Troubleshooting Failed Venipuncture Flashcards
Troubleshooting Failed Venipuncture
TUBE POSITION
NEEDLE POSITION
COLLAPSED VEIN
TUBE VACUUM
TUBE POSITION
Make sure that the:
● tube is properly seated
● needle in the tube holder has penetrated the tube stopper
● needle sleeve is not pushing the tube off the needle
Tube holder end has ___ that
help in the insertion and removal of tube
flanges
NEEDLE POSITION
Correct Needle Position:
●Bevel is correctly positioned within the vein
● Needle adjustments must be made slowly and precisely to avoid
injuring the patient
NEEDLE POSITION
Correct Needle Position: Needle adjustments must be made ___ to avoid
injuring the patient
slowly and precisely
NEEDLE POSITION
Correct Needle Position:
●___ is correctly positioned within the vein
Bevel
NEEDLE POSITION
Needle Not Inserted Far Enough
● Happens if the vein is located more deeply than normal
HOW TO CORRECT NEEDLE NOT INSERTED FAR ENOUGH
HOW TO CORRECT THIS??
slowly advance the needle forward
Bevel not completely under the skin
angle of needle entry is ___
too steep
NEEDLE POSITION
Bevel partially out of the skin
Bevel not completely under the skin
○ using superficial vein/hand veins
○ angle of needle entry is too steep
● Note: tube vacuum can be lost if the bevel backs out of the skin slightly
Bevel not completely under the skin
○ using superficial vein/hand veins
○ angle of needle entry is too steep
Bevel not completely under the skin
using ____
superficial vein/hand veins
how to correct bevel partially out of the skin
Discard the tube,
advance the needle slowly
insert a new tube
blood filling the tube very slowly
Bevel Partially into the Vein
Bevel Partially into the Vein
bevel partly through the upper vein
blood filling the tube very slowly
Bevel Partially into the Vein
blood filling the tube very ___
slowly
Bevel Partially into the Vein
bevel partly through the ___
upper vein wall
bevel partly through the upper vein wall
Bevel Partially into the Vein
how to correct bevel partially into the vein
gently push the needle forward into the vein
Bevel Partially into the Vein
remember to:
partial needle insertion can cause
blood to leak into the tissue and form hematoma
partial needle insertion can cause
blood to leak into the tissue and form hematoma
bevel partially into the vein
Vein not anchored well may roll slightly
Needle Beside the Vein
how to correct Needle Beside the Vein
● disengage the tube to preserve the vacuum
● withdraw the needle slightly
● anchor the vein, redirect the needle into the vein, and reengage the tube
● Do not move the needle in a lateral (sideways) direction
Undetermined Needle Position
● remove the tube from the holder needle
● withdraw the needle until the bevel is just under the skin
● palpate the arm above the needle entry site
○ not too close to the needle (painful)
● relocate the vein, anchor, then redirect the needle into it
first step in Undetermined Needle Position
remove the tube from the holder needle
Undetermined Needle Position
last step
relocate the vein, anchor, then redirect the needle into it
Collapsed Vein
● Causes
○ Too much vacuum on small veins
○ Excessive pulling of the plunger walls draw together
temporarily, shutting
off the blood flow
○ Tourniquet is tied too tightly
○ Tourniquet is removed during the draw
collapsed vein
collapse more
easily
elderly patients (fragile veins)
clue that a vein has collapsed?
vein disappears as soon as the tube is engaged
or when the tourniquet is removed
clue that a vein has collapsed?
○ vein disappears as soon as the tube is ____
engaged or when the tourniquet is removed
Tubes can lose vacuum:
○ during shipping and handling
○ if pushed too far onto the needle prior to venipuncture
TUBE VACUUM
failed to establish blood flow during a draw?
-reposition the needle
-if this doesn’t help, try using a new tube
NEEDLE POSITIONS:
Correct Needle Position:
Needle Not Inserted Far Enough
Bevel Partially out of the Skin
Bevel Partially into the Vein
Needle Beside the Vein
Undetermined Needle Position
