Help! After 2 hours of sticking- no luck
Dear phlebotomists of Reddit,
I am writing to you as an RN in clinical research, seeking tips or tricks for a patient with the worst veins I have ever seen. I have a background in oncology, and this patient's veins are still harder to get than those of patients who have gone through years of chemo.
For context: I work at a clinical research site and we have a patient who will be getting blood work every 4 weeks for about 1.5 years
Her veins are impossible..they are either super tiny, will roll away, or blow immediately.
I cant count how many times I've got the 23g butterfly in the vein with blood return just for it to stop flowing a few seconds in or blow
If you have any tricks that can help, please let me know, we are a start up so we don't have phlebotomists who have done this all day for years or ultrasound guidance.
During the patient's last visit it took me 2 hours to get enough blood to fill just a few drops in the required 6 or 8 tubes or whatever for the study and they still resulted QNS or hemolyzed so I am going to have to try again next week!! Other times it has taken me between 5-10 sticks to do her labs. I'm shocked the patient is so chill because I sure would not be able to handle that if I were in her position, she says it always happens. I dont want to keep torturing her for 1.5 years...!
The following are what I have tried:
- Heat
- Hydration
- Dangling the arm
- Rubbing with alcohol to irritate the vein
- Hands, AC, forearms, almost considered her feet at some point but the veins are basically non existent
Please help!! Thank you!!