Case Study: When the Needle Moves

Phlebotomy Home

Phlebotomy students are very tentative when they first start performing their "live" draws. This student made two errors:
  1. After he inserted the needle into the vein, he failed to gently rest his hand, which was holding the Vacutainer-needle assembly, on the "patient's" arm to help hold the needle steady while in the vein. Trying to hold the assembly steady while in midair will lead to harm to the patient. 
  2. The second error occurred while attempting to change tubes. Since the student's hand was not resting on the arm of the patient, as the tube changes were made, the venipuncture area was sliced due to the movement of the needle. As a tube was pulled off, the needle wiggled back and forth in the outward direction, as he pushed the tube on, it wiggled back and forth going into the vein.

It is CRITICAL that the needle not move while performing a venipuncture. Gently rest your hand, which is holding the assembly, on the patient's arm. Grip the holder firmly while changing tubes. I personally have the holder in a death grip. Sometimes the rubber stopper of the tubes get "hung up" in the holder, and if you don't have a strong grip on the holder you will move the needle, either deeper into (and perhaps) through the vein, completely out of the vein, or will cause damage to the patient's arm as illustrated below. Your goal is that the needle not move at all when changing tubes using the Vacutainer system.

Last Update: December 12, 2000

Web Author: Terry Kotrla MT(ASCP)BB
Copyright 2000 by Terry Kotrla - All Rights Reserved