Question

Northwest Health Care is short-staffed today, and MA Lyza is feeling pressed for time. She has many tasks to complete, but first she must perform a venipuncture. She greets the patient, Wayne Young, in a halfhearted manner, discouraging time-wasting conversation. Although Wayne appears apprehensive, he is not resistant, so Lyza quickly assembles the necessary supplies, applies the tourniquet, and inserts the needle. While she is drawing his blood, Wayne faints.

• What should Lyza do now?
• What could Lyza have done to prevent this situation from occurring?
• In the future, what are some steps Lyza can take to provide a positive experience for venipuncture patients?

Answer 1

1.

Lyza should release the tourniquette, dispose the sharp in the safety box (since sharps may create more accidental hazards) and make him lie down or lower his head and arms to promote blood supply to the brain. Apply pressure to the site and ask for help. Do not leave the patient's side.

2.

Lyza could have asked the patient whether he has had previous experience of fainting during venipuncture. She could have made him lie down or gave him a more reclining position if in an armchair. She could have maintained a good conversation with the patient to divert him from the procedure which would have made him less apprehensive. Document the incident mentioning what had happened, any injuries reported, what was done immediately, and instructions given to the patient.

3.

• Identify patient's who are having history of fainting episodes during venipuncture.
• Reduce prolonged waiting times.
• Encourage patients to be well hydrated.
• Have the patient lie down or use a comfortable reclining chair with arm rests.
• Maintain a comfortable temperature in the collection area.
• If possible instruct the patient regarding applied tension techniques (it helps in raising blood d pressure by tightening skeletal muscles) like crossing over of the legs and stiffen their muscles for atleast 30 secs.