Tips to make sample collection for blood testing easy

Dr Th Dhabali Singh MD
Many routine diagnostic tests require a blood sample. Common, as it is, this brief procedure is the thing that causes the greatest apprehension among people getting lab tests performed.
There are two main sources of this apprehension: 1) the physical one, enduring a needle stick and 2) the emotional one, seeing your blood being removed.
For most people, blood draws are not a problem, just a minor inconvenience. Others feel anxious and need some strategies to help them through the procedure. For a much smaller number of individuals, the physical condition of the veins makes the procedure harder, because their veins are sore from the IV therapy, scarred from frequent venipunctures, or just hard to find and use.
The whole blood needed for a diagnostic test is fairly easy to obtain via a procedure called venepuncture, a term which means, quite simply, “puncturing the vein”. The person performing this procedure is called a phlebotomist.
During the venipuncture, the phlebotomist inserts a needle through the skin into a vein. The amount of blood needed for the test is withdrawn through the needle into a special tube or tubes. The tubes are sent to the laboratory where the blood is analysed as the healthcare practitioner has ordered. Most often, the phlebotomist is able to identify a vein in the crook of your elbow that will easily be accessible and then applies a tourniquet above the site to make the veins more apparent. Making a fist when you are asked to helps make the vein more prominent. The procedure usually takes less than three minutes. Afterwards, the patient is asked to apply gentle pressure over a clean dressing to help the blood clot and prevent swelling and a haematoma.
When the needle is inserted under the skin, you might feel a slight sting, and there may be additional discomfort when it is withdrawn. If you’re accompanying a child or an anxious patient, it helps to explain that he or she will feel momentary pain or discomfort. It’s no use saying, “It won’t hurt” because the patient then will have the reason to mistrust people and situation when it does sting. Be honest, create a reasonable expectation, and you will really help the patient.
Being well-hydrated help blood flow better and makes the veins more likely to raise up and be easily found. Hence, it makes sense to drink plenty of water or fluids a day or two before the test. However, it is necessary to follow the healthcare provider’s instructions – some tests require that you do not need to drink certain fluids prior to the test. You may also want to take a walk while waiting, or on your way to the test, which raises the blood pressure and can make veins more prominent (routinely doing hand exercises also helps those requiring frequent testing). Even eating well the day before, if fasting is not required, improves blood flow.
When the skin is dry, it makes it more difficult for the venipuncture. Applying a moisturiser from the hand to the elbow (or wherever you expect the skin will be punctured) can make the puncture less painful. Lotions work best when applied just after the skin has been wet, for example after bathing, showering, swimming, etc.
Being warm increases your blood circulation, which makes it easier for the phlebotomist to find a vein. While you are waiting, you may want to leave your coat or sweater on and let your arm dangle down to increase the blood pressure in veins. If your blood is difficult to draw, lying down and warming your hands under a heating pad and blanket usually provide good results.
There are people, especially young children who become extremely anxious before a blood test. They also do not like the sight of the blood being drawn away from their veins. The nervousness sometimes make then sick and light-headed. Looking away while the needle is being inserted may help one from becoming anxious.
If the phlebotomist stick the patient twice with the needle but does not succeed in reaching the vein, another phlebotomist may step in to complete the procedure. This keeps both the patient and the technician from becoming flustered and should be seen as a reassuring step. Even after one unsuccessful attempt, if you feel unsure about the phlebotomist, it is okay to ask for someone else to handle the second attempt.
Most diagnostic tests require a small amount of blood only. However, a simple blood collection procedure can be a traumatic experience for a few people. The patient as well as the phlebotomist will need to cooperate in order that the procedure does not become an ordeal.
The writer is Senior Consultant Pathologist & Managing Director, BABINA Diagnostics, Imphal