Author: Wang Yanfang
Case sharing
Walking through the blood drawing window of the laboratory, it was found that some patients were pressing the blood collection point with their elbows bent, and some patients were straightening their elbows and pressing the blood collection point.
Walking in this crowded space, patients with elbows bent can avoid people coming and going, touching their arms that have just drawn blood, both gentlemanly and safe, and fewer and fewer patients in the crowd to straighten their elbows and press.
I don't know when it started, but elbow pressing became the norm.
Even medical staff, after taking blood from a patient, habitually help the patient curl up his arm.
Clinical blood collection procedure
At present, after the clinical blood collection is completed, the medical staff who collect the blood will let the patient do this:
1. Ask the patient to loosen his fist.
2. Cover the blood collection site with an infusion patch.
3. Press the vessel and the skin puncture point parallelly in the direction of the vessel for 3-5 minutes.
Patients with bleeding tendencies such as purpura, hematological disease, etc. are pressed for 5 to 10 minutes until no blood oozes.
4. The pressure is moderate, and there are three available compression methods: thumb pressing method (dry cotton swab pressing method), large fish inter-fish pressing method, and three-finger pressing method.
5. Pay attention to check the hemostasis and observe whether there are complications such as hematoma.
6. Within 30 minutes after the blood collection is completed, try not to do strenuous activities such as gripping, lifting, pushing, pulling, etc., to avoid mutations in the blood pressure of the venous system, resulting in re-bleeding.
Thumb and big fish interstitial compression, pressing time for a long time, its pressure is relatively weak, so that the force at the puncture site is reduced, even if the skin and blood vessel puncture point does not displace, it is easy to make bleeding or bleeding at the puncture point, so more and more clinical use of three-finger compression method.
So when the three fingers are pressed, is it an elbow extension or an elbow?
Literature findings
Because when the elbow is flexed, it hinders the return of the elbow veins, increases the intravascular pressure of the elbow veins, and the blood is more likely to ooze from the blood vessel needle eye, resulting in subcutaneous congestion or subcutaneous hematoma after venous blood collection.
The elbow is in an extended state, which can effectively reduce the pressure of the veins in the limb on the blood collection side.
Blood is not easy to ooze from the eye of the blood vessel needle, which reduces the occurrence of bleeding swelling and bruising at the puncture point, protects the integrity of the skin and blood vessels of the blood collection object, and reduces the pain and psychological pressure on the patient's body.
If the blood is pressed with improper compression after blood collection, it can easily lead to complications such as subcutaneous bleeding, blood stasis, pain, and even limited limb movement.
It can even affect the clarity of blood vessels, making it difficult for the next venipuncture, increasing patient pain, and resulting in an increase in the workload of medical staff.
In order to let more people say no to the elbow compression method, the author has specially created a schematic diagram of correct compression, demonstrating the method of converting from nurse compression to patient compression after completion of collection.
Share it with you, hoping to benefit patients!
Press the hemostasis quadrilogy
So what else does a small blood collection need to be told to the patient?
1. Blood collection cooperation
(1) Do not exercise strenuously, drink alcohol, exert exertion, stay up late, etc. the night before blood collection, so as not to affect the test results.
(2) When collecting blood, do not wear clothes with too small cuffs, which will hinder the collection of blood and will also cause swelling of the arm.
(3) When collecting blood in the vein, avoid being too nervous, and when puncturing, you must not dodge, otherwise it is easy to appear congestion, and even fail to collect blood.
(4) After the blood is drawn, be sure to follow the instructions of the nurse to do a good job of hemostasis measures to avoid congestion due to improper compression.
2. Diet before blood collection:
(1) Examination patients should follow the doctor's instructions to fast water, it is recommended that after 12 o'clock before blood collection, no longer eat (such as liver function, lipid test, etc. need to be fasting).
Not all blood tests require an empty stomach, so consult your doctor.
(2) Patients should not eat too greasy, high-protein foods, avoid drinking alcohol, etc. the day before the blood draw.
3. After blood collection, the common sense of pressing should be kept in mind
(1) Pressing requirements:
After the blood is drawn, local compressions at the puncture point are required for 5 - 10 minutes, do not rub, avoid causing subcutaneous hematomas, and if there is a tendency to bleed, the compression time should be gradually extended.
(2) Pressing technique:
Use the index, middle, and ring fingers of the 3 fingers side by side to press the skin needle eye and above it, without moving.
It is absolutely not advisable to bend the elbow and press!
Fourth, warm tips after blood collection
1. Please stand slowly after the blood is drawn and beware of falling (if you have a faint needle, inform the staff before taking blood).
2. If there is dizziness, dizziness, fatigue and other halo phenomena, immediately lie flat, drink some sugar water, and then leave after the symptoms are relieved.
3. Keep your hands clean and hygienic 24 hours after blood draw. Avoid puncture limbs to carry heavy objects, try not to bathe, and do not take a sauna.
4. Some people stop compressing when they see that there is no blood oozing from the epidermis, which will cause bruising due to subcutaneous bleeding, if bruising occurs, please apply warm compresses after 24 hours.
Blood collection operation, is a very common operation in the clinic, almost all patients who come to the hospital, to take blood tests, I hope this article, can give you or patients some help!
Source: Care time
Edit: Xiao Ran Reviewer: okay