any safety tips on doing blood draw on elderly dementia patient?

[pear8]

Hi!

i was wondering if you have any advice or tips on how to safely do blood draw on a geriatric patient with dementia and possibly alzheimers and that she may possibly move around and may not be still or forget what is going on? with use of butterfly needle.

[BEDPAN76]

Don't apply the tourniquet too tight. Sit with her and talk for about 5 minutes. If possible, have someone else hold her other hand. It will probably turn out fine. Sometimes when you worry about something like that, you end up pleasantly surprised! Good luck!

[GM2RN]

Get some help to hold and or distract the patient.

[iluvivt, BSN, RN]

1 Have everything you need set out and ready to grab at a moments notice

2 Assess the pt........stay calm and try to elicit cooperation......I have even drawn blood when the pt was asleep and or medicated and they never even moved...sometimes if possible time it after pain med or a sedative..each siutation is different and you have to be creative at times

3 Get someone else to help you hold and or distract if needed..sometimes that does not work and the pt actually does better if you tell them ahead of time. what you are going to do and what you need them to do (this is important) ..stay calm and reassuring

4 The elderly often do not need a tourniquet and if they do be very gentle to avoid skin tears ...you can also use a BP cuff inflated to slightly below that pts usual diastolic

5 If using the ACF....prop a towel under the area....

6 Always make sure your pt is as comfortable as possible...the elderly often have joint problems. I find that just pulling their arm out can often elicit shoulder discomfort ...use the other arm if one is more sensitve than the other or work around it if you have to....the pt will be more cooperative

[CapeCodMermaid, RN]

To add to what iluvit has said: ask the doctor if the patient really needs to have a blood test done. So many times these docs jump to testing on an elderly patient when there is no clinical benefit.

[TakeOne]

To add to what iluvit has said: ask the doctor if the patient really needs to have a blood test done. So many times these docs jump to testing on an elderly patient when there is no clinical benefit.

Also, find out if you really need to draw full-sized tubes or could the same tests be done using pediatric tubes or even capillary samples. Smaller sample size can speed up at least that part of the process.

[Esme12, ASN, BSN, RN]

MOst blood tests can be done with pedi tubes but they are more expensive and the test itself costs more (I know I checked). Most LTC,SNF or LTAC's do not supply them . Like with children stay calm, take help to distract or hold if necessary. don't put the tourniquet right on the skin or too tight. It pinches and will agitate/scare them. Have everything you need ahead of time wipes tape 2x2 ect. and of course the butterfly. the smaller the guage the better and insert needle bevel up....less trauma on insertion..