VENIPUNCTURE:

P AT I E N T A N D T E C H N I C A L
C O M P L I C AT I O N S

B Y : R O L A I N E A N N A Ñ O Z A - P O L O , R M T, M P H
PATIENT COMPLICATIONS
1. Apprehensive patients
2. Fainting (Syncope)
3. Seizures
4. Petechiae
5. Allergies
6. Vomiting
7. Additional patient observations
8. Patient refusal
APPREHENSIVE PATIENTS

Enlisting the help of the

nurse who has been
caring for the patient may
help to calm the person’s
fears.
 FAINTING (SYNCOPE)
- the spontaneous loss of consciousness caused
by insufficient blood flow to the brain
- Keeping their minds off the procedure
through conversation can be helpful.
- If a patient begins to faint during the
procedure, immediately remove the
tourniquet and needle, and apply pressure to
the venipuncture site.
- In the inpatient setting, notify the nursing
station as soon as possible.
SEIZURES
- If this situation occurs, the tourniquet and
needle should be removed, pressure applied
to the site.
- Restrain the patient only to the extent that
injury is prevented. Do not
attempt to place anything in the patient’s
mouth.
- Document the time the seizure started and
stopped according to institutional policy.
 PETECHIAE
- Are small, nonraised red hemorrhagic
spots
- Maybe associated with prolonged
bleeding following venipuncture
- can be an indication of a coagulation
disorder, such as a low platelet count or
abnormal platelet function
- Additional pressure should be applied to
the puncture site following needle
removal.
ALLERGIES

- Necessary precautions
must be observed by using
alternate antiseptics, paper
tape or self-adhering wrap
(Coban), and nonlatex
products.
 VOMITING
• If the patient vomits, stop the blood
collection and provide the patient with
an emesis basin or wastebasket and
tissues.
• instruct the patient to breathe deeply
and slowly and apply cold compresses
to the patient’s forehead.
• Notify the patient’s nurse or
designated firstaid personnel.
ADDITIONAL PATIENT OBSERVATIONS

• Such changes could include the

presence of vomitus, urine, or feces;
infiltrated or removed IV fluid lines;
extreme breathing difficulty; and
possibly a patient who has expired.
PATIENT REFUSAL
NOTE:They (Patients) have the right to
do this!
BUT…
• The phlebotomist can stress to the patient
that the results are needed by the health-care
provider for treatment
• The phlebotomist may discuss the problem with the nurse, who may be able to
convince the patient to agree to have the test performed.
If the patient continues to refuse, this decision should be written on the requisition form
and the form should be left at the nursing station or the area stated in the institution
policy.
TECHNICAL COMPLICATIONS

1. Failure to obtain blood

2. Collection Attempts
3. Nerve Injury
4. Iatrogenic Anemia
5. Hemolyzed samples
FAILURE TO OBTAIN BLOOD

A. Needle Position
B. Bevel Against the Wall of the Vein
C. Needle Too Shallow
D. Collapsed Vein
E. Needle Beside the Vein
F. Faulty Evacuated Tube
 COLLECTION ATTEMPTS
• When blood is not obtained from
the initial venipuncture, the
phlebotomist should select
another site, either in the other
arm or below the previous site,
and repeat the procedure using
a new needle.
• A phlebotomist must do TWO
(2) VENIPUNCTURE ATTEMPTS
only on a patient.
 NERVE INJURY
Temporary or permanent nerve damage
may result in loss of movement to
the arm or hand and the possibility
of a lawsuit.
Most common nerve damage:
median antebrachial cutaneous nerve

- treated with a cold ice pack initially and

then warm compresses to the area
- Document the incident and direct the patient
to medical evaluation if indicated, according to
facility policy.
IATROGENIC ANEMIA

• a condition of blood loss caused

by treatment
• can occur when large amounts of
blood are removed for testing at
one time or over a period of time
• Dangerous for infants and the
elderly
 HEMOLYZED SAMPLES
• detected by the presence of pink or red plasma or serum
• Rupture of the red blood cell membrane releases cellular contents
into the serum or plasma and produces interference with many
test results