Chapter 5: Making Difficult Draws Less Difficult

Causes of Difficult Draws

• obesity

• small, deep, or fragile veins

• dehydration

• anxiety or needle phobia

• frequent blood draws

• poor circulation

Tips for Handling Difficult Draws

• warm the site before the draw

• ensure the tourniquet is tight but not painful nor uncomfortable

• allow the patient to dangle their arm to their side in order to locate hard to find veins

• offer the patient water

• ask the patient to lie down

• ensure the patient’s legs are not crossed

Body Conditions Affecting Draws

• Bruises (may worsen the bruise)

• burned and scarred tissue (may worsen the damaged skin further)

• collapsing vein (a syringe is recommended)

• edema

• infected areas

• Intravenous (IV) placements (draw blood on the opposite arm the IV site is on)

• mastectomy (blood should be drawn opposite of mastectomy)

• rashes

• rolling veins

• tattoos (older tattoos are ok but try to find a place with no ink)

Fistula

surgically created permanent connection between an artery and vein

Graft

temporary piece of synthetic tubing surgically inserted under the skin to loop a vein and artery

Ports

small device placed under the skin and connected to a catheter that leads to a central vein

Petechiae

tiny, non raised reddish purple dots that appear below because capillary vessels burst due to the tourniquet when applied too tight

Hematoma

collection of blood beneath the skin because of blood vessel leakage and is due to when needle punctures the side of the vein or passes it completely through it