When the Blood is Harder to Draw
For most people, venipuncture is quick, easy, and relatively painless. "The vast majority of the patients we see are pleasantly surprised," says Saralyn Pruett, a phlebotomy supervisor at the Mayo Foundation in Rochester, Minnesota. "They may have had some anxiety ahead of time, but we get overwhelming comments about how ‘that was faster than I thought,’ ‘less painful than I thought,’ ‘easier than I thought,’" she explains.
Some people, though, have veins that are quite small and difficult to access. Some veins are scarred from repeated punctures to the vein or occluded (blocked). People undergoing chemotherapy, for example, and those being monitored for side effects while taking warfarin (COUMADIN® ) may have more difficulty during a blood draw because their veins have been punctured so often. For these individuals, venipuncture can involve more than one needle stick.
Experienced patients are likely to take a more assertive role in the procedure, telling the technician the good spots to try or the needles, techniques, or instruments that work well. Women who have had a mastectomy, for example, are likely to tell the phlebotomist which arm to use to avoid the lymph nodes more prone to infection. Some people who know their blood is difficult to draw always request the technician with whom they have had the best results. If you are frustrated by a lack of quick success, try to stay open to the phlebotomist’s suggestions so together you can create a protocol that works well for you.
In addition to the tips above, here are some more suggestions from the book Caregiving, which discusses the vein problems cancer patients can have during and after treatment:
Numbing Creams — Ask about products that numb the skin, such as EMLA cream.
Finger-Stick Tests — Ask if a finger-stick test is available. Complete blood counts can be obtained this way. This option is available at most large medical centers.
Catheters and Ports — If you know you need frequent blood draws over a period of time and your blood draws are requiring three or more attempts before they are successful, ask about the availability and advisability of using ports or catheters.