Nursing Insights & Resources

Phlebotomy Tips For Hard Sticks

If you are a medical professional, you will not be able to avoid performing phlebotomy. This means that you cannot run away from making incisions in a patient’s veins. The process can be difficult, especially if you have a patient who is a “hard stick”. How are you going to get around such situations and draw blood from those hard to reach veins?

A hard stick is someone whose veins are difficult to locate. He is a difficult person to draw from because he is dehydrated or has veins that are too small.They may also be flat or difficult to compress.This makes incising them an uphill task.

Encountering a hard stick is indeed a phlebotomist’s nightmare. Being one is also not easy. Such patients may have to undergo a few injections before their blood can be drawn.

As a phlebotomist, having a few tricks up your sleeve can make it easy for you:

• Try locating the vein by tying a tight tourniquet around it first. If the veins are difficult to locate, try gentle slapping around the area to make them more prominent. Do not slap them too hard, as this may cause the veins to constrict themselves.
• Advise the patient to make a fist and relax their hands a few times. Applying a warm compress for about 2 to 3 minutes will make the veins more visible. If a warm compress is not available, try immersing the limb in warm water.
• If both measures fail, try illuminating the vein by placing a torch under the limb. The lights in the room have to be turned off to make the vein more visible.
• Familiarize yourself with the procedures in place. Perhaps the facility where you work requires you to ask for help if 2 or more unsuccessful attempts have been made to locate the patient’s vein.
• Advise the patient to rest for 10 to 15 minutes before a fresh attempt is made to draw his blood another time.

In addition, you might make a few suggestions to patients who are hard sticks. This makes the process easier for both you and them.

• They should drink lots of water before any blood test. Hydrated veins are more accessible. Coffee should be avoided 24 hours before the test as it may cause dehydration.
• Ask the patient if he knows of any spot on his arm has a vein that’s easy to draw blood from. This eases the process of locating the vein.
• Hard stick patients should keep their veins warm. Get them to put a warm compress on the arm 10 minutes before the blood test.
• Advise such patients not to have blood drawn in the early part of the morning, if possible. Veins tend to be flatter in the early part in the morning and hard to locate.
• Hard sticks tend to have bruises after their blood is drawn. To avoid bruising, they should apply pressure on the incised area for 15 minutes after the procedure is completed.
• Advise them to exercise their arms. Exercise makes the veins more compressible. They will also be easier to access.

As a medical professional, you may dislike drawing blood from hard sticks. You aren’t likely to be their favorite person to see either. Bearing a few things in mind may make the process a lot easier.

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