Phlebotomy question

[Blueorchid, ASN, RN]

So I know this doesn't necessarily apply to nursing students as we don't always get to learn blood draws. But I'm learning to do both IVs and straight sticks through my job as an ER tech and I figured I'd ask anyways. My hospital uses the Vacutainer system with butterfly needles to do straight sticks (venipuncture) and I know its a common mistake with the butterfly needles to get a flash and let go of the needle.

Well I did that today on accident and of course it popped out... I feel like an idiot but I hear its a common beginner mistake. What I'm wondering is if I'm drawing blood and I need to take several tubes, is there any reason not to attach the first tube to the Vacutainer in preparation for the stick? That way I can get the blood and remind myself to hold the damn needle so it won't pop loose...particularly for those ever so friendly patients that don't want anything to do with you.

Any thoughts? Help would be appreciated

Thanks!

[lilo2010]

You cannot actually attach the tube in the hub till needle in vein or you will loose the vaccumn in the tube! I just stick the pt then put the hub in hand holding the needle & pop tubes with other hand. Hope this helps or @ least makes sense! If butterfly is in the vein good you can actually let go of needle if you are careful! I am 3rd semester nursing student, but did labwork as an MLT for 10 yrs!

[SolaireSolstice, BSN, RN]

I agree with lilo2010. You lose the vacuum if you attach the tube before you have the needle in the vein.

I also do venipuncture, and I have NEVER gotten the hang of the one-handed switch tubes, attach the tube to the vacutainer trick. If I'm using a butterfly, I always ask for someone to help transfer the tubes (if there are multiple). If it's just one tube, you can hold the end of the vacutainer between your forefinger and your thumb, and use the rest of your hand to attach the tube once the needle gets the flash.

For safety and comfort, it's better to keep you hand on the needle, unless your patient has firm tissue to hold the needle in place.

[+one]

or try to use your middle finger to support the needle so it wont go through and through..