Problem with blood draws..

Nurses General Nursing

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I was told to do a blood draw last night at work. I have done two other blood draws before this one. I got a flash of blood but no blood in vial, the two other times. However, this time I got blood in vial but, only 1/2 an inch. I tried twice and I got the same result. The lab took the vials b/c they only needed 1 ml but am I doing something wrong? I'm thinking about taking phlebotomy classes.

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Specializes in Med-Surg, Emergency, CEN.

Sounds like you are doing ok. I'd check with someone who can see what you are doing for any tips. They can see where you might be able to get a better flow.

Also, each vial only holds enough vacuum for a certain amount depending on the color of the tube. It's usually written on each vial. It could be that they only hold half of an inch.

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Specializes in Hospital Education Coordinator.

agree. Maybe you can get another nurse to assist you. If there is an educator in your facility, talk to that person. I have models for teaching these type of skills and can do it privately if needed for our staff

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Next time when that happens try easing the needle back just a hair...With left hand slightly press thumb down around needle area....imagine the vacuum from the tube...sometimes the wall of the vein is stopping the flow because the vein is pulled against the needle from the vacuum of the tube...slight adjustment of needle position will ensure needle is positioned more towards the middle of the vein.

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It can be positional--especially if you are using a butterfly needle.

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Specializes in 4.

It took me time till I was able to master blood draws & IV starts. It usually is positional. The best advice I received was, anyone can be good at blood draws & IV starts. Just keep at it & you will master it. Trust me, if I did anyone can.

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Specializes in Anesthesia, ICU, PCU.

Generally you access the vein with one hand (getting the flashback), then push the test tube into the vacutainer with your other hand (drawing the blood). Sometimes during the ambidextrous process of sliding the tube into the vacutainer, you pay less attention to the needle hand and it moves the needle out of the vein. You gotta be still as a statue with that hand!

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You just have to get the tip in the vein and no more. They can be very positional. It sounds like you may be entering the vein just a bit too far, which can be hard to adjust when you are use to IVs. You can pull back just a tad (if you had a flash but no blood flowing to tube) and that will pull the tip back from the vein wall. It just takes practice but you will get there. It would be best to have someone watch your technique and give you any tips to help.

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Specializes in L&D, infusion, urology.

Are you breaking the vacuum in the tube before you are in the vein?

If you are using a butterfly needle, are you using a red top to flush out the air in the line? Do this to be sure that you aren't getting that air and then the blood behind it, especially if you're drawing blue tops, which need to be 100% full to the little line when right side up.

Also, make sure you're stabilizing the needle in the vein so that when you pop the tube on, there is NO movement. It's very easy to push through the vein or pull back just a tiny bit and be out of the vein, or only partially in.

You might consider asking one of the lab techs, if available, if you can watch what they do. You can learn a lot from people for whom this is their whole job! :) Used to be my job!

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