Drawing blood

This is a good response to a question about preparing to have blood drawn if you have problems getting a good sample.

Some steps that can definitely be taken to decrease your discomfort. You might try one at a time

before the phlebotomy –

1. Drink lots of fluid on the day of the phlebotomy.
2. Wet some paper towels or whatever is handy with warm water and place them on the arm site. This is little more convenient than keeping your arm under the hot water faucet but the running water is actually a little better since it also applies ‘pressure’.
3. TELL the person that you allow 1 attempt. If that is not successful, then you require a more experienced person.
4. TELL each person where the last successful attempt was and point to it.

At the time of the phlebotomy –

1. Ask (demand) that a smaller needle be used. The smallest that can be used to collect a specimen that is not hemolyzed is a 23 gauge butterfly needle.
2. Ask that the specimen be drawn either through a syringe or in a pediatric tube. One distinct possibility is that your internal venous pressure is too low to withstand the ‘force’ of the vacuum in the collection tube. When that happens, the vein will collapsed on itself only to re-establish itself after the vacuum is withdrawn.
3. The tourniquet can be drawn as tightly as you can stand it but cannot be left on for a prolonged period of time. Usually most folks think that 1-2 minutes is tops. After that, there are both chemical and cellular changes that alter test results.
4. Gravity helps with finer stick more than it does phlebotomy since vacuum is the principle here.

Some things to avoid

1. Don’t keep flexing the arm muscles. It too alters chemical balances which could skew test results.
2. DON’T let the phlebotomist slap the site. All this does is increase inflammatory responses and messes up any coagulation testing.
3. When you make that fist – don’t do it too tightly. A firm fist rather than an overtight one is best. One of the more frustrating things is that sometimes veins will “roll” because there is not enough supportive tissue to keep them in one place. So, you put the needle in at the exact place you saw the vein and it moves an inch or more to the side. Rolling occurs more frequently when fists are overtight than when they are a little more relaxed.