How to succeed with a difficult veinipuncture?

Answer:
Success depends on experience, which produces skill. Try getting help from a skilled Med. Tech, Nurse or doctor. They can check to make sure your basic procedure is ok. Knowing the basic structure of the veins also helps, though an individuals anatomy may be slightly different than the textbook. Practice using a 7cc syringe, and 12/14 gauge on an orange, and learn to feel the different textures with your fingers, as you pierce the outer skin, then into the rind, then into the core. Depending on what lab tests are ordered, you can sometimes use a smaller gauge needle. Most hospitals/labs have a three-stick rule for the protection of the patient. At that time you pass the patient to someone higher up on the venipuncture line. No matter how skilled you are, everyone has off days, and there are some patients whose anatomy will require the doctor to determine whether the requested labwork is worth the increased procedural risk of an art. line, or other order.

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I used to work as a pediatric nurse. Not only would our patients' veins be small to begin with AND they were never happy to be in the hospital and subjected to all kinds of traumatizing and scary procedures, but often they came in dehydrated! Triple whammie.

Like most nurses, I had my favorite vein sites to try. But I think the most important thing to remember is try the largest vein that you can see easily, take a deep breath, and go slowly. :)

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