NHA Certified Phlebotomy Technician (CPT)Safety and ComplianceMedium
A phlebotomy technician is preparing to perform venipuncture on an elderly patient with fragile veins. Which of the following techniques should the technician use to minimize trauma?
- APerform the draw with the patient's arm hanging down to increase venous pressure.
- BApply the tourniquet loosely and use a smaller gauge needle.
- CRepeatedly tap the vein to make it more prominent before insertion.
- DUse a 21-gauge needle with a standard evacuated tube system.
Show answer & explanationAnswer & explanation
Correct answer: B. Apply the tourniquet loosely and use a smaller gauge needle.
Elderly patients often have fragile veins that are prone to collapsing or bruising. Using a smaller gauge needle (e.g., 23-gauge butterfly) and applying the tourniquet loosely helps reduce pressure on the vein, minimizing the risk of trauma and hematoma formation.
Why the other options are wrong
- A. While hanging the arm can make veins more prominent, it doesn't address the fragility and can increase pressure, potentially leading to hematoma.
- C. Repeatedly tapping the vein is unprofessional and can cause discomfort or damage, especially in elderly patients with fragile veins.
- D. A 21-gauge needle can be too large for fragile veins, increasing the risk of collapse or hematoma.
Fragile Vein Venipuncture
Special considerations for venipuncture on patients with delicate, easily damaged veins, often found in the elderly or those on certain medications.
- Use smaller gauge needles (e.g., 23-25 gauge butterfly).
- Apply tourniquet loosely or not at all if veins are prominent.
- Avoid excessive probing or multiple attempts.
- Use minimal pressure during collection.
Memory trick: Fragile veins need a 'tender touch' for a 'tiny track'.