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RWalsh
blood draws from axillary vein

Do any of your facilities draw blood from areas above the AC?  We have had some blood draws being done in the upper arm veins and even as high as the axillary vein.  This doesn't seem right to me.  Just wondering what you are all seeing in your facilities.

lynncrni
Are they using ultrasound to

Are they using ultrasound to locate and access these veins? If not, then I do not see how they are possibly sticking the basilic, brachial or axillary veins as these are deep veins, meaning they are located under the muscle. The basilic is a superficial vein in the forearm, then becomes a deep vein slightly above the AC. The cephalic is a superficial vein from its origin just above the thumb to the shoulder. To actually enter the axillary vein, you would have to make a puncture in the outer chest wall as this vein begins at about the lateral edge of the chest. Is this what is actually happening? Lynn

Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

RWalsh
Yes, I am seeing some

Yes, I am seeing some phlebotomist go right up near the axilla.  They go in other veins as well in the upper arm, some men have very superficial veins that they are sticking.  They do not use ulrtasound.

lynncrni
Well this means that they are

Well this means that they are not actually puncturing the axillary vein. They are sticking superficial veins near the axilla but this is not the same as the axillary vein. Obviously the wet skin of the axilla is not the best place for a puncture due to the larger number and type of organisms located there. This could be a matter of the need for more training on how to correctly palpate for veins. A few months ago, I needed an IV for a procedure. The RN stated many things that I knew were wrong. So I started to teach him how to do it correctly. He was not using gloves because he said he could not palpate with them on. I taught him how to properly use the same finger of the same hand all the time, how to press downward and what a healthy vein actually feels like. I think many times untrained people will look for "blue lines", don't see anything and think there are no veins. This is simply not true. The best veins can be palpated rather than seen. This RN said he had never been taught any of what I was telling him. If these patients are truly ones without any peripheral veins by palpation, you may need to consider use of infrared technology to assist with vein location in these patients. Lynn

Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

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