If you have to give blood, a phlebotomist will need to find a good, strong vein to draw from. For a seasoned phlebotomist, this is typically a fairly easy job. Unfortunately, some people have difficult veins to work with due to obesity, dehydration, and a variety of other issues.
What constitutes a difficult vein? Sometimes they’re very small, or hard to see. Other times, they simply don’t want to pop out or raise for the phlebotomist to be able to draw successfully.
If you’re a phlebotomist who has encountered this problem before, you know how frustrating it can be. It’s your job to make sure the patient is as comfortable as possible as you take blood, and that can be difficult to do when you can’t find a usable vein.
There are some tips to help make your veins pop out when giving blood. They don’t harm the patient in any way, and can be used regularly to make your job easier and safer.
In this article, we’ll cover how to find a standard vein that you can work with, and what you can do if that vein is difficult to draw from.
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How to Find a Vein to Draw Blood
As a phlebotomist, venipuncture is one of the biggest parts of your job. Being able to find a usable vein quickly is important, and something you learn throughout training. Unfortunately, some veins are easier to see than others.
Most of the time, the visibility of the vein depends on the patient. For example, the veins of a middle-aged man will likely be easier to find than that of a woman, unless she’s extremely active. The elderly, young children, and infants can also be difficult to draw from. Patients who are severely dehydrated can also make it difficult to find a vein.
Finding difficult veins isn’t impossible, but it can require a few different methods to be put into place. First, remember where to look. The order of venipuncture sites is important to follow. You should draw in order of the following locations:
- Median antecubital vein – Located on the arm in front of the elbow.
- Cephalic vein – Upper shoulder/side of the arm.
- Basilic vein – Under the arm.
- Dorsal hand veins – Top of the hand. You should only do this draw when all other methods have been exhausted.
- Foot veins – Should only be used under special circumstances and with extreme care.
Successful Venipuncture Tips
Oftentimes, you won’t know your patient personally before drawing their blood, unless you work at a smaller practice and have done it for them before. If it’s possible for you to give your patients a few tips ahead of time, it can make hard to find veins for a blood draw easier to work with. Some patient-friendly tips for getting blood drawn include:
- Drinking plenty of water an hour before the draw.
- Alternate arms if you’ve given blood with one recently.
- Try light exercise beforehand. A few jumping jacks or push ups can make your veins pop out.
As a phlebotomist, though, you can’t expect patients to always follow perfect procedures to make drawing blood easier, and you may even find that some patients are rude. In most cases, simply following best practices and knowing how to find a difficult vein is the best way to carry out a successful draw.
Feel for a Vein
If a vein is not prominent enough to see easily, you can feel around for it. You know what to look for and where to look for it, so sometimes a gentle touch can make finding a usable vein easier than simply looking for it.
Use your index finger to palpate and trace the standard path of the vein on the arm. A good vein should feel somewhat bouncy as you press on it. If you can successfully find that characteristic, you know you’ve found a usable vein, even if it’s not prominent.
Massage to Increase Blood Flow
Veins become more visible when blood is forced into them. You can do that by gently massaging the arm, from the wrist to the elbow. After a few minutes, gently tap the site of the puncture with your fingers to make the vein pop out.
If you’re still having difficulties, placing a warm washcloth over the puncture site can also help to increase blood flow and make a vein more prominent.
Try a Tourniquet
Using a tourniquet is something most people are used to seeing during difficult blood draws. They are popular because they are effective. To use a tourniquet to draw blood correctly, tie it three or four inches directly above the puncture site. You should never tie it too tightly at first. Oftentimes, even a loose bind can help a vein to pop. Only tighten it if necessary.
A tourniquet should also never be left on for more than one minute. This can cause an overall loss of plasma in the blood, and the sample could be unusable.
How to Identify a Usable Vein for Blood Draws
If none of the above options work to help you find a strong vein, you may need to find another puncture site. In that case, you would use the order of venipuncture. These other sites should always only be considered when there are no other options. They can be more dangerous and risky, especially if you need to draw a lot of blood.
Ideally, try to work with your patient ahead of time, or give them information about what they can do to make their blood draw experience easier. If they come in for their appointment well-prepared, it should be easier to find a vein from the start.
However, that’s not always a luxury most phlebotomists can have. So, if you’re working with a patient who has small veins, or veins that are hard to find, practice some of the useful tips and techniques discussed in this article to make it easier. They can help you find a usable vein quickly, so you can get the blood draw you need, and your patient can remain comfortable throughout the entire experience.