blood shoots out with the larger needles and the butterfly seems slow in comparison. The above poster is right, when you are in the vein try changing the angle of the needle ever so slightly and see if the blood flows faster. Where I work the butterflies are like gold because we cant get blood on these little old people with a regular needle. Good luck.
  5. by   EMT-2-RN
    I agree with the above posters. When drawing blood with a butterfly the needle is small and if the blood is not flowing like it should it is probably positional. If you are in the vein just move the angle of the needle around until you get better blood flow and try and steady the needle there until you get the blood you need.
  6. by   BrnEyedGirl
    I still don't understand why people always ask for a butterfly. The needle is shorter, but still a 23g just like the reg needles! Some of our butterflies are even 20g, which is larger in diameter than the reg phlebotomy supplies. I guess they see the shorter needle and in their mind it is "smaller". I don't mind using a butterfly if it's a nice surface vein, like in the hand or forearm, or in an infant, but it is easier for me to use the reg needle that I'm used to handling a thousand times a day.
  7. by   .....RN
    Last edit by .....RN on Oct 25, '10
  8. by   jollydogg_RN
    we only use butterflys with the cord that runs to the port where you push the vacuum sealed blood sample tube in. sometimes you have to check and see if the cord is connected tight on top of the port where you push the vacuum sealed tube in, otherwise it will run slow.

    i dont know if you're SUPPOSED to do this, but sometimes if you have the needle in far enough, you can adjust the level, or try pulling out a tad or going further in to see if the blood flow speeds up.

    you'll get it
  9. by   Roy Fokker
    Sometimes, I find that stretching/pulling the skin towards me, in the same direction as the needle/vein helps to ease blood flow.

    Quote from jwlzbsn
    Just curious, do you always make sure the bevel is up? It may sound really stupid but I used to have the same exact problem (I'm a new nurse too), and I finally realized that the bevel was down, and that's why I couldn't get the blood to flow. May just be me but hey, worth a shot..
    The "bevel"* is relevant only for penetration i.e. the act of breaking through the skin and the blood vessel.

    It has no relation to blood flow once the needle is in the vessel itself.

    Penetration is easier when the "bevel" of the needle-point is facing away from the surface being penetrated (lower surface area in contact = higher pressure at point of contact = lesser force required to achieve penetration).

    On a semi-related tangent - "bevels" and penetration angles were extensively studied by tank designers to build better armor protection for their tanks (the most famous and classic example is the Soviet T-34). It's still a relevant discussion in tank design today.

    'geek'-ily yours,

    * A "bevel" simply refers to any surface that is not perpendicular (90°) to the face.
  10. by   MrsDye
    I have the same problem and when the blood runs out slow sometimes it will even clot off in the tube......So I will attach a syringe to the end and pull SLOWLY and have much better luck doing it that way. If you pull the syringe too fast the sample may be hemolysed and lab will want a re-draw. Hope it helps
  11. by   waitingforthedream
    I never use a butterfly needle unless I am using the hand to draw blood, things are to darn expensive to use for patients convenience! Our Patients seem to think that it is less painful, but I try to explain that it is still going to pinch. It takes twice the amount of time if not longer, and is a pain. We sometimes have problems with sample being hemolysed like above poster said also. If I need to use your hand, you get a butterfly. If I see good veins in arm, no you cannot have a butterfly!
  12. by   blondy2061h
    We only have butterfly needles. I'd be lost trying to use anything else.
  13. by   waitingforthedream
    They are great when someone has no veins left, my employer lets us use them only when necessary because of expense. They are the greatest invention next to sliced bread! We used to hoard them in our pockets because manager never ordered alot of them. I have a secret stash just for me!!!
  14. by   RochesterRN-BSN
    Not sure what size butterflies you have --you mention having larger bore ones and well, what's the point then!? lol
    I have had both stuck in me and the butterfly does hurt less........though this was a 22G or 23G, the regular one like a 20. The problem is that if you are in the AC and have a really large vein and a tiny 22 or 23G that is a lot of pressure and sometimes they will blow, same thing trying to put a 22G IV into a huge far as blood flow there is a big difference, especially if you are used to looking at the rate coming from a 20. The butterflies are usually smaller so the blood has to get through that. And keep in mind having the blood coming out too fast can break the blood cells and you do end up with a hemolyzed tube. Also I find that other then readjusting the needle itself i sometimes will take my other hand and make a V with my fingers, straddle the vein just above the needle, like 1/4 of an inch and lightly pull the skin away from the needle to straighten the vein more. You can also try this by pulling the skin on the other side of the needle and pulling away from the needle towards yourself. This too will pull the vein more taught. You can also ever so lightly milk the vein, rubbing the actual vein down towards the needle--very lightly, being careful not to touch the needle. I have gotten blood from a rock --so to say! lol You sometimes just have to be patient. If the floow stops you may be up against a valve in the
    vessel and puttling back just a hair might help.
    Good luck!