My Nursing Education

Phlebotomy Career Training 2009 August
28050 Ford Road,,Garden City, MI 48135
(313) 575-1214
By Nancy Kimmel RN, PhD, CHMM

Though you would never draw in a leg, this is what cellulitis looks like.

Assessing the skin; Where not to draw, when to ask a nurse
1. Never draw from the paralyzed side of a patient. (reasoning: the blood flow is less, so is muscle tone. There is also decreased venous flow and hence the veins are not as spongy and springy.
2. Never draw from an arm that has been bandaged. (reasoning: you are not aware of what the nature of the bandage represents, it could be cellulitis, and by drawing from that area you could cause systemic blood infection or septicemia .
3. Never draw from a site where you notice swelling, redness, purulent drainage, or it is warm to the touch. (reasoning: these signs indicate an active infection process, and drawing from this site could cause a systemic blood infection)
4. Never draw from the side of a patient who has had a mastectomy. (reasoning: the lymph glands have been removed and blood flow is reduced to the area. It is also possible to cause a lymphatic infection or cause a thrombosis (blood clot). If a patient has had a bilateral mastectomy, then you must consult the nurse to get permission to draw from a distal site.)
5. Never draw from a limb that looks blue or is very cold, without first identifying why the limb is in this state and making an attempt to warm the patient, (offer blanket, turn up the heat in the room).
6. Never draw from a combative person without assistance of someone to hold the arm. (protect yourself)
7. Never draw from a person who is vomiting, emotionally distraught, or is on a bed pan, (attempt to calm the patient, ask for help and wait until the patient has finished toileting)
8. Never draw a patient or ask to draw a patient if they are in the middle of eating. (nourishment is life and health, and patient’s need to eat. Give them their time and privacy.)
9. Never draw a patient when they are in conference with a doctor. If however the nurse is in the room, it is o.k. to approach and interrupt politely, asking permission to draw.)
10. Never draw on the side of a patient that has had an angioplasty. ( surgeons go in from the femoral artery)