Note from SphynxCatVP - I
don't recommend trying this without first
getting proper phlebotomy training because mistakes can be deadly.
You have been warned....
A few tips of phlebotomy from a phlebotomist...
Don't blame me for the following...SphynxCat asked me to write this ***grin****.
Firstly, you're sticking a foreign object directly into a vein...don't
touch the needle (!) and alcohol preps are a GOOD thing! Diabetics are
especially subject to infection, so be extra careful with your technique.
Needles...the higher the gauge, the smaller the needle. I prefer a 23
gauge because it is surprisingly smaller than the common 21 or (egad)
19! Your donors will thank your for using a 23! I don't like the 26 gauge
or smaller because 1) it's hard to pull blood through it, and 2) can't
usually attach a decent sized syringe to one. If your donor is a tough
stick and you can get a butterfly needle, you are in luck! Not only do
you have more control over the needle, but you can switch syringes mid-draw.
If you have these, take the transfer needle (has latex cover) off the
non-business end and attach your syringe. One donor per one needle (duh).
They can be cleaned with bleach (then sterile water) but they get dull
fast.
Syringes...I like 10cc syringes because they are easy to control and get
10cc's of blood :). 3cc syringes don't seem to have a lot of pull. 20cc
syringes are very ungainly even if you use a regular (non-butterfly) needle,
but can be done if your're good. With practice, you'll be able to work
the syringe with one hand. Or get your donor to give you a hand. Whatever
syringe/needle system you use, work the plunger a couple of times to make
sure everything is working. Nothing like getting a good stick just to
learn that your equipment's funky!
Vaccutainer tubes...you probably don't have access to them and I've never
heard of anyone trying it. Let me know if you have done so!! Just one
word...don't use a vaccutainer with any additives included!!!!
About veins (our favorite topic!)...if it pulses, stay away. That means
it's an artery. If you accidentally hit one, don't panic...apply direct
pressure with the gauze you have nearby for at least 5 minutes, then apply
a pressure dressing (fold some gauze, tape it in place tightly, pulling
the tape tight causing the gauze to be held very firmly against the wound).
Leave it on for 1/2 to 1 hour. If your donor is on heparin, coumadin,
or otherwise bleeds easily, use the 5 minutes and pressure bandage thing--depends
upon the person. If a vein "blows" (you'll know when it happens), stop
the draw and tape it--then feed your donor chocolate because you're going
to leave a nasty bruise! Veins that "pop up" are nice but not necessary--feeling
'em is better than seeing 'em. Getting "the touch" takes practice. With
practice, you'll be getting those good ones in the forearm that don't
"pop up". The crook of the elbow is the best, then the hands. The underside
of the wrist really hurts.
A bit on technique...when you stick, go in at an angle (about 45 degrees)
and you don't have to shove hard. However, do go in with some authority
(you'll learn) because the slower the stick, the more it hurts (unless
you're into that). You don't need to tighten your tourniquet to the point
that your donor's arm is turning purple and ready to fall off--just enough
for the veins to pop up. Apply the tourniquet in such a way that it can
be removed easily with one hand--practice before you stick!!! Remove the
tourniquet before you remove the needle or you'll leave a nasty bruise.
Misc. stuff you should have on hand...bandaids (duh), 2 x 2 gauze (get
'em at the pharmacy), alcohol preps (pharmacy again), medical tape (pharmacy--regular
tape damages the skin), something to use as a tourniquet (latex gloves
work nicely...pharmacy), ice pack (in case you really screw up).
Really screwing up...never heard of it happening with phlebotomy, have
heard of it happening with razors. What to do...PRESSURE, elevate limb
above the level of the heart, ice pack (need it handy). If you need to
go to the ER, please tell me the story...I'd love to hear the excuse!
This has been long enough, I think! SphynxCat willing, I'll submit a rant
about blood-borne illnesses that you should REALLY be aware of.
Got questions? Mail me. I don't bite (unless someone really wants me to)...
Be safe and take care of yourself and your donor!
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