2. Make sure to find a vein that is properly hydrated. allnurses, LLC, 175 Pearl St Ste 355, Brooklyn NY 11201 Thyroid function tests. 0000012097 00000 n I was in a patients home a few days ago and had to call EMS, the patient was obese and her spouse said she had terrible veins. Talk to your doctor or therapist about improving your coping skills and consider these tips to cope with obesity and your weight-loss efforts: Journal. BLOOD If you dont know what a vein feels like, practice by feeling on yourself with you index finger. You can do that by gently massaging the arm, from the wrist to the elbow. They can be riskier, especially if you need to draw a lot of blood. There is a nice way to fill the tubes faster. This instructional video, from the Blood Collection series produced by Medcom, Inc., is about special precautions for drawing blood from obese patients. While doing all of this, make sure to penetrate the skin with one quick move. Always start by thinking that a patient is infectious and that he can spread a disease. All these factors contribute to their veins staying low. They dont harm the patient in any way and can be used regularly to make your job easier and safer. 0000031034 00000 n Blood Bloating. If the blood is not delivered in a timely manner it can cause hemolysis and skew the lab results. In order to prevent it, professional will have to avoid phlebotomy from a hematoma and to avoid drawing plunger forcefully. Edematous sites (swollen sites filled with serous fluid), From an IV cannula (unless permitted by your institution), Sites above an IV cannula in the same vessel, Arm with a preexisting or current blood clot, Evacuated Collection Tubes (tubes specific to labs ordered), Personal Protective Equipment (ie gloves), Bio-hazard leak-proof transportation bags. 3. Sign up to receive the latest nursing news and exclusive offers. Best practices in phlebotomy involve the following factors: Obtaining blood samples, either via a venous stick or from a central line, is a critical nursing skill. Otherwise, it may indicate that you have missed which is when you should immediately back up. 0000031735 00000 n 0000001196 00000 n Insertion point should be under 15 to 30 degrees angle. If using wet or damp washcloths, do so with caution. Follow your institutional guidelines or polices or get advice from qualified personnel. If you can find a vein with that desirable characteristic, youll know that youve discovered a usable vein, even if its not prominent. The needle is in place but there is no blood flow? As we mentioned, it is your duty as a medical professional to ensure the patient that everything will be ok. Continuous interaction can help distract a person during this time. Application of heat will cause vasodilation, making veins easier to see or palpate. CMAA exam 1 Flashcards | Quizlet Its important to do everything in your power to ensure the comfort of the patient when drawing blood. Some health care settings may insert blood drawing peripheral intravenous catheters into this vessel for frequent blood draws. Blood Test Vs Blood Donation (Comparisons). go-to source for nursing news, trending topics, and educational resources. 0000017785 00000 n It needs to remain loose. If its possible for you to give your patients some tips ahead of time, this can make hard-to-find veins for a blood draw so much easier. Be sure that youre doing everything in your power to keep a level mindset before and during the blood drawing process. Try tourniquets, hot packs, gravity, and ask the patient where they usually have luck with blood draws. The paramedic immediately brought out a large flash light and pressed it to the patients arm. During phlebotomy, the doctor is the one that needs to ensure everything goes well. The dorsal venous network is of water (or other nonalcoholic drink) before your appointment. While traditionally a nurse would use their hands to feel for a vein, many hospitals are now using vein finders to help reduce the amount of time it takes to find a vein and start treatment. If a person is overweight, it might be harder for a professional to find the vein. Should RaDonda Vaught Have Her Nursing License Reinstated? Has 12 years experience. If a patient is reluctant or fearful, it can interfere with drawing blood. WebApplied Muscle Tension (AMT) is a series of simple exercises that help your blood pressure stay up and improve blood flow, so your chance of experiencing any side effects, like The site should not be warmed to a temperature higher than 42 EC. Carrington College does not recruit or enroll residents of the European Union. Warn the patient that they will experience a sharp scratch. Tips However, in addition to our natural vein anatomy, here are several reasons why your veins may pose some difficulty when doing a blood test. Obesity 0000279572 00000 n If possible, look at areas that tend to have less subcutaneous fat, such as the back of the hand, the thumb, the wrist, and even the top of the foot. Alternate arms if youve given blood This will give you more stability and it will relax you. Pumping fists can lead to pseudohyperkalemia or increased level of potassium in the blood. 0000008644 00000 n I had one not too long ago where I had to do a 1 hour glucose tolerance test and was having trouble finding a vein. Prepare by drinking enough fluids before the blood test. An example of data being processed may be a unique identifier stored in a cookie. Some patient-friendly advice for getting blood drawn include the following: As a phlebotomist, though, you cant expect patients always to follow perfect procedures to make drawing blood easier, and you may even find that some patients are rude. Closely monitor the arm to ensure that is is not applied to tight or for more than 2 minutes. What may be warm to you could burn the elderly. In order to reduce the risk of thrombosis, lines need to be flushed with a solution of heap in. Here, I share with you all the tips and tricks I have learned doing phlebotomy over the years. Contact Us | Work @ Carrington | Privacy Policy | Terms of Service | Do Not Share My Personal Information | Sitemap | Student Consumer Information. Enjoy :). Next, identify the vein that you will be using. It allows the phlebotomist to control the vacuum, which is good because it is much less traumatic on a patient's vein. 0000031373 00000 n Try tourniquets, hot packs, gravity, and ask the patient where they usually have luck with blood draws. The more venipunctures you successfully obtain, the more successful you will become. Is there an IV team, anesthesiologist, or other trained personnel that could be of assistance? At some time in life, every person will do a blood test, and not only one but multiple as life goes on. When performing venipuncture, make sure to sit whenever you can. If the person is tense, try getting them to relax. This technique is especially helpful with hand veins. hb``g`` @16 N$00Le@L,9$)_5M2APPP*dW;b]0D&0dxAAmCfFO7008X`&` *7h_P tex4\T'# ` 1 endstream endobj 239 0 obj <>/Filter/FlateDecode/Index[33 163]/Length 27/Size 196/Type/XRef/W[1 1 1]>>stream Apply heat for about 3 to 5 minutes and then assess for vein. Sometimes, you will need another person or two to help you with difficult patients. Eat a healthy meal, avoiding fatty foods like hamburgers, fries or ice cream. 1. Label appropriate tubes at the bedside and place them into transport bags. Make sure you check with the nurse first for permission. Its important to speak to your supervisor to learn the steps in order to become certified in your hospital. On average, it is much harder to find veins in people with darker skin tone. No matter what, always take your time to find just the right vein. Drawing blood from the elderly, young children, and infants can also be a challenge. Reasons for concern would include numbness, tingling, change of color to blue or white, and extreme pain. Insert the needle into the vein. 0000005129 00000 n Beaumont Laboratory GERIATRIC PHLEBOTOMY TIPS N. Cleanse the puncture site: Cleanse the site with 70% isopropyl alcohol until clean. Hemolysis is one of the most common things that interfere with the tests. What constitutes a difficult vein? Without proper specimens, unhelpful or even harmful medical treatment could happen. 0000001848 00000 n Make sure you have one in your venipuncture equipment. WebPatients who are dehydrated, obese, terminally ill, or hard sticks often get their blood drawn in other locations rather than the antecubital fossa. How to Make Your Veins Pop Out to Give Blood As you get older, most of you systems tend to shrink and they become more fragile. Elderly persons walking in to do blood tests usually have nicer veins, though, there will still be a few difficulties. This will move their fluid and/or tissue out of the way so you can see a good vein. Has 10 years experience. Maybe you have the right environment, chair, and equipment to draw from them successfully, but do you give them the respect that's often lacking in healthcare? Avoid exaggerated hyperextension, which can be uncomfortable for the elderly. With the foot- some places require a specific order r/t other dx that can increase DVT risk :). Go to Alexander Street homepage, Blood Collection: Special Considerations, Obese Patients. (function() { With the foot- some places require a specific order r/t other dx that can increase DVT risk :) Avoid excessive probing. obese : phlebotomy - Reddit For routine antisepsis, you can use a standard alcohol prep pad or alcohol-impregnated swabs. Massage the vein. However, for the elderly, it may be difficult. WebTo clarify: The serum on the left is what normal serum looks like, but actually comes from an obese patient middle aged or older with metabolic issues (the patients I normally work with). For example, in a case of a patient with fragile veins, it is much better to skip a tourniquet as it may cause the vein to blow out. Obesity Apply a tourniquet approximately 3-4 inches above the selected site. We use cookies to ensure that we give you the best experience on our website. If you donate frequently, be sure to take multivitamins with iron to ensure you continue to. It will stop the bleeding and prevent the creation of hematoma. tips on starting IV, drawing blood on obese patient Obesity - Diagnosis and treatment - Mayo Clinic Secondly, they lay most of the time. It is crucial to use needle and cannula that is smaller than the patients vein.

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