Sight Information and Courses from MediaLab, Inc.
These are the MediaLab courses that cover Sight and links to relevant pages within the course.
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|Give Yourself a Chance|
A key element for successful venipuncture is choosing the best vein. To determine the best vein, use both sight and touch. Remember -- the first vein found is not always the best vein. Take enough time to assess the vein before beginning the venipuncture procedure.
Before attempting a venipuncture, the phlebotomist should assess a vein by palpation. Palpating the vein increases the chance of a successful venipuncture. Use the index or middle finger to palpate the vein following this procedure: Align your finger in the direction of the vein Press on top of the vein with enough pressure to depress the skin Keep your finger in contact with the skin so that you may feel the "bounce back" of a resilient, healthy vein. The phlebotomist uses palpation to assess the depth, width, direction and health (resilience) of a vein. When determining a vein suitable for venipuncture, the skilled phlebotomist relies more on touch or feel than on sight. Looking away from the vein while palpating will help the phlebotomist perfect the skill of palpation leading to good vein assessment. The image on the following page illustrates the considerations for vein assessment.
A hematoma is another name for a bruise. A hematoma or bruise is a collection of blood beneath the skin. Hematomas are the most common adverse reaction to venipuncture. There are many factors that can contribute to the formation of a bruise. Venipuncture techniqueIf the phlebotomist pushes the needle too far into and through the vein, blood leaks out of that opening and into the surrounding tissue. The appearance of a blue or purple discoloration at the venipuncture site indicates the presence of a hematoma. This discoloration at the site may occur immediately or some time after the venipuncture is completed. A bruise may cause slight discomfort for the patient, but the mere sight of a bruise may generate undue anxiety and discontent for some patients. A patient may associate a bruise with a negative venipuncture experience and be hesitant to have blood tests in the future. It is not advisable for the phlebotomist to perform a venipuncture at the site of a recent bruise as this may cause discomfort for the patient and may also affect the quality of the blood sample. Bleeding disorders and anticoagulant medications:A hematoma may also form after a venipuncture, if the patient has a medical condition that impairs clot formation. A patient who is on anticoagulant therapy will experience a delay in clot formation. If the phlebotomist is aware of the condition, he/she can reduce the incidence of bruising by applying pressure to the venipuncture site for a longer than normal period of time. Also, it is best to inform the patient that bruising is likely. Communication is important to relieve patient anxiety if a hematoma appears.