Tips For Locating Difficult Veins
2020 ж. 22 Қыр.
2 997 546 Рет қаралды
DISCLAIMER: The tourniquet was not really tied on the arm. This was for visual effect and yes we are aware that it was on the arm longer than a minute but it is for locating veins. Please watch our other video on tourniquet techniques.
Preparing phlebotomy students for their state exam and training them with a correct understanding of CLEA, CLSI, OSHA, and HIPPA procedures.
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I am a retired CRNI (RN certified in IV therapy) and I suggest a few things I learned over 48 years 1. Know vein anatomy and access patient for diagnosis and hydration status. 2. Use your sense of touch more than sight. Veins bounce. 3. Allow time for vein filling after tourniquet placement. A full minute or two. Allow prep to completely dry. 4. Look at size of hand veins , all upper veins will be bigger ( just like a tree-twig to trunk)5. If patient shows signs of dehydration apply a glove filled with warm water. 6. Use dependent positioning to fill difficult veins 7. Know the potential IV use for this patient - what will be infused and how long will they need IV therapy? 8. Use good tools- cheaper IV catheters may have barbs and be less sharp- buyers should look at bevels under magnification before deciding on what to buy for your institutition. Good luck. IV therapy is a learned skill that improves with practice.
Thank you for your comment and suggestions. When you have the tourniquet on you only have one minute to draw the blood while the tourniquet is on. So you can’t allow 1 to 2 minutes to dry or else hemoconcentration will ruin the sample. IV placement has different rules than a blood draw.
# 2 on your list i used that line on my lvn teacher because i have tattoos on both arms and she told me that i should think about nurses before tattooing myself on that area and i told her a person that knows what she/he is doing would not go by what they see but on what they feel. and she dismissed me for the day :)
thank you so much
Yup. Phlebotomist for 4 years, and always trust feel over appearance. There's some deep veins that can't be felt unless I push 1-2 inches in while palpating.
@@MIMI-fw5bp facts
Im in geriatrics and I fill a glove with REALLY warm water and place it on the vein area. It really helps! Then I clean with alcohol of course.
Great Idea!! Thank you so much; gonna try it.
I Always do that.....
Yep, I was just gonna say to use a heel heating pad that they use for kids.
Thank you for that idea! I will have to try that! I'm working a new job where there will be a lot of obese patients and I've always had problems locating their veins
@@cindy7733 yes, we must get creative sometimes. Lol. As long as we do it safely. Good luck w those hard sticks!!
I'm not a medical professional but I am a recovered IV drug user. During that time I was known for being able to hit any vein, even in people with incredibly damaged veins who often were eventually turned away when getting bloodwork because none of the phlebotomists were successful in finding a vein. For these types of patients, I have a few tips. First off, like you said hydration is key. Addicts can be very dehydrated so getting something like Gatorade or Pedialyte in them will help a ton. Make sure they're warm. A warm compress really doesn't provide that much heat, I recommend a heated blanket. Keep them wrapped up even if they feel hot. If they are able, have them sit up with their arms behind them and do essentially push-ups. Ten or so should do, then put the tourniquet on right after they're done. Another note is that many nurses, especially newer ones tend to put the tourniquet on very tight. The arm shouldn't be turning blue/purple and the patient might complain about pain or numbness. If it's too tight not enough blood is able to get to the lower part of the arm. Another mistake I see regularly is slapping the vein. That's what they do in movies, not real life. You want to palpate with the fingers or gently rub the vain to warm it up, and promote blood flow. Now where to hit. An addict is going to know their veins inside and out. Listen to them. Ask them where they haven't been shooting recently and which veins are damaged. If the patient is right handed, try the right arm first because they hit it less. There's a nice fat vein that runs from the elbow to the wrist, on the outside of the arm if I'm facing you with my arms to my sides and the back of my hands facing you. This vein is very difficult for addicts to hit, especially on their dominant hand. The problem is that it rolls really badly, but I'm sure y'all know how to deal with rolling veins. Overall though, talk to your patients and have some patience with them and odds are they'll be able to help you out more than any textbook!
Have you considered becoming a professional? It sounds like it's your calling.
now i learned something
You’re speaking straight facts. Everyone always used to come to me when they couldn’t draw blood before I left and went to pa school. One thing I comment on too is if you are to slap a vein, only do it for hand veins and do it slowly and soon as your hand slaps the vein then quickly pull it back. Do slow slapping for like a minute rather than doing fast slapping for like 5 seconds which most people do.
When you’re drawing blood, you really don’t want your patient to be doing those “back push ups” as that’s gonna screw up the potassium reading. Also, from experience, giving them a good old slap usually helps, but maybe that’s just me 😂
I needed these tips
I’ve always been fairly good at blood draws and IV’s but this really helped me find the deep veins. Haven’t missed a stick since watching this a couple weeks ago. Thanks for the help!
Great to hear! I’m glad it helped you.
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I like this idea tried on me I have deep veins, I will try on larger patients thank you
I agree! Thank you! 😀
Thank you for your videos! I can't tell you how much I've learned from all of your videos. My phlebotomy teacher was the worst. When taking his class I would often double-check facts with you and he was often wrong and you were right! You were the reason why I did so well on my national exam. Keep doing what you're doing! You're videos are life savers! You have a gift!
Thank you for your wonderful comment. I really appreciate the support.
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Power concedes nothing without a demand. It never did, and it never will. Always be a first-rate version of yourself instead of a second-rate version of somebody else. Action is a great restorer and builder of confidence. Inaction is not only the result but the cause of fear. The greatest discovery of any generation is that a human can alter his life by altering his attitude. When you're different, sometimes you don't see the millions of people who accept you for what you are. All you notice is the person who doesn't. With confidence, you have won before you have started. You are right whether you think you can or can't. A woman is like a tea bag; you never know how strong it is until it's in hot water. The sky is the limit. Believe you can, and you're halfway there. Always remember, you are braver than you believe, stronger than you seem, and smarter than you think. Anything's possible if you've got enough nerve.
Just came across your channel and I subscribed to it. Nothing messes up your day like missing a vein...you're going along successfully drawing patient after patient and there's that one you miss and (maybe it's me...) ruins the streak and then I feel like a failure. This is a great tip, the marking with the cap. Can't wait to watch more videos. Never too experienced to learn something new.
Thank you very much for watching and subscribing. 🙏
This is exactly what happened to me yesterday. I was on a good streak and then poof, I'm binge watching KZhead iv cannulation videos trying not to make the mistake again 😅
@@rochellemarissa880me right now, have been on a good streak and then yesterday what do you know, now look at me lol
It stressed me out how long the tourniquet was on that arm.
You don’t have to worry. The tourniquet was barely on his arm for the video. I made sure to keep it really light. Nobody was harmed or injured while making the video. lol
😂😂
My anxiety while seeing the tourniquet on for this long 📈📈📈📈
@@ToltAztec As I stated in the other post above your post, the tourniquet was not really on the arm. It’s was super loose and using video special FX it looks real. Thank you.
same here 😅
Very good tutorial. I truly appreciate and enjoy your teaching style. Clear, concise, and correct. I’m in Georgia and even though you’re not I’m enjoying taking your classes. Blessings.
Thank you for the comment. I’m glad you are enjoying it. Blessings to you too.
Baby Power concedes nothing without a demand. It never did, and it never will. Always be a first-rate version of yourself instead of a second-rate version of somebody else. Action is a great restorer and builder of confidence. Inaction is not only the result but the cause of fear. The greatest discovery of any generation is that a human can alter his life by altering his attitude. When you're different, sometimes you don't see the millions of people who accept you for what you are. All you notice is the person who doesn't. With confidence, you have won before you have started. You are right whether you think you can or can't. A woman is like a tea bag; you never know how strong it is until it's in hot water. The sky is the limit. Believe you can, and you're halfway there. Always remember, you are braver than you believe, stronger than you seem, and smarter than you think. Anything's possible if you've got enough nerve.
Thanks for the advice. I'm a new phleb and I'm not hitting all the goals I need to. I really like this job so I want to do whatever I have to to keep it.
Well I been drawing blood for 8 yrs, and this is a first for me. I can't wait to try this method on my next difficult stick. Thanks
Power concedes nothing without a demand. It never did, and it never will. Always be a first-rate version of yourself instead of a second-rate version of somebody else. Action is a great restorer and builder of confidence. Inaction is not only the result but the cause of fear. The greatest discovery of any generation is that a human can alter his life by altering his attitude. When you're different, sometimes you don't see the millions of people who accept you for what you are. All you notice is the person who doesn't. With confidence, you have won before you have started. You are right whether you think you can or can't. A woman is like a tea bag; you never know how strong it is until it's in hot water. The sky is the limit. Believe you can, and you're halfway there. Always remember, you are braver than you believe, stronger than you seem, and smarter than you think. Anything's possible if you've got enough nerve.
Did it work?
I'm a MA student and my teacher isn't the best. I want to thank you for sharing this content as it made me more confident than I ever felt during my MA enrollment. Thank you.
Thank you for the wonderful comment. I’m glad my videos helped you. I appreciate you watching.
I've learned more from YT for FREE than overpriced, in-person courses! Teaching style is everything.
@@MJ-gj6mj I agree. Thank you for watching.
Baby Power concedes nothing without a demand. It never did, and it never will. Always be a first-rate version of yourself instead of a second-rate version of somebody else. Action is a great restorer and builder of confidence. Inaction is not only the result but the cause of fear. The greatest discovery of any generation is that a human can alter his life by altering his attitude. When you're different, sometimes you don't see the millions of people who accept you for what you are. All you notice is the person who doesn't. With confidence, you have won before you have started. You are right whether you think you can or can't. A woman is like a tea bag; you never know how strong it is until it's in hot water. The sky is the limit. Believe you can, and you're halfway there. Always remember, you are braver than you believe, stronger than you seem, and smarter than you think. Anything's possible if you've got enough nerve.
@@bengood7337 lol WOW. Didn't expect to see a comment with so many powerful quotes. 100% I am a first-rate version of me, that hit so damn hard. thank you stranger
Thank you for these tips. I don't think I have been taught any of them this far (5th year med school). They look like good options that will not harm patients or impact the quality of the sample in a bad way unlike many supposed hacks I have been shown this far.
Baby Power concedes nothing without a demand. It never did, and it never will. Always be a first-rate version of yourself instead of a second-rate version of somebody else. Action is a great restorer and builder of confidence. Inaction is not only the result but the cause of fear. The greatest discovery of any generation is that a human can alter his life by altering his attitude. When you're different, sometimes you don't see the millions of people who accept you for what you are. All you notice is the person who doesn't. With confidence, you have won before you have started. You are right whether you think you can or can't. A woman is like a tea bag; you never know how strong it is until it's in hot water. The sky is the limit. Believe you can, and you're halfway there. Always remember, you are braver than you believe, stronger than you seem, and smarter than you think. Anything's possible if you've got enough nerve.
I wish I had you as my instructor. You are fantastic!! Thank you for taking the time to upload the videos and explaining everything in depth. I would fail my phlebotomy class if it wasn't for you.. lol.
Thank you so much for the wonderful comment. I’m very glad my videos helped you pass the class.
kzhead.info/sun/mMVml76dg6CkjYk/bejne.html
Baby Power concedes nothing without a demand. It never did, and it never will. Always be a first-rate version of yourself instead of a second-rate version of somebody else. Action is a great restorer and builder of confidence. Inaction is not only the result but the cause of fear. The greatest discovery of any generation is that a human can alter his life by altering his attitude. When you're different, sometimes you don't see the millions of people who accept you for what you are. All you notice is the person who doesn't. With confidence, you have won before you have started. You are right whether you think you can or can't. A woman is like a tea bag; you never know how strong it is until it's in hot water. The sky is the limit. Believe you can, and you're halfway there. Always remember, you are braver than you believe, stronger than you seem, and smarter than you think. Anything's possible if you've got enough nerve.
A couple of good tips from me working in a hospital are always have the arms below the shoulders so veins have to work against gravity, you can get blood from even the thinnest of veins with a 25 gauge needle and syringe, if patient is cold and dehydrated then get a wet paper towel with warm water (better than heating pad since water can diffuse into the veins), if you are to slap veins do it in the hand and at a slow pace (about 1 every second for about a minute), for beginners make sure your tourniquet is on tight, know decent amount about the anatomy of veins, know how much volume is needed in each tube and use pediatric tubes if needed (extremely important especially if using syringe, I can’t even count how many times I got the bare minimum of volume then would use the small volume pediatric tubes to make sure all the tests can be done (cbc and other lavender tube tests you only need to fill bottom hemisphere of tube unless esr you need more, serum and heparin tubes you really do not need as much as you think for pretty much all tests in red or green tubes (even like half an inch of blood), blue tube requires good amount obviously since you need to fill all the way which is why I liked the pediatric tube, lactic acid you don’t need crazy amount, blood cultures they tell you to get 5ml but less than that is most often accepted (what’s most important is proper technique so the right bacteria in the blood enter the blood culture), so yeah knowing the volume needed for tests will save you a lot of extra pokes), I’ve probably got more tips that I can’t think of but yeah keep practicing and have no shame in failure to get blood Bc it takes about 6-12 months to get really good if you work in a hospital that is
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Just started my hospital job this made me feel so much better
@@hailyeeh1315 I’m glad :)
@@hailyeeh1315 if you have any more questions let me know, although I’m a PA now not a phleb
About to start as a phlebotomist and one of my greatest fears is invisible veins
With training and working, you will have no problem finding veins.
So excited to have a new technique to try. I’ve had a few pts that I was unable fo find a vein on and had to relinquish them to another phleb. Thank you for this thorough explanation! 👏🏾
Do you have any tricks for CHF'ers and Renal patients?
@Greg Brown thank you. Your tips have helped me get back into my groove with difficult sticks
@Greg Brown yep
I don't get why there's a stigma around not being able to find veins on some people. Everyone has off days, and swallowing pride / knowing your limits goes a long ways towards preventing extra sticks.
@@avothello chf and renal failure patients usually have peripheral edema so I’m assuming you’re referring to them. With patients with significant edema, try to move the skin to the side. The one good thing about people with edema is that their veins are big also, so if you know the basic anatomy of veins then it should be easier
not a medical professional but a high school student who wants to become a phlebotomist, so your videos are informative, thanks :)
I wish you the best. And thank you for watching.
I’m a high school student that has an interest in phlebotomy as a hobby
Don’t make a career out of it. It’ll be a waste of time beicaee the money is terrible and the job is very stressful depending on where your at but go for something else in addition to phlebotomy like a nurse or sonography or some type of radiology the money is triple and much better future
As simple as you showed in the video, at times you still get 50/50. The first thing I do is see if I could visually see a vein nearby the draw site then use my nondominate to feel. I do like the tips you showed and will try. Regardless it can be frustrating at times to be successful at something when difficult situations arises out of the blue.
My tips help with deeper veins and hard to feel.
@@PhlebotomySolutions Of course. Regardless things happens when one least expect it.
This video saved us!! After trying 6 or 7 times unsuccessfully, we watched this video and it worked!!! 100% recommended technique!
Thank you. I’m happy it helped you.
The cap trick is something I'll have to try on patients that I have to do ammonia tests on. To my surprise I've already been doing most of this--bending the elbow, turning the wrist ect. The only thing I haven't tried is using the cap to mark the area. I've heard some phlebotomists using their fingernail too but I always felt a little weird doing that...I'll give a shot one day, thank you!
Thank you for watching. I hope it works for you.
Use heating pads..usually the kind used for pediatrics and that helps plump the veins..also ask patient to let arm hang down so gravity work with you and the blood and also feel for the vein while it's hanging down..and last but not least..take your time..sometimes you may be searching for a vein for 10-15 mins if it's really deep so don't be so hard on yourself.
I wish they took 10 minutes to do it. But they are always in a hurry and they really hurt people. This morning i went to the emergency for a pain in my right lower abdomen. The nurse couldnt find a vein. She didn't bother to search. She stuck the needle in but she got my nerve instead of the vein. And she still kept the needle in twistin it, moving it and she sprayed the water inside and that was so painful. I yelled begging her to stop but nothing. In the end she started cursing and said i cant work like this and left while the blood kept ghushing out
I’m sure there are cases where patients are in a rush but I like what you mentioned about taking your time and how it was take up to 15 minutes to find a vein. My veins are pretty easy to locate so blood draws never take more than 10 minutes from start to finish. But my grandmother has very small veins and she’s been hurt countless times but nurses who get frustrated.
@@eveyk.1204 omg..nooo..I feel so bad for you..that is definitely a no no..please make sure to do a formal complaint to her manager and the corporate office. This field is no for her anymore..she may have caused permanent damage.
@@Shayvideos1 i most definitely will. After that i couldnt move my arm for two days and the blood wouldn't stop coming out for three hours, which isn't normal. It's been two weeks now and i still have pain that wouldn't go away neither with creams or pain killers. I went to my doctor yesterday and he prescribed an anti inflamatory cream to put 4 times every day and aspirin. It seems a bit better but he said that it will take long to heal because she didn't take the vein at all but damaged all the tissue around, including muscles and a nerve.
@@eveyk.1204 that’s upsetting to hear. I think many of these people are not trained properly.
I start phlebotomy training for my job at the hospital on Tuesday. Thank you!
Thank you for watching. I’m glad it helped.
Power concedes nothing without a demand. It never did, and it never will. Always be a first-rate version of yourself instead of a second-rate version of somebody else. Action is a great restorer and builder of confidence. Inaction is not only the result but the cause of fear. The greatest discovery of any generation is that a human can alter his life by altering his attitude. When you're different, sometimes you don't see the millions of people who accept you for what you are. All you notice is the person who doesn't. With confidence, you have won before you have started. You are right whether you think you can or can't. A woman is like a tea bag; you never know how strong it is until it's in hot water. The sky is the limit. Believe you can, and you're halfway there. Always remember, you are braver than you believe, stronger than you seem, and smarter than you think. Anything's possible if you've got enough nerve.
As one of the people always being called for hard patients at my hospital the bending/twisting is such a big thing for the really hard stuff. I've never marked as I find I can usually find the vein again regardless when I've felt it once, then again I'd never consider going for a really hard vein with a 21 gauge either 😊 Good video 👍
The tip for marking the vein was simple and great idea+ of course your other tips. Thanks
You’re welcome. And thank you for watching and supporting the channel.
Power concedes nothing without a demand. It never did, and it never will. Always be a first-rate version of yourself instead of a second-rate version of somebody else. Action is a great restorer and builder of confidence. Inaction is not only the result but the cause of fear. The greatest discovery of any generation is that a human can alter his life by altering his attitude. When you're different, sometimes you don't see the millions of people who accept you for what you are. All you notice is the person who doesn't. With confidence, you have won before you have started. You are right whether you think you can or can't. A woman is like a tea bag; you never know how strong it is until it's in hot water. The sky is the limit. Believe you can, and you're halfway there. Always remember, you are braver than you believe, stronger than you seem, and smarter than you think. Anything's possible if you've got enough nerve.
I've always had difficult veins, since I had severe hives as a teenager. For 20 to 30 mins before I have to get blood taken I hold a very hot wheatbag on my arm. It's the only way anyone has been able to get blood outta me besides using ultrasound to locate the vein. The ultrasound guy showed both the blood collection lady and the doctor that my veins move around alot, at least according to him. As I live in a small rural town that has ultrasound facilities once a week (it's booked a month ahead) and because I need regular blood tests, we stick to what worked best for me.
People can never find my veins. I have mine coming up in a few weeks time and I dread it haha. They say to drink lots of water before. I have never used an ultrasound to locate a vein before.
I had an ultrasound done once to find a vein when I was in the ER. Not sure it made it any easier, they still had to fish around in there with the needle. Meanwhile phlebotomists and Red Cross people who find veins all day have no trouble....
@@katiestory5704 Today I had a blood test. They took it from the back of my hand. Luckily it wasn't too hard. She tapped my hand and put a rubber band around my hand to put pressure on it. I drank a whole bottle of water before.
Oh, sorry dear.
Baby Power concedes nothing without a demand. It never did, and it never will. Always be a first-rate version of yourself instead of a second-rate version of somebody else. Action is a great restorer and builder of confidence. Inaction is not only the result but the cause of fear. The greatest discovery of any generation is that a human can alter his life by altering his attitude. When you're different, sometimes you don't see the millions of people who accept you for what you are. All you notice is the person who doesn't. With confidence, you have won before you have started. You are right whether you think you can or can't. A woman is like a tea bag; you never know how strong it is until it's in hot water. The sky is the limit. Believe you can, and you're halfway there. Always remember, you are braver than you believe, stronger than you seem, and smarter than you think. Anything's possible if you've got enough nerve.
Thanks a million.. I have to be getting all my blood draws as a home health nurse. I had an arm as big as a leg and could not get it even in her hand. I had to dig a little then I got in. But I know there has to be a better way
wow that’s insane! i’m obese and my veins are pretty deep but still visible. i can’t imagine. 😳
Two tourniquets help find those collapsed ones
@@pamc7307 i wouldn’t stick a collapsed vein, dangerous.
Thank you for this video! I'm starting phlebotomy classes, and found this video to be very helpful~ I start poke practice next week, so nothing to do but wait and watch.
Thank you for watching!
Thank you. You explain so well.
Power concedes nothing without a demand. It never did, and it never will. Always be a first-rate version of yourself instead of a second-rate version of somebody else. Action is a great restorer and builder of confidence. Inaction is not only the result but the cause of fear. The greatest discovery of any generation is that a human can alter his life by altering his attitude. When you're different, sometimes you don't see the millions of people who accept you for what you are. All you notice is the person who doesn't. With confidence, you have won before you have started. You are right whether you think you can or can't. A woman is like a tea bag; you never know how strong it is until it's in hot water. The sky is the limit. Believe you can, and you're halfway there. Always remember, you are braver than you believe, stronger than you seem, and smarter than you think. Anything's possible if you've got enough nerve.
In my case me having hemophilia A..really helped me in this department I learnt how to infuse with a butterfly needle myself at the age of 11
I'm a MA. When I have to stick the hands, I usually pat the back of the hand a couple times. Not straight slapping it. Using a heating pad or a bag or really warm water helps. Especially on geriatric patient. Sometimes I will stroke the arm up to help increase blood flow.
This is so helpful, thank you I struggle finding the perfect vein
I’m glad it helped. Thank you for the comment.
Oof, I hope you never draw my blood if you can't even get something perfect
Power concedes nothing without a demand. It never did, and it never will. Always be a first-rate version of yourself instead of a second-rate version of somebody else. Action is a great restorer and builder of confidence. Inaction is not only the result but the cause of fear. The greatest discovery of any generation is that a human can alter his life by altering his attitude. When you're different, sometimes you don't see the millions of people who accept you for what you are. All you notice is the person who doesn't. With confidence, you have won before you have started. You are right whether you think you can or can't. A woman is like a tea bag; you never know how strong it is until it's in hot water. The sky is the limit. Believe you can, and you're halfway there. Always remember, you are braver than you believe, stronger than you seem, and smarter than you think. Anything's possible if you've got enough nerve.
Good tip. I will try this in class next week and show my classmates. Thank you.
Are you a nurse?
Power concedes nothing without a demand. It never did, and it never will. Always be a first-rate version of yourself instead of a second-rate version of somebody else. Action is a great restorer and builder of confidence. Inaction is not only the result but the cause of fear. The greatest discovery of any generation is that a human can alter his life by altering his attitude. When you're different, sometimes you don't see the millions of people who accept you for what you are. All you notice is the person who doesn't. With confidence, you have won before you have started. You are right whether you think you can or can't. A woman is like a tea bag; you never know how strong it is until it's in hot water. The sky is the limit. Believe you can, and you're halfway there. Always remember, you are braver than you believe, stronger than you seem, and smarter than you think. Anything's possible if you've got enough nerve.
Thanks so much, il try and apply the tips and hopefully il be successful. I've been having trouble with small and difficult veins , to locate and get blood.
Thank you. Let me know how it’s works for you.
How did it work for you?
You have to be assertive when dealing with small and fragile veins. Adjusting the angle , if possible, will help even on difficult veins. A lyyle adjustment on how you tie and position your torniquets helps. Just be very cautious how long shall you keep the tourniquet to avoid hemoconc. Your hint where to find vein is always the anatomical position. Take note how you tie your torniquet. Practice makes perfect. Keep trying to get blood from “ hard - to find veins”. The hardest things are mostly depending on the helath status of your patient like in edema, ERSD, burns etc
@@PhlebotomySolutions tgtgtftfgtg to come Lol
Excellent advice! Thank you for sharing
Thank you and I’m glad you enjoyed the video.
Power concedes nothing without a demand. It never did, and it never will. Always be a first-rate version of yourself instead of a second-rate version of somebody else. Action is a great restorer and builder of confidence. Inaction is not only the result but the cause of fear. The greatest discovery of any generation is that a human can alter his life by altering his attitude. When you're different, sometimes you don't see the millions of people who accept you for what you are. All you notice is the person who doesn't. With confidence, you have won before you have started. You are right whether you think you can or can't. A woman is like a tea bag; you never know how strong it is until it's in hot water. The sky is the limit. Believe you can, and you're halfway there. Always remember, you are braver than you believe, stronger than you seem, and smarter than you think. Anything's possible if you've got enough nerve.
Based on my experience. So many patients ive encountered that veins collapse due to dehydration.. what i did is i use warm cloth to warm the area where you plan to insert an iv. Very effective.. promise hehe
yes! i always give them a ton of water to hydrate and come back to them in a little while to palpate.
I found this video was spot on & as I'm continuing to watch, i took note of the person's arm, noticing the lack of visible veins & was curious to see if u were going to be successful - what method u used ETC. . . . Otherwise, a great video with the instructions clear & easy to understand what he means. HOPEFULLY 🤞🤞🤞 you can do a PART 2!
Thank you for watching. We will be doing a part 2 soon.
I tried this on my arm which was the hard one to find a vein and I FELT it doing this technique THANK YOU SO MUCH I will be practicing this to get really good at it and remember it!! amazing video THANK YOU again !!
Thank you! I’m glad it helped you.
Great video! Just want to add that anchoring the vein on the distal part of the arm can help with hard draws or rolling veins.
Thank you for watching! 🙏
great tip using the cap, saved my life!
I’m glad it helped. Thank you for watching.
Wowww its really helpful for all phlebotomist.🙏🏻❤️
Thank you!
I missed a vein twice on the same patient, came back in a week to try again, missed once more and the patient doesn’t want me to do it again. So I’m here lmao
Hopefully our video helps.
kzhead.info/sun/mMVml76dg6CkjYk/bejne.html
While For the first time I got my iv in median cubital vein, I was so happy 😊 because the patient was very fat and I did no prick! Thanks for sharing this video!
Thank you for sharing and watching.
Gonna try this next time! Thanks!
Im a medical assistant who works with pediatrics and it is kinda of a tricky situation sometimes finding a vein especially on obese children. I would love to learn more and get used to it more. Though i love what i do.
Pediatric veins are difficult sometimes. We have other videos that touch on the subject.
@PhlebotomySolutions I have now subscribed to your channel and am looking through your videos thanks for the tips!
Where are you from?
@@lazynassyify east tx
This is the hardest part of the draw. I’ll try this in class next time. Thank you. Looking forward to the next video
Did it work for you ?
Power concedes nothing without a demand. It never did, and it never will. Always be a first-rate version of yourself instead of a second-rate version of somebody else. Action is a great restorer and builder of confidence. Inaction is not only the result but the cause of fear. The greatest discovery of any generation is that a human can alter his life by altering his attitude. When you're different, sometimes you don't see the millions of people who accept you for what you are. All you notice is the person who doesn't. With confidence, you have won before you have started. You are right whether you think you can or can't. A woman is like a tea bag; you never know how strong it is until it's in hot water. The sky is the limit. Believe you can, and you're halfway there. Always remember, you are braver than you believe, stronger than you seem, and smarter than you think. Anything's possible if you've got enough nerve.
Your instruction is very clear. I appreciate it.
Thank you for the comment and for watching.
This works; I have been successful 99% of the time since I started applying this technique 👌 thank you
That is great! I’m glad it works for you. Thank you for watching.
@@PhlebotomySolutions it didn't work for the phlebotomists working at a plasma center I'm going to.
Thank you for the tip. I tried it and it worked. 😁
I've had 7 I.O.'s because my veins are impossible. I'm not obese, nor have I ever been. I got into an accident which caused me to have Epilepsy. That's required me to have blood draws for medicine levels or have rescue medicine to stop me seizing. I've had I.O's, as I said. IV's in my neck, feet, palms of my hands, fingers, armpits, behind my knee, ankles, fingers, toes. Now, I have a mediport, thankfully.
Power concedes nothing without a demand. It never did, and it never will. Always be a first-rate version of yourself instead of a second-rate version of somebody else. Action is a great restorer and builder of confidence. Inaction is not only the result but the cause of fear. The greatest discovery of any generation is that a human can alter his life by altering his attitude. When you're different, sometimes you don't see the millions of people who accept you for what you are. All you notice is the person who doesn't. With confidence, you have won before you have started. You are right whether you think you can or can't. A woman is like a tea bag; you never know how strong it is until it's in hot water. The sky is the limit. Believe you can, and you're halfway there. Always remember, you are braver than you believe, stronger than you seem, and smarter than you think. Anything's possible if you've got enough nerve.
Using the double tourniquet technique while having the patient hang their arm down helps me to find the small/deep ones.
i'm literally phobic of the blood exam thing or whatever you call in english AND I GOT RECOMMENDED THIS? please i even got nervous by the thumbnail
I was 4 years old and went to hospital for blood work. In days of old (the 50's), I was not a happy camper and being held down. Broke the tubes and went through it all over. I detest blood work to this day. A good nurse knows how to do it. I lived through cancer and all. But I will avoid blood draws when possible.
I prefer to use my swabstick (whether using chloraprep or betadine) to make the impression and always make at least two impressions. That way I have a guide for where I want to stick and the direction to aim my needle.
Can you give more detail with this. ? I would like to try this method.
I've been an RN for over 10 years and now finishing my doctorate to become a nurse anesthetist. Here is a little tip that may help that I just learned, and has helped me land some 14g and 16g IV starts. Some providers like to put a slight bend in the needle to allow for a more shallow approach to a vein. They also will lift the vein up after they enter the vein and as they make the angle of approach less. This makes it less likely to pass the needle through the other side of the vein. The bevel is flat and not a cutting edge, so there is no worry about cutting the superficial portion of the vein by doing this.
Sorry, but for a phlebotomist that is against CLSI standards.
@@PhlebotomySolutionsyes it is
Thank you, much needed video for how to.
You are welcome. Thank you for watching.
I'm trying to donate plasma, now I've donated before, and they found a vein before on me, and sat through a whole session, I go to another plasma center, no one can find a vein on me. These people are experienced phlebotomists.
Bigger arms you can palpable to feel deeper veins, small arms with small veins with a very soft touch, and even roll your finger lateral. Just my 2 cents.
5 and a half hours it took the hospital to get a line into me! It was excruciating,they were thinking of either getting an anaesthetist with an ultrasound machine or if they were not available they would have done a cut down procedure which involves cutting through the skin till you see a vein eventually,it was a nightmare honestly!
I’m sorry to hear that.
This was such a helpful video. Thank you so much
You are welcome. Thank you for watching.
I'm very grateful for your videos. They've been a helpful addition to my studies towards getting certified. Thank you! Also, I noticed you have Paleo on your wrist! Interested in your meaning of it🙌🏽
Thank you for watching. I’m very glad they are helping. I have Bible verses in Paleo-Hebrew on my arm. My wrist is a creation of my own based on a Hebrew word. (Private) 😉
@@PhlebotomySolutions Haha fair enough, thanks for sharing!
Thank you for your videos, they are much appreciated ❤️ RN, Northern Territory, Australia.
Random Rapper You are very welcome. I’m glad it helps.
In my personal case when I need to get my own blood work I usually tell the phlebotomist to use the accessory cephalic vein in my right elbow and I did the same with my pts when I was in medical college and in my Doctor’s office.
Baby Power concedes nothing without a demand. It never did, and it never will. Always be a first-rate version of yourself instead of a second-rate version of somebody else. Action is a great restorer and builder of confidence. Inaction is not only the result but the cause of fear. The greatest discovery of any generation is that a human can alter his life by altering his attitude. When you're different, sometimes you don't see the millions of people who accept you for what you are. All you notice is the person who doesn't. With confidence, you have won before you have started. You are right whether you think you can or can't. A woman is like a tea bag; you never know how strong it is until it's in hot water. The sky is the limit. Believe you can, and you're halfway there. Always remember, you are braver than you believe, stronger than you seem, and smarter than you think. Anything's possible if you've got enough nerve.
thank you very much for this information 💗🙏
My pleasure.
I wish people would read more before commenting. That's why God gave us 2 eyes. Thanks for the video.
I like the idea of that cap! but some of the patients would go crazy if I did that lol
So true..
Lol.. so true. 🤍
Why?
@@fluffytail6355 because they don’t like phlebotomist. People don’t like us(people who literally stab their arms and hands lol). But trust me overtime you will become much better I have4 years of experience. And Phlebotomy is so easy now. You won’t need the cap thing
I do it. Luckily I’ve never had a patient complain about it.
wow i like that! Just "passed" my pucture test, even though i didnt actually draw blood! it was the only points i missed! Now im off to clinicals without having properly drawn blood!! All my classmates who drew on me passed, bc my veins are immaculate, but I lost points bc my classmates veins were so hard to palpate! I know i must get used to this but wished i was heading into clinicals with blood drawn!
Update, I did great in clinicals! I am a certified phlebotomist now!
Thanks for this video. Watching from Nepal 🤗❤️
Thank you for watching from Nepal! Great to have you as a subscriber.
I’ve had heat compresses, turning my arm every which way under the sun (so much it hurt), and up to 3 tourniquets on my arm at once, and they still couldn’t find a vein. Even with the portable ultrasound they couldn’t find a vein! It takes 2 hours to get an mri iv in me, and the ct iv blew my vein so bad I ended up back in er, and needed tramadol, advil, and tylenol to deal with the pain. They killed every vein in me from failed attempts during childbirth, that they had to do blood draw from my wrist! I drink 2 litres of water before going for blood tests, and they still struggle! Any other tips for someone who seemingly has no veins at all? Ya, I get told all the time I must not have any veins. 😢
So have they been successful yet? My mum gets told the same thing. She has no veins which to the staff they think is quite an amusing comment to make but to the person who has been constantly pricked and prodded with no success it’s not funny at all!! She is covered in bruises and she expects that to happen now!! It’s absolute bullshit that this occurs!! I was looking at those Vein Finder Machines!! Yeah I know I’m sure they don’t work. But I’m sick of her having to go through this. As I’m sure you are well and truly over it. This woman who worked at Gribbles Pathology which I’m sure you haven’t heard of was the master. She could always find a vein and do it so quickly. So if she can do it then these other useless assholes should be able to do it as well!! She of course wasn’t always available. I don’t think the Nurses Appreciated her help at all as she showed them what idiots they were. What’s the solution? That’s what I want to know? My mum is dying!! She doesn’t need this crap on top of everything else she is going through. Putting in an IV should be a simple thing!! One would think!! Sorry I just needed to vent to someone who knows the hell my mum goes through!! I cringe the minute they walk into her room thinking that they will be able to do it!! Then they can’t!! I wasn’t there this particular day but Mum was yelled at and blamed for the fact they were so useless. They took their frustrations out on a very sick patient. She would always apologise to them like she had done something wrong. I knew every single one of them blamed her!! Not themselves!! ASSHOLES!!!
Awesome phlebotomy tips..Thanks Al..
D. S. You are welcome. Glad it helped.
If you every get the chance, could you please show an example draw on a tiny elderly patient.Like 90lbs with difficult veins?
YES DEAR LORD
I still sink them 18’s in the elderly. 🤷🏽♂️
Do you really need to?
i need help locating my deep vein in my elbows please and the degree to push the needle tip in and far, thank you
This help me alot. Thanks....
Great to hear. Thank you for watching.
Thankyou so much for sharing these tips on vein location. I used the marking techniques today and have gone from very poor success rate to 100%.
That is great!
In Australia we use hands,feet,the back of the wrist the bicep up around the shoulder and we do arterial gases also. The arterial gases we need to be signed of by a ICU doctor. We also do cannula’s but need to be signed of by a ED doctor.
Power concedes nothing without a demand. It never did, and it never will. Always be a first-rate version of yourself instead of a second-rate version of somebody else. Action is a great restorer and builder of confidence. Inaction is not only the result but the cause of fear. The greatest discovery of any generation is that a human can alter his life by altering his attitude. When you're different, sometimes you don't see the millions of people who accept you for what you are. All you notice is the person who doesn't. With confidence, you have won before you have started. You are right whether you think you can or can't. A woman is like a tea bag; you never know how strong it is until it's in hot water. The sky is the limit. Believe you can, and you're halfway there. Always remember, you are braver than you believe, stronger than you seem, and smarter than you think. Anything's possible if you've got enough nerve.
So when a vet nurse presses your arm and keeps the turn on till your about down.....might cause clots or future issues? Esspeically if done over and over again and made to look like im the one being finicky and passing out.........thanks the few nurses at san diego AHF! How many times to really mess me up or get the medical board up on there?
I use an alcohol pad to mark my vein. I find it more effective than the pen cap or blanching techniques, especially for dark skinned patients. Any tips r helpful though!!
I've tried this too
How do you mark with an alcohol pad?
@@xxblackgeishaxx you use the corners as arrows to point where to insert needle
Can you do a video on small children and very fragile elderly veined?
Yes, I am working on those videos. They should be out soon.
@@PhlebotomySolutions they could not find my vein and my arms and muscular firm what where are the cause of why they couldn't find a vein I have more my arms are very tight so it's not that fat I wasn't supposed to drink water I haven't drunk anything since 9 tonight before and I was there at 9:30 in the morning I was supposed to stop drinking or eating at night do you think the hydration has something to do with it or because my Melissa was so tight and firm that you couldn't find the vein what do you think of the cause of why the oral surgeon come to find a vein for needle for the anesthesia by the person you're working with individual have tight forearms is that why they're having a hard time finding a vein
Nice video!! Don't forget to remove the tourniquet or leave it on for too long!
Thank you and don’t forget to read my disclaimer before watching the videos.
My thing is I HATE ac's when admitted for long term stays. Can we get tips on other locations? Forearms .. upper arms?
Thank you for the help it mean alot to mee
Thank you for watching.
Thanks for the excellent tips! you explain so clearly makes it simple💉💉
ora 🐾 Thank you. I’m glad it helped.
@@PhlebotomySolutions what is the name of of the vein to use for IV
@@annoupale2sante210 There is no specific vein for an IV. Nurse will look at the dorsal metacarpal veins or the ante-cubital fossa veins.
Can you do a video for finding veins in someone with scar tissue... I have come across a lot of people who don't have experience with this and it makes things difficult... Example in ER or someone working in a place that gives Methadone/Suboxone or just people who need blood draws that happen to have small veins and scar tissue and hard to find when need
Pebbles BamBam Great question. I have a video that talks about scarred arms and hands. It’s in the Veni-Puncture Complications video.
Omg I’m so glad I found this comment
The dreaded scar tissue! I fill a glove w really warm water and place it on the vein. Then clean with alcohol of course
Was there ever a video made for this??
I learned new things, thank you 😉
Great to hear. Thank you for watching.
Thanks, will try this, I almost never struggle but I pricked someone 3 times before getting a vein today felt so bad but was the only one working. She wasn't even fat just like this person.
No need to shame yourself about this stuff. No one’s perfect not even after years of working
kzhead.info/sun/mMVml76dg6CkjYk/bejne.html
You are good at iv that 😎
Thank you for that helpful video. One of my classmates has deep veins and mine are surface and palpate easily. Hers are very hard to find. I would not proceed when I tried and failed to find a vein. I'll try your methods: fisted hand, not pumping, slightly bend the arm, and if that doesn't work turning wrist while continuing to look then marking the site found with cap, pushing down just enough to leave an impression. Q: Assuming the angle of the needle will still be 15-30%, should we aim more for 30% as it is deeper? (Thanks again!)
Yes, the deeper the vein go up to 30 on the angle.
Thank you!
I don't get the degree and angle thing. I mean I understand the concept, but how do you know your angle?
Since you are able to see the vein, where is your insertion point from the imprinted cap, what angle should the needle come in, and how deep should you go into his skin?
CLSI says youryour angle should be 15 to 30. And if the vein is visible then you enter until the bevel is in.
wah, this is great! thank you
Thank you for watching!
Thank you so much for this video!!!
You are welcome.
I'm an intern right now. It's still difficult for me to draw blood from a female or male bulge patient. I had a patient earlier. His veins are not visible. I palpitated the cephalic vein, but there was no backflow when I inserted the needle. I tried to change my direction and angle. It didn't work. The patient was mad and gave me hateful comments. I want to improve my phlebotomy skills, so I won't get those kinds of comments anymore. so I can serve more and the patient won't feel pain. It made me feel less of a person.
So sorry you had this experience. Don't let it get to you. The patient shouldn't have reacted that way. Sometimes when there is no backfow, try and draw the needle back a tiny bit and up. Usually the needle is just stuck to the wall of the vain. Also while Palpating, don't just palpate the spot you want to stick, but half an inch above and below. That way you know the direction of the vain. They sometimes curve a little. I have been doing this for 23 years. Practice makes perfect. Good luck.
Great tips, definitely gonna try them. Question: What to do in case blood comes out slowly?
Great question. The only thing you are allowed to do is move the needle further in or pull it back a little. You might not be all the way in the vein. Also you can pull back on the forearm skin like the anchor position which sometimes brings the vein in the needle more.
@@PhlebotomySolutions Thank you so much!
Thank you so much 😊
Thank you for watching.
Palpating my own veins while following along. I had a little difficulty with the "turn the wrist" and the "press down on the hand veins" tricks. When turning the wrist, it seems pronation enlarges the cephalic vein, while supination enlarges the basilic vein. But the difference is so slight that it seems barely useful at all. And the only difference I feel near the AC is the connective tissue. Am I maybe doing it wrong? Pressing down on the hand veins, I see no real difference. Certainly not enough to spot a good vein. Again, thoughts please?
Try adjusting the tourniquet.
@@PhlebotomySolutions Making it tighter? (I didn't have one on me when I was palpating.) If that's what made the difference, I'm glad for the heads up. I was able to feel the veins even without.
@@RedT...TheOriginal.NotANumber The tourniquet helps lift the vein up which helps you palpate and feel it.
The "pressing down on the vein" for hands helps sort of flatten out or drain the surrounding tissues so the vein will stand out more (visually and to the touch). It's especially helpful for obese patients or those with edema in the hands. I usually try to use the side of my finger or thumb, and sort of gently roll upwards to "clear" a small spot, because that edema can be really painful for the patient.
I'm in college to become a MA and gosh I've been missing a few times and I hurt a girl by accident, I just feel like garbage when I mess up. If anyone sees this when you started school was it also hard for you? And how did you feel about your mistakes?
Every person who draws blood as a phlebotomist or medical assistant makes mistakes. It takes a lot of time and practice to be successful in the field. I recommend practicing on a plastic arm if you are still worried. Get your technique down on a plastic arm first.
I started skl 3 months ago started doing in class practical 3 weeks now, Thursday practical class was being greade an every students were nervous in certain way we all mess up in but most of us get blood an some don't I did my first draw an find d vein an my classmate move an let the needle com out her hand I fail at my first try, dn I let she try find to find my small veins she couldn't at all so she remove d needle, then I ask a next class mate if I can draw blood from her she say yes, I got one tube of blood wen I was gonna insert d red top tube the hub was screwing off d multi draw needdle, I screw it on back to try get d 2nd draw same ting happen thee teacher time was literally ended an she tell me next week Thursday again u suppose to do 1 or 2 draw , best part I draw blood, I always take out all my equipments one time I pass there ik how to take off the glove I pass dat an I always know how to tie d tourniquet before I started class I pass dat an I always pass d other of draw we take 3 tubes from d kit which we have to place in order light blue, red an gray I pass there, I greet an introduce myself to d patient an I ask for d requesyform an I tell d patient wat I'm gonna do an so on. Over here trying to prep myself more for next Thursday class coming, plus d teacher gonna address some issues of students who want to juck u but don't want u to juck them at all that's unfair, and selfishness everyone must partake in class in groups of 2 to 3 I'm just focusing on practical class cause Tuesday class in is for writing an doing written test an I pass all 4 internal test so far 1 more to go, I'm so ready for it, month month I have d biggest external practan that's just totally hands on Heart (NCTVET) practical that's d main one for me to pass but students can do it or not if they don't want or need to but I'm doing it
Thank you
Thank you for watching.
Nice 👍
Im about to start with Quest...I an office that draws 60 pts before lunch.. I'm so scared because I have great difficulty finding veins. Thank you for this!
You are welcome and thank you for watching.
aww i was waiting you’ll insert one in
I opt to using the hand veins when I can't feel his/her veins in the median cubital fossa
it worked! 😁
That’s great!