As a phlebotomist, knowing how to properly apply a tourniquet to a patient is crucial. You’ll likely be using a tourniquet each time you draw blood from a patient’s arm. It’s a standard part of any routine venipuncture routine.
If you’re new to using a tourniquet before drawing blood, it might feel a bit overwhelming. And while it’s important to get everything from the positioning to the pressure correct, it doesn’t have to be intimidating.
Keeping a few simple steps and tips in mind can really help your confidence. Other than that, being comfortable with applying a tourniquet to a patient takes time. Your skill levels will increase as you do it more often. Eventually, putting on a tourniquet will be as simple as actually drawing blood itself.
Not only will knowing how to tie a tourniquet correctly make your job easier, but it will make your patient more comfortable with the draw, too. Let’s take a closer look at some tips you can use to apply a tourniquet for a blood draw.
Table of Contents
Why is a Tourniquet Necessary?
A tourniquet isn’t always necessary when drawing blood. However, it does tend to make things a lot easier. It helps to distend the veins below wherever the band may be tied. This can be especially helpful for patients with hard to find veins. If you’re newer to phlebotomy, it can also help to give you confidence in finding the right vein to stick.
On occasion, a patient will have veins visible enough to stick without the use of a tourniquet. But, using one can really add an extra level of assurance in finding a viable vein to use, especially if you’re drawing blood from overweight patients.
How to Choose the Right Band
The best way to start feeling comfortable is to use a tourniquet that is easy to use. Most blood drawing kits come with a standard rubber tourniquet band. These bands are flexible and stretch easily. More importantly, you don’t have to tie a knot for them to be effective.
Instead of tying a knot on the rubber tourniquet band, you simply make a loop. Loop the band snugly around the patient’s arm and cross the bands where they meet. This can save a bit of time, and it’s easier to remove the tourniquet when you’re finished. There is no difficult knot to untie. All you have to do is release the loop.
How to Apply a Tourniquet to a Patient
Before applying a tourniquet, make sure you’re following the proper order of venipuncture. There are several steps to take before a tourniquet should be use. These include:
- Confirming with the patient the amount of blood that will be drawn.
- Putting together any equipment that may be necessary.
- Washing hands and putting on gloves.
- Positioning the patient correctly.
- Finding the appropriate vein for blood draw.
Once the previous steps have been taken in the process, you can apply the tourniquet. It’s always a good idea to let your patient know what you’re doing while you’re doing it. This helps to put them at ease. When you’re ready, begin to put on the band with the following steps:
- Place the band at the back of the patient’s arm. A tourniquet should be placed 3 to 4 inches above the site of collection.
- Be sure to stretch it out enough. A proper stretch will help with compression, so you won’t have to use a knot.
- Make a loop with the tourniquet around their arm and cross the ends.
- Taking one end, loop it around the cross-section, and underneath.
- As you lower the tourniquet, it will tighten over the loop.
- The loop and the natural compression of the cross-section will apply enough pressure to hold the band in place.
- Once the tourniquet is applied, make sure the patient is comfortable. Ask them if the band is too tight. If it is, you may need to start the process over.
What Precautions Should You Take?
Whenever you’re applying a tourniquet, it’s important to make sure it’s not uncomfortable or painful for the patient. Keep a conversation going with your patient to ensure everything feels as it should.
Once the tourniquet has been successfully applied, never leave it on for more than one minute at a time. If you’re having difficulty finding a vein, remove the tourniquet after one minute and try again on the other arm.
If veins still are not popping, you may need to look at other locations for the site of the draw. Once a vein is found, remove the tourniquet and begin the draw. With the band off, you can ask your patient to make a fist. This helps to distend the veins even more.
Leaving a tourniquet tied for too long can cause hemoconcentration. This is when blood pools at the site of the venipuncture. It can cause a sudden increase in cholesterol and potassium and glucose levels. Therefore, your patient’s lab results may not be accurate.
Using a Tourniquet Correctly in Phlebotomy
As you can imagine, using a tourniquet to help find a patient’s vein is an important step in venipuncture. It can help you if you regularly have a hard time finding veins, or if the patient’s veins are difficult to see.
If you’re new to the field, or have always had a difficult time with tourniquets, the key is to keep practicing. Ultimately, it is a skill that is developed with time and repetition.
If you’re just getting started, try the method used in this article. The band is easy to apply, and you don’t have to worry about any difficult knots. It also allows you to put the tourniquet on quickly, and remove it quickly. This makes it easier to ensure it won’t be left on the patient’s arm for too long.
Once you know how to apply a tourniquet for blood draw, you can make your patients more comfortable, and find a vein faster. Being able to do that makes your job a lot easier, and your patients much happier.