NHA Certified Phlebotomy Technician (CPT)Collection RoutineHard

A phlebotomy technician is performing a venipuncture and notices that the blood flow into the vacuum tube stops abruptly after a small amount of blood has been collected. The needle is still in the vein. Which of the following is the most likely cause?

  1. AThe vacuum in the tube has been lost.
  2. BThe tourniquet was removed too soon.
  3. CThe needle has gone completely through the vein.
  4. DThe patient has a vasovagal reaction.
Show answer & explanation

Correct answer: C. The needle has gone completely through the vein.

If blood flow stops abruptly after a small amount has been collected, and the needle is still in the vein, a common cause is that the needle has gone completely through the vein. This creates a new opening in the vein wall, causing blood to leak into the surrounding tissue (hematoma formation) instead of entering the tube.

Why the other options are wrong

  • A. Loss of vacuum in the tube would prevent any blood from entering, not just stop it after a small amount.
  • B. Removing the tourniquet too soon would cause a gradual decrease in flow, not an abrupt stop.
  • D. A vasovagal reaction typically causes fainting or lightheadedness, not an abrupt stop in blood flow from the needle.

Abrupt Blood Flow Cessation

Sudden stopping of blood flow into a collection tube during venipuncture despite the needle appearing to be in the vein.

  • Common cause: needle goes through the vein.
  • Blood leaks into surrounding tissue (hematoma).
  • Can also be caused by bevel against vein wall or collapsed vein.

Memory trick: Flow Stops? Check the Needle's Plot!

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