Phlebotomy is the process of inserting a needle into a vein to withdraw a blood sample. Phlebotomy is frequently performed in hospitals and doctors' offices for a variety of blood tests. Each facility has their own policies and procedures to ensure that phlebotomy procedures are performed as safely and correctly as possible. Even under the best of circumstances, it is possible for patients to experience complications after a phlebotomy procedure.
Hematoma
According to "Clinical Hematology: Theory and Procedures" by Mary Louise Turgeon, the most common complication experienced by patients after a phlebotomy procedure is performed is a hematoma. A hematoma is a bruise, and occurs when blood leaks out of a damaged vein. In order to help prevent a hematoma from occurring, the nurse or phlebotomist should carefully perform the venipuncture, making sure to only go through the top wall of the vein and not all the way through the vein. It also helps to remove the tourniquet from the patient's arm prior to removing the needle from the vein.
Nerve Injury
Nerve injury occurs most often when blood is drawn from antecubital veins or veins in the bend of the arm on the inside of the elbow. Researchers writing in a 2007 edition of the "Journal of Brachial Plexus and Peripheral Nerve Injury" noted that this type of injury is rare but can cause significant discomfort for patients. Nerve injury does not affect the function of the hand or arm, although the patient can experience shooting pains in the affected arm. To avoid hitting this nerve, deep needle sticks should be avoided.
Infection
Phlebotomy involves breaking the skin barrier, providing the opportunity for germs and other bacteria to enter the blood stream and tissue. Infection can occur if the skin is not cleaned properly with alcohol or any antibacterial cleansing agent recommended by the policy of the institution. Failure of the clinician to properly wash their hands and use gloves can also transfer bacteria which may lead to infection.
References
- University of Utah: Blood Collection
- Journal of Brachial Plexus and Peripheral Nerve Injury"; Lateral Antebrachial Cutaneous Nerve Injury Induced by Phlebotomy; S. Mansoor Rayegani and Arezoo Azadi; 2007
- "Clinical Hematology: Theory and Procedures"; Mary Louise Turgeon; 2005
