Note from SphynxCatVP - I don't recommend
trying this without first
getting proper phlebotomy training because mistakes can be deadly.
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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