Phlebotomy, the practice of taking blood samples from a patient and other body tissues for a medical test, investigation or blood bank, is usually done with the help of a trained phlebotomist or a professional in the laboratory. The usually performed procedures are venipuncture in which a quantity of blood is taken from the vein (mainly in the arm) and a puncture procedure in the finger that takes a smaller quantity of blood from the tip of the finger. Although most of these procedures are simple and without incidents, the complications can be generated due to the patient’s health or because the phlebotomist failed to follow the order of draw phlebotomy correctly.
This occurs when there is a collection of blood that fills the tissue around a vein. It can be mistakenly seen as a bruise or spread and is often painful. Bruising usually develops when a phlebotomist “ignores” a vein, only enters it partially or it stings the entire vein during a routine venipuncture. Most bruises are not uncomfortable; however, special care and measures should be done when dealing with children, the elderly, and patients suffering from blood disorders or taking anticoagulants.
To avoid a bruise, the phlebotomist must:
- Choose a vein surface to make the puncture
- Make sure that you do not place the vein in an incorrect angle
- And avoid looking for the vein with the needle.
Treatment of a hematoma involves lifting the influenced area of the patient to a higher height of the heart while applying ice and gently pressing on the area.
Prolonged Tourniquet Application
A tourniquet is an essential tool that helps a phlebotomist to initially locate (palpate) and enter the vein. However, they must not be used on the patient for more than two minutes, otherwise, the phlebotomist puts the integrity of the blood sample (known as hemoconcentration) and the patient’s health at risk. Using the tourniquet for too long can result in irreversible tissue or nerve damage.
If a phlebotomist has trouble finding the vein, you must undo the tourniquet and heat the area with warm light or a manual heater and ask the patient to close his fist slightly. The tourniquet should be undone, and the area should be palpated again. If the phlebotomist still does not find the vein, you must remove it and try another area.
If a patient has a tourniquet applied and complains of unusual pain, numbness or tingling, a supervisor and medical staff attention should be brought in immediately.
Hemolysis is a complication that occurs more in the blood sample than in the patient. When this sample is roughly handled, red blood cells can generate “lysis,” a complication in which the cells separate. Hemolysis can affect or even show negative results in many of the samples.
Phlebotomists should carefully handle the blood collected. If these contain an additive and you have to mix, the phlebotomist shouldn’t make the mistake of roughly shaking the tubes, instead, slightly invert it.