I’ve been accused of having them by phlebotomists for years and if the phlebotomists think it’s a pain, the should try being on the other end of the needle. Today when I came home from a doctor’s visit I decided to take my bruised and aching arms, look it up and see exactly what it is, why it happens and what I can do about it.
Well, what I found is that some people don’t even believe there is such a thing as rolling veins. Many believe that “rolling veins” are really just 'bad phlebotomists". Does anybody have the straight dope on rolling veins?
I have been told the same thing by more than 1 person - that I have rolling veins. I just took it to mean that for some reason it’s hard to get blood from me. Maybe it’s the veins are narrow which could be true for me because my arms are very skinny.
It’s a vein that moves usually from side to side. They are usually in the hand.
But don’t all veins roll around? I’ve never seen anybody whose veins remain static when walking or writing.
Plus the bloodsu. . . um, phlebotomist mentioned my rolling veins after sticking me in my inner elbows (after she tried the first hand but before the second hand.)
Well…my veins don’t move around much, even if I try to. And on a hot day like today, they are pretty prominent.
Some people do have veins that will roll to one side or the other if you attempt a venipuncture straight on from the top. There are, however, techniques that can be used to minimize it, and I personally don’t find it to be a problem (of course I’m rarely the one being poked 
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St. Urho
Paramedic
Rolling veins can be anywhere in the body, and are generally veins that are not as thoroughly anchored to the surrounding subcutaneous tissue. To really understand what it means, it helps to know how a blood draw or catheter placement on a non-rolly vein goes. You prep your site, position your needle, and push through the skin and then the wall of the vein. With a rolling vein, you push through the skin, but then when your needle hits the vein wall, the vein moves away instead of laying there quietly and letting you pierce it. Then you play an invigorating game of Chase the Vein, which is frustrating and stressful for everybody involved. I generally try twice to find the vein by luck before pulling out, then stabilizing the vein with a finger and approaching the vein from the opposite side.
Some people are consistently easy to stick, and some are consistently difficult to stick. Sure, phebotomists vary in their abilities, and an “ace” can often get a vein that eludes some of his colleagues, but to say “bad phlebotomists” are the ONLY factor involved is blithely ignoring reality.
So, my veins are the special, smart ones that run away from sharp pointy things.
And I wasn’t trying to bad mouth all the bloodsu. . um, phlebotomists out there. I really was trying to find a way to make it easier on the both of us the next time I need blood drawn. Half the sites I stumbled upon noted that “rolling veins” were just veins and a skilled person should have no problem drawing blood from them. These sites not medical sites but patient advocate-type sites. That’s why I came here for the real deal.
I always warn a phlebotomist that I’ve got rolling veins, so they can cut out the Chase the Vein portion of the proceedings and go straight to the special tricks for rolling veins. Really, that simple step can save you a whole lot of poking, prodding, and digging around. The fruitless digging around is what hurts so badly and causes so much bruising.
I venepuncture and cannulate daily as part of my job, and I’m good at it- I’m the one they come to when there’s an IVDU or a hypotensive 90 year old on the ward. Normally get it in two tries.
Now, a lot of people with “bad veins” simply have bad phebotomists, this is unquestionably true. I’ve had too many people with veins like stovepipes tell me that people usually struggle with them to claim otherwise.
However, the true rolling vein exists. It has two nefarious properties that can in isolation make a patient tricky to cannulate- the first is that the vein appears to have no tethering whatsoever to the skin around it and moves completely freely, whereas most people’s connective tissue tends to hold the veins more or less in place. The second quality is a bouncy, needle repelling vein wall. I’ve only ever had two patients with what I would call rolling veins- both were west asian, though I don’t know if that’s a coincidence or not.
I am an excellent phlebotomist. Here’s how you spot a bad one.
A good phlebotomist will “bounce” the vein- unless your vein is extremely prominent, actually just looking at it is not good enough to assess its quality for cannulation. A bad phlebotomist will see a vein and just go for it without further preparation.
I donated blood last Thurs. The dude doing the prep work fooled around, checking both arms, kept peering at one vein. Seemed dubious as to whether he could make a decent stick. I told him I’d never had any “real” trouble donating before. He said, “your rolling vein is troublesome”. He got it on the first try, though. Gonna tell me not to come back?
My phebotomists always compliment me on what a nice draw I am.
In 1961 at an ARMY induction center we had a skinny Hispanic kid in our group. He must have had really unconnected veins, they were those big obvious type. Also they must have been made of super antistick walls.
There were 4 different guys trying to stick him, not all at once, and they were making a pincushion out of him. Now these guys were probably doing hundreds of ‘sticks’ a day for a long time, so I am thinking they were pretty experienced. When I was through that room, they were still stabbing the poor kid.
Later the rumor was that they finally got it done but they put the kid back a day in processing so he could recover.
Every time I get some blood work, even though it has been over 50 years now, I still think about that incident. I am a hard stick for different reasons which I tell up front but still, it is quite easy for me to tell the ‘good sticks’ from the average ones.
I think there is a bit of art to it.
I suppose zombie veins have little blood in them. 
I too have difficult veins (plus I have scar tissue from excema on my inner elbows), and I too always warn the phlebs about it. Some just laugh and think they’re better than my hide-y veins, and I endure several minutes of exploratory inaccurate puncturing. There are good ones who get it the first time.
Tip: drink lots of water 30 minutes before your appt. It might help some in making your veins fuller; but I guarantee if you are at all dehydrated it makes it a lot harder. That’s why I have such a problem with a colonoscopy, where you can’t even drink water for the last 4 hours. It took them 20 minutes to find a place to give me the sedative or whatever it was.
Roddy