tips for drawing blood on obese patients

WebPatients who are dehydrated, obese, terminally ill, or hard sticks often get their blood drawn in other locations rather than the antecubital fossa. This will cause a lot of mess. window.ClickTable.mount(options); Using alcohol or some other antiseptic, wet the site. Nursing schools do not teach this skill due to legality issues. }); Check between the knuckles. 0000001848 00000 n This can cause an overall loss of plasma in the blood, and the sample could be unusable. Try light exercise beforehand. 0000001512 00000 n 1) Phlebotomy Pages, Words of Wisdom From and to Phlebotomists, 2014,http://www.phlebotomypages.com/expert_tips.htm, 2) The American Red Cross, Tips For A Successful Donation, 2015,http://www.redcrossblood.org/donating-blood/tips-successful-donation. HlV7WF#J$% r!h {7@)RRXZ4J9(e??@!o]h&Do?Y[L *fIXH^ I am a full time phlebotomist and I enjoy my job. There are numerous considerations when performing venipuncture or phlebotomy. So, before attempting to draw blood, look at the 3 areas mentioned above for the best veins to access and draw a blood sample. Youll be the first to know about nursing news, trending topics and educational resources. We strive to be the In the event that you cant locate the appropriate vein strictly by vision, this can be a great alternative method. These other sites should always only be considered when there are no other viable options available to you. Patients hand should be dangling so that the blood can rush down and fill the veins. After that, you need to see if the patient has any medical condition, if he is using drugs or if he is fasting. If you have specific questions, but don't want to wait, give us a call at. We are a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com. By placing a warm towel over the veins, you are increasing the blood vessels which will make them more visible. Average delivery time is 5-10 business days. 0000001689 00000 n Place it at the chin and lightly draw a straight line. If you are a bit stiffer while rubbing the alcohol, it will prepare the hand for the procedure. The WHO has set forth the following standards of patient care for hospitals to adhere by: They also identify dangerous and unsafe practices for blood draws including, >> Related: Arterial Blood Gases (ABGs) Explained. So, the choice of equipment will change from patient to patient. Another way that prednisone can increase blood pressure is weight gain. possible. Please enter a valid e-mail address. While holding patients arm, make sure that your finger is well above the insertion point. CMAA exam 1 Flashcards | Quizlet Should RaDonda Vaught Have Her Nursing License Reinstated? Some individuals will have far more noticeable veins than others, some will be calm about the procedure and others will require a great deal of calming down, etc. What Does Blood Draw or Venipuncture Training Involve? Anchor the vein. Do not massage down as doing so will defeat the purpose. Standard laboratory studies in the evaluation of obesity should include the following: Fasting lipid panel. 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. Those veinfinders are worthless. obese Once you have located a vein, you can cause increase distention through massaging or exaggerated palpation (pressing repeatedly over the top of the vein). WebDrink an extra 16 oz. 11. Find a convenient blood drive near you and schedule an appointment to donate today. To view the purposes they believe they have legitimate interest for, or to object to this data processing use the vendor list link below. If you are drawing from a leg, the extremity needs to be placed over the bed so that the blood can easily flow into it. Create well-written care plans that meets your patient's health goals. 0000027834 00000 n Over the years I have drawn blood from many older patients, learning tips and techniques along the way in dealing with them and drawing blood from them. Most times, drawing blood is not that difficult, but there those occasions when you will get a difficult person. Next, identify the vein that you will be using. How to Use a Vein Finder on Obese Patient. Apply heat for about 3 to 5 minutes and then assess for vein. Specializes in Wound Care. When the blood draw is complete, gently release the tourniquet. Its important to remember that the patient is actually your most valuable resource during this process. Usually, the antecubital area has the best veins for drawing blood. As the body ages, the skin becomes thinner and blood vessels become weaker. However, there are numerous things that can go wrong while you draw blood. Firstly, they are sick. Insert the needle at a 15 to 30-degree angle into the vessel. The elderly are prone to bruising when applying the tourniquet. Ask the patient where they usually get stuck. Only tighten it if necessary. Spend a decent amount of time looking for good veins. Try tourniquets, hot packs, gravity, and ask the patient where they usually have luck with bl mount_type: "" When you are retaining water, it increases the total volume of fluid that is being pushed through your blood vessels by your heart. Continue with Recommended Cookies. If the person is tense, try getting them to relax. Sometimes the veins are deeper so therefore you will have to go deeper. Phlebotomy basics : Nursing made Incredibly Easy - LWW My trick is to press on their hand or arm with both of my thumbs. Weight gain. Application of heat will cause vasodilation, making veins easier to see or palpate. Some jumping jacks or push-ups can make your veins pop out. The rightvein should feel somewhat bouncy as you press on it. glasses of liquids and avoid alcohol over the next 24 hours. I Feel Stuck - Like My Options Are Limited, Ethical Arguments Against Mandatory Vaccination, Nursing Student on Spring Break Saves Collapsed Man's Life, Candida Auris: Dangerous Fungus Spreading in US Health Care Facilities, Nurses Week 2023 | Best Discounts, Freebies, and More. WebFor routine blood draws, 70% isopropyl alcohol or 70% ethyl alcohol is recommended. Massage the arm from the wrist to the elbow if using arm veins. Difficult Blood Draws: Best Tips For Difficult Veins A doctor can access the femoral vein and others to draw blood. Web Place the tourniquet over the patients sleeve of the patient shirt sleeve if drawing an arm vein. Sometimes, doing so can reveal a vein. If you are drawing from a leg, the extremity needs to be placed over the bed so Always start by thinking that a patient is infectious and that he can spread a disease. You may need the approval of a physician or someone else. Then, deflate blood pressure cuff and apply tourniquet. 0000017785 00000 n Syringe, vacutainer, and needle size should Doctors have access to deep veins like the femoral and subclavian vein that other phlebotomists dont have. Our members represent more than 60 professional nursing specialties. Follow your institutional guidelines or polices or get advice from qualified personnel. They need to be labeled in advance. Identify the patient using two patient identifiers as mandated by JCAHO. Quizlet As a phlebotomist, venipuncture is one of the main parts of your job. Avoid snapping or tapping veins. It is crucial to use needle and cannula that is smaller than the patients vein. They will be much easier to spot and throbbing. A 3ml, 5ml or 10ml syringe will work fine. A medical expert should stroke them from distal to the proximal vein. Blood tests are one of the most important diagnostic techniques available to physicians. Some patients are easier than others because of the prominence of their veins. 0000005129 00000 n If other sites are resulting in no signs of veins then go back and re-examine the sites. This will give you more stability and it will relax you. Additional equipment such as goggles and splash shields should also be worn in extreme situations. 4. 0000279572 00000 n It is the best thing for patients with low blood pressure. Pull it back slightly and blood should flow. This is the first and crucial rule of venipuncture. WebIn this module, you'll learn why the right approach is critical when drawing from overweight patients, and you'll have a newfound appreciation for what it's like for too many It can be easy, especially when youre conducting multiple blood drawing procedures on a daily basis, to become somewhat detached from the patient that youre drawing blood from. You need to have a firm, strong grip on patients hand. They are not as healthy and strong as they once were. Top Cheap and Fast Online RN to BSN Programs, Affordable Online Nurse Practitioner Programs, Top Direct-Entry Nurse Practitioner Programs, Top Psychiatric Nurse Practitioner Programs, Top Pediatric Nurse Practitioner Programs, Top Acute Care Nurse Practitioner Programs, Top Online Family Nurse Practitioner Programs, Top RN to Psychiatric Nurse Practitioner Programs, Top Womens Health Nurse Practitioner Programs, How to Get an Associate Degree in Nursing. Patients who are severely dehydrated can also make it difficult to find a vein. allnurses is a Nursing Career & Support site for Nurses and Students. 1. hbba`b``3~0 U endstream endobj 197 0 obj <>/Metadata 31 0 R/Pages 30 0 R/StructTreeRoot 33 0 R/Type/Catalog/ViewerPreferences<>>> endobj 198 0 obj >/PageTransformationMatrixList<0[1.0 0.0 0.0 1.0 -306.0 -396.0]>>/PageUIDList<0 193>>/PageWidthList<0 612.0>>>>>>/Resources<>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageC]/XObject<>>>/Rotate 0/StructParents 0/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>> endobj 199 0 obj <> endobj 200 0 obj [/Separation/Beaumont#20Blue 221 0 R<>] endobj 201 0 obj <>stream Going there is risky as you can hit a nerve or tendon. }; Stay away from the palm of the hand, fingers and from the wrist area. Next, locate the vein you will be using for the blood draw. Top Vein Sites Used in Phlebotomy | PhlebotomyU | CPT1 Course If you have an issue finding the vein, do not hesitate and call for a senior, more proficient colleague. I understand that consent is not required to purchase any goods or services from this school and that my consent can be revoked at any time. Without further ado, here are 50 tips that will help you perform this crucial procedure. Although this is something you mightve seen a lot in the movies, you should always avoid it. Doing so can help move veins and tendons away from each other increasing the likelihood for a vein to show up. How to Select a Right Vein Finder for an Obese Patient - Healtholine The needle may have pulled out of the vein. On the surface, it seems as a rudimentary procedure, one that doesnt require any special training. Big ppl are not bad to stick at all, especially the ones with edema. My trick is to press on their hand or arm with both of my thumbs. Put ur finge It uses high intensity light that is directed down through the skin. WebInflate cuff to 30mm Hg above systolic reading and maintain pressure for about 1 to 2 minutes. The paramedic immediately brought out a large flash light and pressed it to the patients arm. Prep the venipuncture site by cleansing the area with an alcohol prep pad for 30 seconds and allow to air dry for 30 seconds. Obesity Phlebotomy, the practice of drawing blood from a vein, is a proficiency that all nurses need to learn. Blood allnurses, LLC, 175 Pearl St Ste 355, Brooklyn NY 11201 While doing all of this, make sure to penetrate the skin with one quick move. 8, 9 Even Follow your institutional policy when using blood pressure cuffs. They already have pain, so lets make the process easier and more comfortable for them. At outpatient areas, ask the patient to hold their arm at their side for a few minutes. When performing venipuncture, make sure to sit whenever you can. In this module, you'll learn why the right approach is critical when drawing from overweight patients, and you'll have a newfound appreciation for what it's like for too many patients when they encounter insensitive healthcare professionals. These three together can help you find a vein. Press the space key then arrow keys to make a selection. Congratulations, you just took the first step towards a new future by furthering your education. Then, apply heat to the lowered arm. The medical expert needs a certain amount of practice as there are many things that can go wrong. The World Health Organizations (WHO) best practice guidelines for blood draws include the following: The overall purpose of establishing the guidelines is to. All information provided to Carrington College shall be subject to our Privacy Policy. When you draw their blood, are you ready for them? Students should study venipuncture in books and watch licensed nurses in clinical settings perform this task. WebIf you are drawing blood from an arm, make sure to sit near the patient, as close as possible. 0000036112 00000 n Patients 0000025579 00000 n If you donate your blood to organizations like the American Red Cross, then you can rest easy knowing, A phlebotomist is a medical professional whose main job is drawing blood. Whether youre becoming a nurse, a doctor or a certified medical assistant, youll probably have to draw blood countless times over the course of your career. Always remember to ask for help from seasoned nurses and seize opportunities to practice your skills. Continuous interaction can help distract a person during this time. With the foot- some places require a specific order r/t other dx that can increase DVT risk :). Do it by performing a quick backward motion. WebUsing consistent, proficient personnel to per-form blood draws. A lot of patients have the needle phobia. You want to lessen the number of sticks you give to the elderly. She hit the vein on the first try. The needle has passed through the vein. Venipuncture or drawing blood is one of the most common procedures performed in any medical center. Can You Get an Associate Degree in Nursing Online? Ask the person to lower their arm for a few minutes before applying the tourniquet. 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. The person performing venipuncture can administer 10 units of bacteriostatic saline which need to be injected intradermally. The patients vein may have collapsed. 196 45 Sure, its easier said than done when a needle is about to enter a persons vein, but tension can constrict veins. Deliver blood specimens to the laboratory promptly. You dont have to drink tons of water the night before but the recommended daily water intake should suffice. Before and after the insertion, the tube should be left in the holder. Insertion point should be under 15 to 30 degrees angle. %PDF-1.4 % Sign up to receive the latest nursing news and exclusive offers. 6. Additionally, these steps only apply to the adult and pediatric population and not neonates. If all else fails, you can always use drugs. If a vein is not prominent enough to see easily, you can feel around for it. In the case of children or uncooperative individuals, restraints are an option but they should be avoided at all costs. There are various reasons to perform a phlebotomy. Obesity Screening: MedlinePlus Medical Test Your approach is something that can vastly affect the patient, making the whole experience more or less enjoyable. In order to prevent hematoma, you should only puncture the uppermost wall. Here are the basic steps to drawing blood: The first step in drawing blood correctly is to identify the appropriate veins to puncture. There are two main ways to find a vein to draw blood. Put ur fingers on the bottom of their arm and press the tops with your thumbs. It worries me to see so many people in this thread and others talk about seeing veins and palpating them only if you can't see one. Finally, an ER tech came up and he used a venoscope, which is basically a fancy flashlight - basically the same thing that bruali described in their post. The gratification of giving blood is a feeling you'll want to share. Attach the needed tubes or syringes to remove the proper volume of blood. When drawing blood, you will need several tubes for different samples in your equipment. However, thats not always a luxury most phlebotomists are afforded. An elderly persons veins are prone to collapsing, which could mean, you may have to try several times at drawing blood. 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