# Why are some people's veins easy to stick and others nearly impossible? **URL:** \ **Category:** Factual Questions\ **Created:** [December 17, 2011, 2:59am UTC](https://boards.straightdope.com/t/why-are-some-peoples-veins-easy-to-stick-and-others-nearly-impossible/606495 "2011-12-17T02:59:58Z")\ **Posts on this page:** 13\ **Page:** 2
**Author:** ![WhyNot](https://avatars.discourse-cdn.com/v4/letter/w/c77e96/32.png) [@WhyNot](https://boards.straightdope.com/u/WhyNot)\ **Post date:** [December 18, 2011, 5:58pm UTC](https://boards.straightdope.com/t/why-are-some-peoples-veins-easy-to-stick-and-others-nearly-impossible/606495/21 "2011-12-18T17:58:11Z")
> [@Nunavut\_Boy](#): > > Hi. I’ve been a lab tech for the last 10 years (holy shit 10 years?) and these are my reasons why: > > 1. Some people just have small veins that are hard to feel for and hard to get a needle into > 2. Fatter people tend to have their veins buried deeper and are thus harder to find > 3. 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 > 4. Chemo patients’ veins turn to rubber. Seriously, it’s like trying to poke through a tiny garden hose that wiggles around all higgely-piggely. > 5. 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. > 6. 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. Excellent post! I’d add that some people like to go for the juicy looking vein, instead of \*feeling \*for a good vein. I have a lovely juicy \*looking \*vein in my left AC that’s utterly useless for actually drawing blood or holding an IV. There’s a ginormous strong valve just past the nice blue visible part, and it blocks the catheter every time. If people know what they’re doing, they feel it and notice the valve. If they’re new or ill-trained, they believe their eyes instead of their fingers. I’ll add the dirty little secret of nursing education: they don’t teach us blood draws or IV placement in school. They teach us \*about \*blood draws and IV placement, and they have a few plastic models in lab, but we are absolutely forbidden to draw blood on a patient, or even on another student, to learn the actual physical skill. That means that almost every nurse’s first blood draw is on a living, breathing patient. So you might think you’re a “hard stick” because you were, unknowingly, the very first or second person that nurse ever tried to stick. It’s absolutely ridiculous, in my opinion. Thank you, school liability lawyers. :rolleyes: > [@Nava](#): > > I tell, but they don’t believe me! ☹ This doesn’t excuse it, but perhaps it explains it…EVERYONE says they’re a “hard stick” with “bad veins”. Literally everyone I’ve ever handled, including the big bodybuilder with bulging veins I could toss a 16 gauge into from across the room, like a human dartboard. Unfortunately, all these chicken littles desensitize many techs and nurses, and we don’t believe you until we see it for ourselves. I’m trying hard not to fall into that trap, myself. > [@KarlGauss](#): > > 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). Ooh! _frantically scribbles down notes_ Makes sense, I’ll keep that trick in mind. Thanks! ---
**Author:** ![aux203](https://avatars.discourse-cdn.com/v4/letter/a/77aa72/32.png) [@aux203](https://boards.straightdope.com/u/aux203)\ **Post date:** [December 18, 2011, 6:02pm UTC](https://boards.straightdope.com/t/why-are-some-peoples-veins-easy-to-stick-and-others-nearly-impossible/606495/22 "2011-12-18T18:02:52Z")
> [@constanze](#): > > Question to the nurses, doctors and blood techs in this thread (who do listen anyway): > > 1. Do you think that would work? > > 2. 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? 1. Sure. They might think you’re a PITA if you phrase it that way but they’d probably do it. But that leads into point 2… 2. Most people will take a whatever tips they can get on a tough stick. However, if they don’t listen, it’s probably because most fo the time, they’re right and the patient is wrong. Mostly might mean only 70-80%, but it’s still high enough they rely on their own judgement over yours. There’s recall bias on both sides, I suspect. There’s also an absolutely huge variation in technical skill when it comes to this sort of thing. There are also some good reasons to try for the arm first, though that’s a whole discussion it and of itself. Arterial BP has nothing to do with the prominence of your veins. ---
**Author:** ![constanze](https://avatars.discourse-cdn.com/v4/letter/c/f9ae1b/32.png) [@constanze](https://boards.straightdope.com/u/constanze)\ **Post date:** [December 18, 2011, 6:04pm UTC](https://boards.straightdope.com/t/why-are-some-peoples-veins-easy-to-stick-and-others-nearly-impossible/606495/23 "2011-12-18T18:04:57Z")
> [@WhyNot](#): > > I’ll add the dirty little secret of nursing education: they don’t teach us blood draws or IV placement in school. They teach us \*about \*blood draws and IV placement, and they have a few plastic models in lab, but we are absolutely forbidden to draw blood on a patient, or even on another student, to learn the actual physical skill. That means that almost every nurse’s first blood draw is on a living, breathing patient. So you might think you’re a “hard stick” because you were, unknowingly, the very first or second person that nurse ever tried to stick. It’s absolutely ridiculous, in my opinion. Thank you, school liability lawyers. :rolleyes: That surprises me - I remember reading about people who volunteer for nursing and doctors schools so that people can learn exams and putting needles on living persons. It’s less risk/ trouble than pharma experiments, and earns a little money. Have these been discontinued due to liability? ---
**Author:** ![constanze](https://avatars.discourse-cdn.com/v4/letter/c/f9ae1b/32.png) [@constanze](https://boards.straightdope.com/u/constanze)\ **Post date:** [December 18, 2011, 6:06pm UTC](https://boards.straightdope.com/t/why-are-some-peoples-veins-easy-to-stick-and-others-nearly-impossible/606495/24 "2011-12-18T18:06:07Z")
> [@KarlGauss](#): > > 2 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!). I can see why many women with low blood pressure, sitting in an AC room, will then have small veins from being cold! ---
**Author:** ![Elendil\_s\_Heir](https://avatars.discourse-cdn.com/v4/letter/e/7cd45c/32.png) [@Elendil\_s\_Heir](https://boards.straightdope.com/u/Elendil_s_Heir)\ **Post date:** [December 18, 2011, 6:11pm UTC](https://boards.straightdope.com/t/why-are-some-peoples-veins-easy-to-stick-and-others-nearly-impossible/606495/25 "2011-12-18T18:11:14Z")
> [@Elendil\_s\_Heir](#): > > 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.” Emphasis added. I guess I should have added “and politely.” ---
**Author:** ![Nunavut\_Boy](https://avatars.discourse-cdn.com/v4/letter/n/e95f7d/32.png) [@Nunavut\_Boy](https://boards.straightdope.com/u/Nunavut_Boy)\ **Post date:** [December 18, 2011, 6:31pm UTC](https://boards.straightdope.com/t/why-are-some-peoples-veins-easy-to-stick-and-others-nearly-impossible/606495/26 "2011-12-18T18:31:47Z")
> [@constanze](#): > > That surprises me - I remember reading about people who volunteer for nursing and doctors schools so that people can learn exams and putting needles on living persons. It’s less risk/ trouble than pharma experiments, and earns a little money. > > Have these been discontinued due to liability? When I trained, we poked our classmates. I have also helped organize and supervise phlebotomy training sessions for first year medical students (who also poked their classmates) when I was in university. This was in Canada though, maybe things are different in the US ---
**Author:** ![Lynn\_Bodoni](https://avatars.discourse-cdn.com/v4/letter/l/e47c2d/32.png) [@Lynn\_Bodoni](https://boards.straightdope.com/u/Lynn_Bodoni)\ **Post date:** [December 18, 2011, 6:55pm UTC](https://boards.straightdope.com/t/why-are-some-peoples-veins-easy-to-stick-and-others-nearly-impossible/606495/27 "2011-12-18T18:55:30Z")
I’ve found that if I make sure to drink lots of water on the day before I go to the doctor, the inevitable stick is a lot easier. I’ve also gotten into the habit of telling the phlebotomist that there’s a very nice vein in my left elbow, but it’s deep, and s/he’s going to have to pull that tourniquet rather tight. It’s not that I ENJOY tight tourniquets, it’s just that I’d rather have the stick done as quickly and smoothly as possible. What I really hate is when the tech can’t get red, then pulls the needle out most of the way and sticks it in in another direction. ---
**Author:** ![WhyNot](https://avatars.discourse-cdn.com/v4/letter/w/c77e96/32.png) [@WhyNot](https://boards.straightdope.com/u/WhyNot)\ **Post date:** [December 18, 2011, 7:30pm UTC](https://boards.straightdope.com/t/why-are-some-peoples-veins-easy-to-stick-and-others-nearly-impossible/606495/28 "2011-12-18T19:30:44Z")
> [@constanze](#): > > That surprises me - I remember reading about people who volunteer for nursing and doctors schools so that people can learn exams and putting needles on living persons. It’s less risk/ trouble than pharma experiments, and earns a little money. > > Have these been discontinued due to liability? We were told by our instructors that it was a liability issue, yes. Whether they were telling me the truth, I couldn’t say. I’ve had four friends from different nursing schools - some two year programs, some four year programs - also report the same. So it seems widespread in my area, if not state, if not country. My friend in the RN/Midwifery program at UIC has volunteer “patients” to practice PAP smears and pelvic/cervical checks on, but they’re not allowed to do blood draws or IVs in that program, either. I assume, but don’t actually know, that \*phlebotomy \*students actually get some practice on real people who aren’t patients, but not nursing students. ETA: I know nursing students used to practice on each other with the knowledge and approval of their school, because veteran nurses have told me so. I don’t know when that ended, but I can narrow it down to sometime between 1990 and 2005, based on graduation dates. ---
**Author:** ![Ambivalid](https://avatars.discourse-cdn.com/v4/letter/a/a5b964/32.png) [@Ambivalid](https://boards.straightdope.com/u/Ambivalid)\ **Post date:** [December 18, 2011, 7:43pm UTC](https://boards.straightdope.com/t/why-are-some-peoples-veins-easy-to-stick-and-others-nearly-impossible/606495/29 "2011-12-18T19:43:01Z")
> [@nivlac](#): > > 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. > **[Redirect Notice](http://www.google.com/url?sa=t&rct=j&q=arterial%20blood%20pressure%20and%20vein%20prominence&source=web&cd=16&ved=0CE4QFjAFOAo&url=http%3A%2F%2Fwww.ehow.com%2Ffacts_5837863_meaning-prominent-blood-veins_.html&ei=vkDuTu7uA-jy0gHvnZSrCQ&usg=AFQjCNHhnWwiIkPlJum5fg2rr_l6SMsHkQ)** “According to Dr. Kirksey, prominent veins can have roots in heart problems such as heart failure and **high blood pressure**.”-quote from link (bolding mine) ---
**Author:** ![KarlGauss](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/karlgauss/32/3713_2.png) [@KarlGauss](https://boards.straightdope.com/u/KarlGauss)\ **Post date:** [December 18, 2011, 8:00pm UTC](https://boards.straightdope.com/t/why-are-some-peoples-veins-easy-to-stick-and-others-nearly-impossible/606495/30 "2011-12-18T20:00:44Z")
> [@Ambivalid](#): > > [Redirect Notice](http://www.google.com/url?sa=t&rct=j&q=arterial%20blood%20pressure%20and%20vein%20prominence&source=web&cd=16&ved=0CE4QFjAFOAo&url=http%3A%2F%2Fwww.ehow.com%2Ffacts_5837863_meaning-prominent-blood-veins_.html&ei=vkDuTu7uA-jy0gHvnZSrCQ&usg=AFQjCNHhnWwiIkPlJum5fg2rr_l6SMsHkQ) > > “According to Dr. Kirksey, prominent veins can have roots in heart problems such as heart failure and **high blood pressure**.”-quote from link (bolding mine) Actually, if you go to [the source of his quote](http://www.medhelp.org/posts/Peripheral-Arterial-Disease-PAD-/Prominent-Veins/show/595181), it states that _pulmonary hypertension_ may lead to distended veins. That is a very different entity than the usual hypertension we hear about so often and refers to high pressures within the blood vessels of the lungs (which may be transmitted out and back into the veins). There is no relationship between the ‘common’ hypertension (i.e. arterial or systemic hypertension) and distended veins. ---
**Author:** ![WhyNot](https://avatars.discourse-cdn.com/v4/letter/w/c77e96/32.png) [@WhyNot](https://boards.straightdope.com/u/WhyNot)\ **Post date:** [December 18, 2011, 8:06pm UTC](https://boards.straightdope.com/t/why-are-some-peoples-veins-easy-to-stick-and-others-nearly-impossible/606495/31 "2011-12-18T20:06:24Z")
> [@Ambivalid](#): > > [Redirect Notice](http://www.google.com/url?sa=t&rct=j&q=arterial%20blood%20pressure%20and%20vein%20prominence&source=web&cd=16&ved=0CE4QFjAFOAo&url=http%3A%2F%2Fwww.ehow.com%2Ffacts_5837863_meaning-prominent-blood-veins_.html&ei=vkDuTu7uA-jy0gHvnZSrCQ&usg=AFQjCNHhnWwiIkPlJum5fg2rr_l6SMsHkQ) > > “According to Dr. Kirksey, prominent veins can have roots in heart problems such as heart failure and **high blood pressure**.”-quote from link (bolding mine) Right, but there is little correlation between prominent veins and easy-to-stick veins. There is some, yeah. Bodybuilders, being comprised mainly of mesomorphs, tend to have both prominent and easy to stick veins. But plenty of old people with high blood pressure have prominent, easy to see but hard to stick “rolling” veins, or veins with lots of scarring or annoyingly placed valves. Low blood pressure is related to a hard stick in extreme situations like hemorrhage, but a BP of 110/70 instead of 160/90 isn’t going to make a difference. Hydration status makes much more of a difference. ---
**Author:** ![Digital\_is\_the\_new\_Analog](https://avatars.discourse-cdn.com/v4/letter/d/a88e4f/32.png) [@Digital\_is\_the\_new\_Analog](https://boards.straightdope.com/u/Digital_is_the_new_Analog)\ **Post date:** [December 18, 2011, 10:37pm UTC](https://boards.straightdope.com/t/why-are-some-peoples-veins-easy-to-stick-and-others-nearly-impossible/606495/32 "2011-12-18T22:37:57Z")
> [@WhyNot](#): > > I assume, but don’t actually know, that \*phlebotomy \*students actually get some practice on real people who aren’t patients, but not nursing students. When my sister took a course to become certified as a phlebotomist, they stuck each other. They did it enough to be decent at it, with the understanding that if they actually wanted to be GOOD they should spend some time working at a hospital doing phlebotomy. There’s nothing like experience. -D/a ---
**Author:** ![aux203](https://avatars.discourse-cdn.com/v4/letter/a/77aa72/32.png) [@aux203](https://boards.straightdope.com/u/aux203)\ **Post date:** [December 18, 2011, 11:13pm UTC](https://boards.straightdope.com/t/why-are-some-peoples-veins-easy-to-stick-and-others-nearly-impossible/606495/33 "2011-12-18T23:13:35Z")
> [@WhyNot](#): > > Right, but there is little correlation between prominent veins and easy-to-stick veins. There is some, yeah. Bodybuilders, being comprised mainly of mesomorphs, tend to have both prominent and easy to stick veins. But plenty of old people with high blood pressure have prominent, easy to see but hard to stick “rolling” veins, or veins with lots of scarring or annoyingly placed valves. > > Low blood pressure is related to a hard stick in extreme situations like hemorrhage, but a BP of 110/70 instead of 160/90 isn’t going to make a difference. Hydration status makes much more of a difference. To echo KarlGauss, the difference between a systolic of 110 or 160 isn’t going to mean jack as far as the prominence of your veins. Under normal conditions in a healthy person, the pressure of the arterial system is almost entirely dissipated as it crosses the high resistance capillary system. The veins have a high capacitance and will dialate in response to increased blood volume limiting changes in venous pressure. In the setting of blood loss you can maintain a normal blood pressure through vasoconstriction. Your veins will start to constrict long before your blood pressure drops significantly in a healthy young person. Venous distension as a result of increased venous pressure is generally associated with a significant disease state. It can be associated with primary pulmonary hypertension (extremely rare) or pulmonary hypertension due to various other cardiac and pulmonary conditions i.e COPD, CHF, etc. That’s not what anyone means when they use the terms high blood pressure or hypertension, however. Others can chime in but getting proficient at IVs and blood draws, to say nothing of expertise, takes dozens or even hundreds of reps. Considering how many people need to at least be minimally proficient in that skill, it’s not something easily accomodated by most training programs. They have other things to worry about. Just for the record, I’ll take skinny old woman veins over obese veins any day… [Previous page](https://boards.straightdope.com/t/why-are-some-peoples-veins-easy-to-stick-and-others-nearly-impossible/606495.md?page=1)