I’m one of the unlucky people with veins that are hard to stick. IV’s sometimes takes three or four tries by an experienced blood technician. A regular nurse could stick me ten times and never hit a vein. I even have trouble getting blood drawn unless it’s a really, really experienced blood tech.
My cousin was the same way. She developed ovarian cancer and got a pic port in her chest. That was the only way she could get chemo. But, they still wanted to draw blood from her arm because the blood drawn from the port wasn’t as clean. I’ve seen her take six or more sticks before they got blood.
Is there a medical reason the lucky ones have nice, juicy veins that are easy to stick?
I don’t think blood pressure has anything to do with it. People are just different. For some the veins are closer to the surface and more visible, for others the veins are deeper under muscle for instance. I know when I get blood drawn the tech sometimes has problems finding the vein, so I’d point out to them the exact spots where I’m usually poked. That usually leads to success in one poke.
Hi. I’ve been a lab tech for the last 10 years (holy shit 10 years?) and these are my reasons why:
Some people just have small veins that are hard to feel for and hard to get a needle into
Fatter people tend to have their veins buried deeper and are thus harder to find
Being dehydrated (and more people are more dehydrated than they realize) means that even if I get a needle in, the vein will just collapse a lot of the time
Chemo patients’ veins turn to rubber. Seriously, it’s like trying to poke through a tiny garden hose that wiggles around all higgely-piggely.
Older people’s collagen has collapsed meaning their veins flop all over and are hard to keep still when you’re poking them even if you’re anchoring them with your non needle hand.
Some people get nervous and jerk involuntarily making the job at least twice as hard.
The most important factor is number 1, but many people have multiple factors and some have almost all of the above making them extremely hard to get.
If get phlebotomized often and know what areas are better than others or which arm is better, PLEASE tell the tech.
Yeah, assuming the tech doesn’t take “I can be hard to stick, so I usually get a butterfly on the top of my hand” as a challenge. I’m diabetic, so I’m getting blood drawn for an A1C usually twice a year, at least, and I can’t count the number of times that explanation was met with “Oh, I’m sure I can get a good vein in your arm!” followed by five minutes of stick-pull-dig around-pull-dig around some more-pull out-stick in a new spot-rinse-repeat. And usually ending, after five minutes of annoyance and pain, with them using the damn butterfly on the top of my hand.
That cite had to do with with bodybuilders. For more typical people I don’t think there’s much correlation between the variations in blood pressure and the ease at which veins can be found for drawing blood. Show me a scientific cite that says otherwise. In my experience I’ve known people who have very prominent veins with normal bp and others who have high bp with barely visible veins. What Nunavut Boy posted sounds like the voice of experience and the definitive answer to me.
The worst time, I ended up with large bruises inside both elbows… for a week, I pretty much couldn’t do anything without mentally cursing the ancestry of the iron-shoe-wearing pseudo-blood-tech who’d got paid to treat me like a voodoo doll.
When they ignore us, do we have permission to stab them? I was at the hospital last week for a pre-op exam, and I told them that my right arm usually works best. Naturally, she dives into my left arm, only to find a dry well. :smack:
BP generally doesn’t matter. We have tourniquets to bring up peoples’ veins. The only time BP matters is if the patient is bleeding out or otherwise lost a lot of blood. In fact, there’s been a few times that during my morning rounds I am the one to discover that a patient in hospital for a minor routine thing has bled internally overnight due to fact that they are hard to rouse and their giant veins will not come up at all due to extremely low BP.
Re: techs not listening to the patient as to where to get blood. I always listen as there is very little downside. I can generally get blood on anyone and if someone prefers I stick them in a more painful location even when I think I can get it somewhere else, well, I don’t want to get in a pissing contest with them and they may just be right. People who routinely get their blood taken generally know where blood can be collected; on the other hand, we get a lot of people who come in with perfectly fine veins whose last blood collection was in 1986 and who are convinced that they are a hard stick due to a bad experience probably due to an inexperienced tech. It can be a judgement call, but like I said there is very little downside to doing like they want.
If I had had blood techs disregard me several times and it had hurt, I would say very calmly to the next, “Please draw the blood from [favored site or arm]. I have learned, unfortunately, that drawing it from anywhere else almost never works, and is very painful to me. If you will not draw from [favored site or arm], I would like to speak to your supervisor. I respectfully refuse to give my consent for you to draw from anywhere else.”
I have a really obvious juicy-loking vein in my left arm, and nothing visible in the right. I have never had a successful draw of even a vial out of that pretty left-arm vein - it rolls and jumps, and in the rare event of a stick it gives a little and peters out. The one in the right is a little hard to find, but it sticks smoothly and gives actual blood. Of course new techs want to try the left and bash the skills of previous techs who failed. I haven’t needed blood drawn in 5 years or so, and I’m hoping that now that I’m in my late 20s I’ll be able to keep my wits about me and insist on the right stick spot the next time it has to happen.
I draw blood on a occasional basis (once or twice a week) almost always on elderly patients. I ask them where previous blood draws have been successful, because I need all the help I can get! I have had my share of big, fat, pretty veins give a half a milliliter of blood and refuse to put out any more. I have woken up in the middle of the night thinking about the difficult blood draw I have scheduled for the next day, because I hate sticking my patients more than once. Really.
Tell me where others have gotten blood easily before, I promise I will listen. Also please be sure to drink an extra glass of water to be sure you aren’t dehydrated. Plump veins are happy veins (and happy nurses.)
I think the two reasons most applicable to most people are:
the more muscular someone’s arms are, the more the blood is needed by them (duh). So, with time, and repeated muscle use and demand for blood, the blood vessels gradually enlarge (hypertrophy), in the same way that the muscles hypertrophy.
when it’s hot, or more accurately, when a person is hot, their body tries to give off the excess heat. One way of doing so is by dilating the veins. That causes them to have more surface area and, thus, more area to give off heat. So, on a hot, sticky summer day, getting blood from most people is a breeze (and that’s why blood techs will sometimes wrap a warm, moist towel around the forearm of the person they’re trying to get blood from). Conversely, when someone’s cold, their veins constrict (and you know, it really is impossible to get blood from a frail, sedentary old person when you’re in a cold room!).
Question to the nurses, doctors and blood techs in this thread (who do listen anyway):
Do you think that would work?
Can you imagine why some techs, nurses etc. don’t want to listen? Is it power trip? Bad training leading to insecurity? Do you know other nurses or techs who you would consider less than competent or less willing to listen?
It should work, in general. As long as you’re not being a rude dick about it, telling me your left arm is better will simplify the process for both of us.
Sometimes, the patient doesn’t know better. The best place to stick a person, in general, is in the arm. A needle to the hand hurts more, is more likely to bruise, and the butterfly needle is harder to keep in place through the blood draw. So, someone who is scared of needles and asks for the butterfly because it’s a smaller needle - they may be asking out of ignorance and fear. Obviously, some people do need to be drawn from the hand, and people who have a lot of blood work done will know how to direct a phlebotomist. It’s sometimes hard to know which is which, unfortunately.
The real issue is when a tech tries to prove the patient wrong by going after an impossible vein. I’ve known a couple with a bad attitude who will try to do it their way first to prove a point, and that really pisses me off. That said, if a patient asks me for a butterfly to the hand, I will ask why, and I will ask if I am allowed to check their arms for good veins first, promising I will not stick unless I find a good vein there. I try to explain why I’m doing that, and I describe the process as I go, showing them how I’m looking for only the best veins. If they freak out, sure, I’ll get them in the hand with the butterfly, but I make sure they know it’s more likely to sting and they may bruise. I hate hearing “the tech was so bad, look at the big bruise on my hand”, because in general it’s almost impossible to avoid some bruising when you’re sticking a needle into that area.
Some places won’t go straight to the butterfly until the arms have been checked for good veins accessible by a straight needle, because butterflies are so much more expensive and also increase the risk of unacceptable draws due to the dead space in the tubing.
I even have trouble getting blood drawn unless it’s a really, really experienced blood tech.