Monday 15 May, 2006

Index: Alternatives to venepuncture

Posted in Best Topics, Michael Tam at 17:46 by Michael Tam

Original article by: Michael Tam

The most skilled phlebotomist of them all

This is an index page linking a series of articles on alternatives to venepuncture.

Blood collection is the bane of every intern. However, there are many tricks that you can utilise and once you become skilled at it, believe it or not, you may find yourself enjoying the challenge of a difficult venepuncture.

Now, just about anyone can stick a needle into a vein and draw back some blood. The question is what you do when you cannot see a single reasonable vein on any accessible limb? This occurs with alarming regularity in hospital, especially with oncology and renal patients who happen to require regular blood tests.

What you need to do is to break the mindset that the only way you can get blood is by sticking a needle into the lumen of a vein. Arguably, this is the best option for the majority of your patients, but chasing a non-existent vein is not a game that you or your patient finds entertaining.

You have options!

I now have a mix of pity and sense of superiority when I see an intern stressed over a very difficult venepuncture. The books talk about complicated ritualistic techniques such as using a sphygmomanometer cuff to cut circulation to the limb for a few minutes and then taking advantage of the vasodilatation on release. My opinion is that this is mostly nonsense. If an experienced hospital phlebotomist (who literally takes dozens of blood tests each day for a living) cannot get venous blood, it is unlikely that you will either (unless you go for veins he or she dare not touch like the femoral vein or external jugular vein).

YMMV.

The following are a collection of methods outside the realms of “normal” blood collecting. They are all pretty safe and effective.

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