PROBLEMS WHICH CAN BE ENCOUNTERED ANXIETY Explanation of the procedure in broad terms before starting Importance of a confident approach Try to understand how the patient sees the procedure and act accordingly NEEDLE PHOBIA Help the patient to become familiar with the equipment Use of local analgesic gel, especially for children Use diversionary tactics to distract the patients attention HISTORY OF FAINTING Take the specimen with the patient laying down OLDER PEOPLE WITH COLLAGEN LOSS "Anchor" the vein with the thumb Make sure that the needle is in line with the vein OBESITY AND HIDDEN VEINS Take time to learn the position of veins by palpation Gently tap or rub the area Ask the patient to open and close their fist to encourage veneous return Immerse the arm in warm water to cause Vasodilation Consider the use of an alternative site, such as, the back of the hand or ankle.
TRICKS TO HELP DISTEND THE VEIN Have the patient "pump" the hand a few times. Don't overdo it because over-pumping can create haemoconcentration Have the patient dangle arm below the heart level for 1-3 minutes. Warm the area with a hot pack or warm, moist cloth heated to approximately 42 degree C Tap the skin with an open hand on the puncture site. This frequently produces the same effects as warming the area. If all else fails, consult another technician for their opinion and/or intervention.
TO WEAR OR NOT TO WEAR GLOVES Generally, gloves should be worn when taking or handling blood products (RCN 1995), in order to prevent contamination of the nurse from potential blood spillage. However, it must be remembered that gloves will not prevent a needlestick injury. It has been shown that a loss of tactile sensation caused by wearing gloves could make a needlestick injury more likely (DOH 1990, RCN 1999). It has been recommended by the Department of Health (1990) that gloves should be worn when taking blood in the following circumstances; When the Phlebotomist is inexperienced The patient is restless The Health Care Worker has cuts or abrasions on the hands The patient is known to be Hepatitis or HIV infected