If you have ever had your blood drawn for a donation or for a medical test you may have ended up with a huge purple bruise on your arm or you may not have had any bruise at all and the only way you can tell that you gave blood at all is the little tiny mark from where the needle pricked your skin.
Phlebotomy technicians need to become skilled in venipuncture technique or phlebotomy technique as it is often called. Drawing blood should not be a painful experience for the patient either as the blood is being drawn or afterward. Drawing blood is somewhat of an art, but a good technique is something that can be practiced and learned. If you are planning to be a phlebotomy technician the art of venipuncture is something that you should work on daily.
Preparing for Venipuncture
It is important to properly prepare the patient to prevent possible patient injury and infection. Possible fainting or dizziness can occur in even the healthiest patients so the patient should always be seated before starting. All tight or constricting clothing or jewelry should also be removed.
The phlebotomy technician or nurse will select the most appropriate vein for blood collection. The skin over the vein must then be cleaned thoroughly with a 70% alcohol solution wipe in a spiral motion from the inside out.
The phlebotomy technician should always practice good venipuncture techniques including:
1. Washing hands thoroughly with a hospital recognized antiseptic hand soap. The phlebotomy technician should also always wear examination gloves that are either latex or vinyl.
2. Selecting the most suitable vein. This is the vein that can most easily accommodate the blood draw with just one stick. No patient likes to be poked again and again.
3. Clean the area thoroughly with the hospital or clinic approved swabs, usually either povidone-iodine 1% or an alcohol or CHG prep.
The Vein Puncture
A tourniquet is usually applied about 3 to 4 inches above the collection site on an extremity, such as the arms. This forces the blood to pool inside the vein making it easier for the stick and for the blood collection or for an intravenous catheter insertion. The patient can also make a fist and this will also aid in the pooling of the blood in the vein.
The needle chosen is selected based upon the size of the patient, the patient’s age, the condition of the vein and the reason for the venipuncture. The needles are flattened to point on one side. This flat side is called a bevel and it allows the needle to slide easily through the skin and into the vein. The needle should be positioned with the bevel facing upward, parallel to the vein at a 15-degree angle so that it can press through the vein in a quick and smooth motion.
The phlebotomy technician should also be confident and have a steady hand when poking the patient. An unsteady hand can be frightening for a patient. After the venipuncture is complete it is important to apply pressure to the site in order to stop the blood flow and prevent bruising.