Page 14 - THE FIRST DAY OF PHLEBOTOMY FREE

Page 12 of 15

pen that does not bleed. Always label your tubes after you have obtained the
specimen. Never pre-label.
17) Place labeled tubes inside the biohazards transport bag.
18) Before leaving, check the venipuncture site. If it is still bleeding, apply pressure for
another 2 minutes. If after this time, it is still bleeding, continue to apply pressure for
another 3 minutes. If bleeding persists after a total of 8 minutes of applying pressure,
call for help.
19) At any point when the bleeding stops, an adhesive bandage is applied over a folded
gauze square. Clean up everything and dispose of waste properly.
23) In an in-patient facility leave the patient’s call light within his/her reach.
24) Remove the gloves, wash your hands, say good-bye to the patient and inform him/her
that his/her physician will deliver the results.

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.

This document is property of Career Employment Consultants, LLC. It cannot be reproduced, transmitted, or copied for any reason without the written
consent from Career Employment Consultants, LLC