I’m a registered nurse and have a lot of experience with phlebotomy.
I’ve also taught it to quite a few vamps. Donors can do this too
if they’re so inclined. Most phlebotomists aren’t licensed,
it’s a skill they’ve been taught and improved by experience.
Everybody starts somewhere.
Some donors prefer venipuncture because it’s something they’ve
experienced before and they know what to expect in terms of pain and/or
because it can be easier to conceal than a cut. However, also be aware
there are people who are very squeamish about needles. Find a good diagram
of veins and arteries and study it thoroughly, although it probably won’t
show all the smaller veins in the hand and lower arm, and there are always
individual variations.
Make sure your donor is warm and comfortable, as veins just disappear
in cold nervous people, and it’s also a nice thing to do for your
donor.
Should you choose to undertake
any of these practices discussed here you do so entirely at your own
risk.
Neither the author nor editor
advocate any of these practices, nor guarantee their safety, nor do
they promote support or encourage the breach of any applicable laws.
This is dangerous and not
to be undertaken without proper medical training!
The technique:
Most venipunctures are done in the arms, although hands are acceptable.
Most people have a large vein in the inner aspect of the elbow called
the antecubital vein. You’ll need to feel it as it runs to the
side in some people rather than the center. To tap a vein, place the
tourniquet just above the elbow. Cross ends of the tourniquet once ,
then tuck the upper piece back under the lower piece to make like a
half bow, so the tourniquet can be released easily with one hand. If
you’re going to use a vein below the elbow, you can either put
the tourniquet above or below the elbow. Sometimes below makes the lower
veins stand out better. You want the tourniquet to be snug but not painful.
Also be aware some people have a latex allergy so be sure to ask your
donor. There are latex-free tourniquets available.
If someone has little or no experience with venipuncture, I usually
recommend they start with a butterfly needle setup. A 23-gauge needle
is a good one to learn with. The larger the number the smaller the needle.
A butterfly needle has little plastic wings on it and it’s easier
to guide. It also has a length of tubing on it that can either be attached
to a syringe or used like a straw by the vamp.
(Sample image of butterfly needle - sourced from Wikipedia. Public domain)
When you’re starting out, it’s usually good to use a vein
that you can both see and feel. After you’ve applied the tourniquet,
use either a cotton ball or small gauze pad soaked with alcohol or hydrogen
peroxide and stroke the veins as you look. Stroking makes them stand
out better. You can also lightly slap the area with the tips of your
fingers. When you’re picking a vein, see if it ‘rolls’
easily from side to side. If so have the donor make a loose or tight
fist, whichever works. Stay away from anything that pulses. Those are
arteries not veins, so don’t mess with them. Also be sure you’re
feeling a vein and not a tendon, as sticking a tendon just downright
hurts and you won’t get any blood either. Rotating the donor's
wrist gently in either direction, while feeling for the vein with your
finger, can move the vein away from a close-by tendon or bone, reducing
the risk of hitting something other than the intended vein. Once you’ve
chosen a vein, clean the area with alcohol or hydrogen peroxide. If
you prefer to use betadine, be sure to clean it off, as it’s irritating
to the skin if left on. Hydrogen peroxide is my personal favorite because
if there’s any sucking involved, it has the least taste to it.
(Diagram of veins in the arm, sourced from Gray's Anatomy. Public domain.)
Uncap the needle and look at the tip and turn it bevel up (like a
scoop, longest pointy part on bottom). Don’t touch the needle itself,
it needs to stay sterile. For ‘rolling’ veins, you need to
pull back on the skin a little behind where you’re going to pierce,
to keep the vein steady as you pierce. Pierce the skin at about a 45
degree angle directly on top of the vein, then lower the needle closer
to the skin as you go into the vein (a few people prefer to pierce on
one side of the vein and then go into the vein, it’s a personal
preference). You need to pierce the vein in the direction towards the
body (just keep in mind, veins are flowing back to the heart). Don’t
be too slow about it but don’t jab either. Just do it in one steady
move. If your hand shakes, don’t freak out; after 15 years I still
have times when my hand shakes too. Just don’t scare the donor.
If you’re shaking too much, best to wait until you settle down
a little.
If you’re in the vein, you’ll see a blood return in the
needle hub or the tubing. Once you see blood you don’t have to
advance very far, just far enough so it won’t fall out, a little
under half an inch. You don’t want to take the chance of going
through the vein. If you going to be drawing the blood into a syringe
or sipping from the tubing, you need to leave the tourniquet on for
as long as you’re drawing. You can also put a small piece of tape
across the needle or wings to hold it in place. When you’re done,
release the tourniquet first, then withdraw the needle as you get ready
to apply pressure with another cottonball or piece of gauze. Now we’re
talking vampires here, not laboratories, so the vampire may want to
suck directly from the site once the needle’s been removed. If
so, the tourniquet can be left on for a short time, or the vamp may
just prefer to use pressure from his or her hand like a tourniquet.
Blood Draw:
Another newsflash: For years we were taught to apply the cotton ball
and bend the person’s arm up, to hold pressure. Now the standard
is just to apply the cottonball or gauze and hold pressure a few minutes.
I’m told bending actually causes more bruising and breaks up the
platelet clot that’s forming. After you’ve released the pressure,
check to see if it’s bleeding through the gauze/cotton/bandaid
and if so, continue to hold pressure a little longer. Change it if necessary.
You can apply a bandaid or a piece of tape over it, but sometimes bandaids
cause more bruising when left on. They do on me and then I have a bruise
to cover up instead just a small needle mark.
(Picture of butterfly needle in use from original article on LesVampires.
Credit unknown.)
Now what if you make an oops? Don’t feel too bad, everyone does,
even the most experienced people now and then. If you just don’t
get any blood back, but you don’t see any swelling at the site,
then pull the needle back a little, but not out. Feel the vein again,
then move forward again in the direction where you feel the vein. If
you can’t get it after a few tries or it’s hurting the donor,
then take it out and do aftercare. If you remove the needle completely
from the skin, don’t reinsert it. You can however, use the same
hole again with a new needle, if you just missed and didn’t ‘blow’
the vein. Or depending on the state of your donor, you can try in another
spot. Release the tourniquet between tries so the donor’s arm can
get some circulation. If you can’t see or feel any veins, you can
try a warm wet compress around the arm for 10 or 15 minutes and again
be sure your donor is warm and comfortable. Something warm to drink
like tea may help too or a glass of wine is also a good vasodilator.
If you put the needle in and you see blood come back but the area starts
to swell, pull the tourniquet immediately, withdraw the needle and do
aftercare. What’s happened is that the vein has ‘blown’.
You either went through the vein, or scraped the side of it and it’s
bleeding under the skin. Or a few people just have very fragile veins.
It’s not dangerous, but be nice to your donor because it will leave
a nasty bruise. Warm wet compresses for awhile can give some relief
and help the swelling go down. They can take an over-the-counter pain
reliever if they need it. If you accidently hit an artery, which is
highly unlikely if you’ve stayed away from anything that pulses
and studied your veins and arteries, you’ll know because it will
be bright red and the blood will fill the tubing or syringe quickly.
Release the tourniquet, withdraw the needle and apply firm pressure
with a gauze pad or cottonball for at least 5 minutes. Then tape it
snugly and check it to be sure it’s not bleeding through. If so,
hold pressure longer.
Syringes:
If you’re going to draw blood into a syringe, I would recommend
a 10cc syringe. That’s the equivalent of 2 teaspoons of blood.
You can use a 20cc syringe, but if you do, be sure you’re using
a 21 or 19 gauge needle, or it’s just too hard to draw. Pull gently
back on the plunger while you hold the needle in place at the hub (or
tape a butterfly needle). If the blood’s not coming easily, ask
the donor to take some slow deep breaths and relax. When you see the
blood coming just give it time with slow steady gentle pulling until
it’s full. Too much suction can cause the vein to collapse. Some
vamps draw more than one syringe, if they’re experienced enough
to switch out syringes and not move the needle. It’s easier with
a butterfly setup to do multiple syringes.
Needles:
Once you’re prolific with a 23 gauge (I don’t recommend anything
smaller or it will be hard to draw the blood), then you can increase
the gauge size if you wish to 19g or 21g. An 18g will give a lot of
blood quickly, but it does have a bite to it and I recommend it only
after the donor (and the vamp) are experienced. And for heaven’s
sake, don’t harpoon someone with a 16g or 14g, it’s not recommended
unless you’re very experienced and your donor doesn’t complain.
You can also use a plain hypodermic needle either with a syringe or
just let the blood freeflow down the arm or into a preferred vessel.
Try to get your hypodermic needles in the 1 inch length. Anything longer
than that is sometimes unwieldy. When ordering needles, for example,
a 21g x 1” is a 21 gauge needle that is one inch long. The butterfly
sets come in gauges with different lengths of tubing usually 6 or 12
inches. You really shouldn’t ever reuse needles, even the butterfly
ones. Use a new sterile one each time. And if you have to pull the needle
completely out of the skin, don’t reinsert the same needle. And
please dispose of needles safely in something like an empty plastic
soft drink or water bottle with a screw-on cap.
Where do you find supplies? Asking around is usually your best source.
Most items can be purchased online. More on supplies will be found on
the Needful Things page.
Lancets:
I’ll mention lancets here as they are a way of drawing blood. Lancets
may be found at any store that carries diabetic supplies. You can use
them on the tips of the fingers (I like to call it fingerfood), the
forearms or other areas. For the purposes of bloodletting, it will usually
take more than one puncture. There are some new lancets on the market
that slice rather than puncture and yield up more blood with one application;
however, they are considered a specialty medical product and may be
harder to find.
