Page 15 - PHLEBOTOMY STUDY GUIDE

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FAILURE TO OBTAIN BLOOD (Trouble Shooting)
Most venipunctures are routine, but in some instances, complications can arise
resulting in failure to obtain blood. At most facilities, a phlebotomist has 2 attempts
to obtain blood from a patient. If you miss twice ask for assistance.
Possible causes for:
The tube has lost its vacuum. This is maybe due to:
o A manufacturing defect
o Expired tube
o A very fine crack in the tube

Improperly positioned needle. In many instances, a slight movement of the
needle can correct this.
o The bevel of the needle is resting against the wall of the vein. Slightly
rotate the needle, making sure the bevel of the needle is still facing
upward.
o The needle is not fully in the vein (Slowly advance the needle.)The
needle has passed through the vein. (Slowly pull back the needle.)
o The vein was missed completely. With a gloved finger, gently
determine the positions of the vein and the needle, and redirect the

needle. Never move the needle from side to side you may strike a
nerve, the movement from side to side is called “FISHING” A skilled
phlebotomist does not FISH!

Collapsed vein. This may be due to excessive pull from the vacuum tube; the
use of a smaller vacuum tube may remedy the situation. If it does not, remove
the tourniquet, withdraw the needle, and select another vein preferably using
either a syringe or butterfly.

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