Alcohol = Solution to your phlebotomy and cannulation problems
Wipes, Alcohol wipes - not vodka
Taking bloods can be easy or difficult.
Things that matter: Your skill level, your confidence, experience etc
but mainly, in my opinion, the veins of the patient.
If your patient’s arms look like this, I am sure you will have an easy time taking blood
One advice I received early on from a resident is,
You don’t have to SEE the vein, you just have to FEEL it
This has changed my way of approaching blood taking and cannulation. I no longer get nervous when I do not see any veins because I know with the right techniques I can feel for the veins. So advice #1 is:
If you can’t see the veins, don’t freak out. Approach the patient, tie the tourniquet, try the different manouvers listed below and you may feel for a very clear vein or maybe even see it.
What can you do to feel and maybe see the veins more?:
You already probably know some of these but let me just reiterate
Tourniquet tight around the arm - but not too tight
Don’t worry about this being too tight as sometimes we are too scared to be firm with patient.
My suggestion, take a tourniquet one day and tie it around your own arm as tight as you want and see how it feels. Look at how tight you can go without causing yourself any discomfort or pain. This is one way by which you will learn that you can go a bit tighter on the patient because it’s not *that* bad.
Hang the arm of the patient on the side of the bed
Tap the vein to cause vasodilation
Rub the vein to cause vasodilation
All these are common tips given to me or ones that I have seen on videos or read about, however, one of the best ones I received was from a nurse during my GI rotation.
He mentioned rubbing alcohol around the entire site will bring their veins to the surface. I didn’t get it at first until I was trying to cannulate a patient and I couldn’t see the veins but I could feel them. The nurse said hold on, he got alcohol wipes and wiped the arm and boom, I could see all the veins.
Things to take into consideration:
It could just be the wetness of the alcohol causing me to see the veins
It could just be the rubbing motion that causes extra vasodilation
I have tried looking it up and it’s slightly unclear as to what it actually is. All I know is that it works and it has helped me visualise veins. (Even thought you don’t NEED to necessarily visualise them and feeling is more important).
I chose to try this alcohol thing out on my own arm and a colleague. *Little disclaimer, I have difficult to see veins and people always struggle to take bloods from me or to cannulate me*
My arm: It may be hard to see through images but it does make a difference
My colleague (Follow him on IG here @SozosHadjivasileou - he is able for modelling hire):
Sozos already has good veins before wiping, but they become much darker once you wipe.
The best thing I can say is, there is nothing wrong with wiping a lot, it cleans the area and it may give you a better view of the vein, so just try it next time.
The actual procedure:
I’m not going to teach you how to take bloods or cannulate, hopefully you have had a few sessions on them and practiced on mannequins. Here are two things I have learnt that may help you in general.
Anchoring and stabilising the skin below where you plan to penetrate will cause less pain and will ensure the vein doesn’t move around. So make sure to always anchor the vein below the site. Never above. Please, never above. Don’t even ask why (needle injury if you really can’t figure it out).
Don’t be scared to look at the entire arm for any veins. The ones on the cubital fossa are preferred but don’t be scared to use the ones in the hand and the forearm. DON’T FORGET to warn the patient that the forearm and hand ones may be a bit more painful than the fossa but you will try to be as gentle as possible.
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My name is Habib and I am a 5th-year Medical student currently in Cyprus. I grew up in Tanzania (Hakuna Matata is from the local language of my country and the second tallest mountain (Kilimanjaro) is found there).
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