Help With Blood Draws

Rustyhammer · Dec 13, 2003

Why aren't you using a butterfly and vacutainers?

-Russell

EyesForward · Dec 13, 2003

You know what, our facility discourages us from using the vacutainer system on hands, I guess because the vacuum is so strong in the tube it blows the veins? I'm relatively new at doing draws, and am learning different techniques while I improve mine. Do you use vacutainers and butterflies on hands?

Erin RN · Dec 13, 2003

For the times that I did use a butterfly and I had to go in the hand I would attach it to a syringe to control the pressure..vacutainers in the hand are pretty risky to blow unless you have the healthly, pumped up 20 something male (with ropes for veins)

AlixCoastRN · Dec 16, 2003

I always use a butterfly and syringe - also, get some pediatric tubes from the lab - they don't require as much blood as the adult tubes do...Sometimes even infant tubes will do (if you have a NICU nearby..) Hope this helps

EyesForward · Dec 16, 2003

Alix,

I'm so glad you mentioned pediatric tubes, since I've never seen one, and wondered if such a thing existed. Are they exactly like any other vacutainer tube, but just smaller? Is an infant tube used with the vacutainer system too, or do you mean microtainers? I wish we had pediatric vacutainer tubes, because if I have a small volume draw my only option is to draw with a syring, and pour a bit into each microtainer for cbc's, etc. Do you use butterflies and small vacutainer tubes on hands? Since I posted I've tried using butterflies with syringes, and I am having much more success. Thanks everybody for the tips!

sassynurse78 · Jan 22, 2004

I try not to use the hand, but have had to many times. If the blood stops flowing sometimes I hang the hand over the bed a little. Sometimes a little gravity works.

LisaintheLab · May 23, 2004

Just wanted to mention Order of Draw to ensure your patients are getting accurate results (otherwise what's the point of drawing). Phlebotomy.com has an excellent book for Nurses for anyone who could use a little help, also be sure to check with your Lab as to the correct order to draw (or fill for microtainer and syringe draws) as cross contamination can give erroneous results. As a Lab Assistant, not a Nurse (hope you don't mind me butting in on your page, but I was looking for info as my 75 year old Mother was just diagnosed with Diabetes in addition to her Alzheimer's) I recommend a 23 gauge butterfly and syringe for hand draws as a 25 can cause hemolysis. If using microtainers, remove the butterfly and insert blood directly into them, avoiding hemolysis again. Please don't use straight needles in hands as it causes a lot of trauma and puts you at a higher risk for needle stick injuries. Also always apply sufficient pressure after drawing to reduce bruising and save the vein for you to draw from later. Please don't use straight needles in hands as it causes a lot of trauma and puts you at a higher risk for needle stick injuries. Also always apply sufficient pressure after drawing to reduce bruising and save the vein for you to draw from later. P.S. gravity is great, be sure your syringe is lower than the inserted butterfly or you're working to hard. If all else fails, warm the hand with a wet washcloth for 2-3 minutes.