NHA Certified Phlebotomy Technician (CPT)Collection RoutineHard
A phlebotomy technician is performing a venipuncture on a patient with fragile veins, such as an elderly patient. Which of the following modifications should the technician consider?
- AUse a winged infusion set (butterfly) with a smaller gauge needle.
- BUse a larger gauge needle (e.g., 18-gauge) to ensure quick collection.
- CPerform the venipuncture without a tourniquet to avoid vein collapse.
- DApply the tourniquet tighter than usual to make veins more prominent.
Show answer & explanationAnswer & explanation
Correct answer: A. Use a winged infusion set (butterfly) with a smaller gauge needle.
For patients with fragile veins, a winged infusion set (butterfly needle) with a smaller gauge (e.g., 23-25 gauge) is preferred. The smaller needle causes less trauma, and the butterfly's flexibility allows for better control and less pressure on the vein, reducing the risk of collapse or hematoma.
Why the other options are wrong
- B. A larger gauge needle would cause more trauma to fragile veins, increasing the risk of collapse, hematoma, and pain.
- C. Performing venipuncture without a tourniquet can make veins difficult to visualize and palpate, often leading to unsuccessful attempts and requiring more probing.
- D. Applying the tourniquet tighter than usual would increase pressure on fragile veins, making them more prone to collapse or rupture.
Fragile Vein Venipuncture
Specialized techniques and equipment used to perform venipuncture on patients with delicate, easily damaged veins, common in elderly or chronically ill individuals.
- Use a winged infusion set (butterfly) with a small gauge needle (23-25G).
- Apply tourniquet gently and for the minimum necessary time.
- Consider using a blood pressure cuff inflated to just below diastolic pressure instead of a tourniquet.
- Anchor the vein carefully but firmly; pull skin taut to prevent rolling.
Memory trick: Fragile veins need a gentle touch, like a butterfly.