Venipuncture - How to Position a Needle 

Thank you , really needed that

I'm having trouble getting a vein

Same here I want to quit because i also feel Iam not good at this

Stacey Arey, venupuncture is a skill and it takes practice to learn. The more you do it, the better you will get. What helped me was making it a practice to feel the vein not just looking for it. You can do this by applying a tourniquet on your own arm and feeling the difference between the vein and non vein spaces. Watch for the ones that move and do not use those this is called the roll test. What you can do is ask to follow an er nurse or emt for a day or more and do all of their iv insertions most facilities will allow you to schedule this in. Practice makes perfect! DO NOT beat your self up, REMEMBER it takes a year to learn how to be a nurse. You’re going to get this!!

It made me kind of happy to see this bc so many nurses don't know how to do it and I go home with 4-5 marks on my arms and some trauma tbh it hikes my anxiety through the roof to go get any blood work and I wish more nurses were like you and took steps to actually learn how to do it better... 😊😊🎉

----- me too ....they said they have scarred my veins with so many blood tests. They said my veins are small and deep and they can't even find them on my right arm

Even the best phlebotomists have came across veins they cannot draw from.

@@julianadamico4702 I don’t know anything about your health problems, but if you are able bodied in your upper body, doing some rowing or weight lifting exercises might help enlarge your veins.we as women are more prone to difficult veins because our subcutaneous tissue is thicker.

Very helpful thanks

This is a wonderful breakdown. Thank you!

Thank you so much!

I’m a MAT student and we just went over phlebotomy. When I anchor my vein should I use my finger and anchor on the side instead of on the vein below where I’m going to stick?

@@andreabautista53 Finger placement alongside anchors the vein by using fascia under the skin without compressing the source of flow that can collapse the vein. It accomplishes the same thing without hindering the whole point of a tourniquet.

It's ok to take out your protractor if need be. No one will judge you. Ok maybe just a bit.

Why are you watching she has no hijab? It’s haram

You have to use the needle gently, when u access the vein, blood will start flowing to your tubes immediately. That's when you stop introducing the needle. If you apply unnecessary power while introducing the needle you might pierce the opposite wall of the vein and the blood flow will suddenly stop, causing hematoma. Always be delicate handling a needle 👍

​@@crisbioyou don't put the tubes in until you know there's blood. So how do you know there's blood

@@cr.-lb1hj It all depends on the type of collection material you are using. many materials indicate that you have access ready (you're right in the vein). True, if you are using an adapter cannon it can be problematic, because if you are not in the vein, the flow will not come. Now, either you messed up the access or you need to gently introduce more. I wish you success in your collections!

@@crisbio I'm talking about the BD vacutainers

@@crisbio BD vacutainer eclipse

Have you stated your class ? how is it going. ?

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Dan Y. -----Practice on your friends and family members

i’ve read about people practicing on fruits at home, like oranges and bananas!

@@julianadamico4702 like seriously -? BRUH be more sensible She/he said "practice" While practicing you might have lot's of mistakes as most of us are new to learning it If the needle get into uper or lower the vessels it will occur a lot of problems

@@fake_in_world2635 my friends were really happy that i asked to practice on them, dont know what the issue is. if they trust you and know you arent fully confident, theyre prepared for anything...

You don't want to fully withdraw the needle to reposition because that will contaminate the tip of the needle, so you wouldn't want to reinsert it. The contamination can lead to injection or alter test results. Instead, you can try repositioning a bit, but not too much, or the vein can be injured. If in doubt, I find it's best to withdraw the needle, bandage the puncture site, and try again with a whole new needle at a different site.

Thanks for the comment though, it's a good question!

If she had done it gently then there should be no issue but if it's one where she kept pulling out and then trying again it might be an issue referred to as "fishing". I'm still practicing Phlebotomy so I'm not the best reference so I suggest speaking to your nurses for your next checkup and ask if there is anything wrong.

A little of both. There's some flexibility of the vessel along the shaft but the tip can scratch the inner surface. Mostly the damage is minor, and heals quickly once the needle is taped down. Self butterfly in a dominant arm is difficult for anyone so don't be too hard on yourself. Just be careful you aren't resting the butt of your nondominant hand holding the needle right on top of the vein feeding the insertion site. The weight of your hand can reduce backpressure and change the shape of the vessel to oval. You want to keep it round if possible. To keep the skin taut so it doesn't dimple under the point you could try a piece of tape to pull the skin alongside tight, leaving your nondominant hand free to concentrate on insertion, not stretching. Come in shallow, being careful not to rest your wrist on the blood vessel but beside it, and then level out after you get a flash. Tape as soon as expedient.

You cant re use needles bro, old blood is dangerous and you need to use a mutch thinner needle bro

Ugh. It's already a high tension moment under needle. The LAST thing a patient needs is chaos adding to anxiety. The worker needs to get his/her act together. Needles ain't no joke.

Blood cultures are done from two different sites to ensure accurate results. 2 bottles for each draw, two different veins. So two pokes and four bottles.

lmao 😂

I've drawn blood for nearly 40 years and I nearly always insert at roughly 10 degrees for lean people with visible vessels that I could feel on the surface. This vessel is riding on top of muscle and has a thin veneer of skin over it, less than 1/16 inch. People with more fatty tissue just under the skin (i.e. the dermis layer containing fat) can still have veins you can feel but can't see. Then a 30 degree was the way to go, leveling out after flashback. One of the biggest errors I see when teaching, is 45 degree angle approach, and the student putting their THUMB on the vein to pull the skin taut. Of course, what they're doing is shutting off the blood flow to the insertion which is why the vein suddenly 'disappears' . Pull skin BESIDE and in line to the vessel, so flow can keep the vein puffed up long enough for puncture.

@@dandeleona4760 I was taught to stabilize the vein with a thumb while pulling skin taut, so the opposite of what you're saying. How do you avoid the vein rolling if you don't anchor it with a thumb?

@@TessaAvonlea In this technique you ARE stabilizing the vein with your thumb. You're just not putting your thumb ON the vein (your source of flow) but BESIDE the vein instead. It's not the opposite of what we're taught, but a more efficient variation. And on most patients that are not elderly, veins are secured by fascia or embedded in fat so rolling isn't that much of a problem anyway. We SAY their veins rolled to explain how we missed an obvious stick by going right through it to the other side. Elderly and some physiological conditions do allow veins to be pushed one side or the other ... particularly in the back of the hand ... so pinning the vein without occluding it is win-win. If the vein is visible it's probably less than 1/8 of an inch below the skin, so a 45 degree angle will not be successful. The needle will be at the back wall of the vessel before the top wall pops back, and we wind up stabbing a vessel double wall 'sandwich', not a lumen. This is why NOT occluding with our thumb is the way to go. It keeps back and top walls from touching at the time of insertion. I hope that helps.

Depends on the type of catheter, some retract, some like the Brauns have a sheet/covering that cover the end of needle. I use the BD Insyte BC blood control caths since you don’t have to worry about holding tamponade, and they retract into themselves.

You will stop bleeding after a few minutes. No surgery needed.

Nah, I bleed after I have needles in my veins, but it stops after a few minutes. It’s nothing serious.

Just be patient! Sometimes it helps to have the person dangle their arm with a tourniquet on for a few moment to help the blood flow into the veins and engorge them. You can also use a second tourniquet if necessary. Sometimes a NIBP cuff can do the trick too, but this can be more uncomfortable. Make sure to take into account your patient's physiology before you stick them. A very obese person will usually have more subcutaneous fat covering their veins, so their veins will be deeper. An elderly person usually has very shallow veins that aren't anchored well due to the deterioration of collagen - so make sure to stretch the skin and vein before you poke to ensure nothing rolls! Practice makes perfect, and it's okay to miss your veins as long as you do your best and learn from your mistakes.

@@CaseyCorrupted Aww that was some excellent experience advice there. You can be teacher or an instructor or something cuz Iam still blown on how u gave out good advice. A lot of people don't do that as much often as they should I guess cause they don't want to see the next person to advance in life which is wrong and because I was gonna give advice but nothing like what u just said that was freaking awesome once again nice job on that. 💯👏🏼💣✌

First of all stop using that disgusting language!! Instead learn and practice!!

Say a million of us junkies every fookin day lol! Calm down and heat up your arm or wherever with a hot compress.Youll find it.Unfortunately it takes years of abuse to get good at it.Good luck.

@@joannaluca8495fuck 😂 you had me going for a second. I love how all these phlebotomy video comments are junkies and nurses, but you can’t always tell who is who

She’s doing a great job explaining, not quite sure what more tips and directions you need!!?

@@joannaluca8495errr actual examples rather than just some diagrams!!???

I've drawn blood nearly 40 years and this is my take, not seeing your patient: If you have bleeding you did hit a vein, hopefully the one you were aiming at. If you have no flash in the needle you went through to the backside, and may be able to recover by slowly pulling back to flash, then angle parallel to the skin. When you push on a vein, the thin walls are deformed with the pressure, forming a dimple on the vessel wall, and making the lumen oval. When it's punctured, the vessel pops back up to round, but if you advance too quickly, you're already at the back wall by the time the vessel recovered its shape. Glide slowly, paying attention to show of blood. If a vessel 'disappears' during insertion, chances are good your thumb or hand is sitting on the vein and shutting it off. Remember, vein blood is traveling UP from the hand to the elbow, and your support hand for the needle is usually between the wrist and the insertion hole. If you're not careful, you'll find yourself leaning on the wrist to steady your hand and accidentally shutting off the vein flow just when you need it most. Take note of the length of needle you're using. If you're using a 1 1/2 inch and half is not visible, you know how much of that needle is already in play under the skin. If half is not visible to you, you're too deep for superficial veins on average people. Half is not unusual for obese arms, but you have to take greater care when advancing because even that can be too much needle in action. TIP: Practice on family members. No, not with needles, but with the tourniquet. Then close your eyes and run your fingertips over the skin to feel for elevated veins. You'll feel them without seeing them. One of the problems with students is they depend on their eyes looking for blue. What they NEED to do is FEEL for the elevation changes of engorged veins without seeing them. THOSE veins are the good ones to cannulate. Without needles, practice feeling for veins on everyone willing to submit to it, because variety will make you better as your intuition is honed. Eventually, on the job you'll feel before you see, and your strikes will be far more accurate with fewer hematomas.

@@dandeleona4760 can you please make a video? Your info is excellent. I lost my confidence with drawing labs as a nursing student and graduate in May. Bc of Covid we have not really had chances to do IV starts either and it seems so basic but between Covid and confidence I feel like a moron no matter how much I tell myself I got this! I am literally pretty great at other nursing things and critical thinking etc but gosh darn I cannot get this. 😢

@@dandeleona4760 thanks a lot🙌🏼

@@dandeleona4760 tq

The vein can vacuum on the bevel and pulling it back a little could remove this vacuum, might be also an issue with the tubes, as with air bubbles and movements, the tube can lose it's vacuum

Usually you're too shallow and the cannula is not in the vein, this the "tissues" the cannula. Try advancing 1-2mm more after the flashback then slide the cannula in. The cannula will glide in smoothly if it is in the vein, it will buckle and be tough to advance if it is not or if its only partially in..

After you get the flashback of blood you want to insert it a little more, to make sure you’re in the vein. Otherwise more likely, soon as you see the flashback of blood, it will not be enough to advance the cannula.

I just had a successful insertion following your tips and also reducing the angle of the needle more. Yay!

I get this problem too 😞