Phlebotomist / Lab Technician

Phlebotomist / Lab Technician

Sr. Lab Guy

20 Years Experience

San Bernardino, CA

Male, 52

For 6 years I was a Laboratory Technician in the Air Force Reserves, working all aspects of the laboratory as well as accomplishing "blood draws" (phlebotomy) in every imaginable setting (inpatient and outpatient).  I have also worked in the private sector for hospitals, doctor offices, and clinical lab sites.  This was my primary field for 20 total years (which began with the Air Force training).  I've been in a new career for ten years, though I recall virtually all of my lab science.

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Last Answer on November 02, 2018

Best Rated

how come when I do a venipuncture in the antecubital area and I don't get in the vein (chubby arm/deeper veins), that I can no longer feel the vein to redirect? what do you do in that scenario?

Asked by alicia over 8 years ago

Hi Alicia,

Your question is a perennial scenario for phlebotomists.  Over the years, I finally realized that the secret to "redirecting" the needle during venipuncture in an especially well-endowed arm is to be proactive BEFORE that needle even touches the skin.  By this I mean, have the patient make a fist around a large object, one that fits the relative size of their hand.  In the past, I've had patients use everything from a few hand towels to a few large (unused, needle-less) syringes.  This creates, in effect, a larger fist, one that can exert more pressure per square inch than just a hand without this assist.  Then, and this next part you need to be careful about (I'll explain that in a moment), you tell the patient that the tourniquet is going to be "really tight" so that you can "see" the vein better.  Now tie that tourniquet tight, tighter than usual.  But not so tight as to cut off arterial circulation (which by the way is actually fairly hard to do at the antecubital site - but not impossible).  Have them open their hand momentarily to check for circulation.  You should be able to see blood flow returning to the palm of the hand (turns white to red).  You can also feel for a radial pulse if necessary.  Finally, have them make a tight fist again around the aforementioned object, and then have them make their arm as straight as possible.  You should easily be able to feel a vein.  Note:  I realize your question asks what to do DURING a difficult draw.  My answer would be to ask a fellow phlebotomist or a nurse to re-tie the tourniquet tighter, feel for the vein above the entry site, and carefully redirect.  If that's not possible, you'll need to withdraw the needle and try again, preferably at a different vein.  Some text books will tell you that tourniquets that are too tight can cause hemolysis in the tubes, and also cause invalid electrolyte levels.  I have to say, for the short period the tourniquet is in place, not once did I find this to be true.  A tourniquet, tight or otherwise, left in place TOO LONG, will cause the above.  I have seen that.  But not for short periods.  Hope this helps.  Best of luck to you.

2. Blood fills the stopper end of the tube first.

Asked by Samir over 8 years ago

Samir, this sounds like a very slow blood draw when using a multi-sample system (such as the BD Eclipse blood collection system).  Most commonly this is caused by the tip of the needle not sitting well inside the vein.  I'm going to presume that the tourniquet is tight enough (if it isn't, a fellow phlebotomist or a nurse can re-tighten it for you).  You should gently and ever so slowly withdraw the needle a bit to allow better blood flow and if that doesn't work, ever so slowly push the needle in a tiny bit farther.  Both of these methods are best done while, with your free hand, carefully pulling down on the skin (using your thumb) below the site, to help stabilize the vein.  If that doesn't work, you can try redirecting the needle with caution.  The risk here is the same as any "slow draw" incident:  hemolysis and even blood clotting in the tube or needle before the draw is complete.

I'm prescribed vyvanse for adhd, can a hair test show if I took more than the prescribed dose in one day? Some days I don't take it at all some days I take more than my prescribed dose.

Asked by Capnltrain over 7 years ago

Hi thanks for your question, Quantitative analysis, or "How much"" of a substance, is usually done on blood samples in a regular laboratory. Forensic labs may be able to quantify other samples but I don't know if that includes hair. You could Google a forensic lab or your local coroners office for more info if you like.

My family tends to get false low platelet and wbc counts. I was told by a friend that there is a special tube or procedure that they do while drawing blood that prevents any false low readings but could not recall what exactly it was. Do you know?

Asked by Sally over 7 years ago

Hi thank you for your question. This sounds like the patient may have an underlying condition that is contributing to falsely low WBC and platelet levels. Since I am not a physician I really couldn't say what those conditions are. There are ways to separate cells in the blood outside of the body. A process called "phoresis" is one I've heard of. But for a very good answer to your question call a local hospital, ask for the lab, then ask for a "Lab Tech". They could help you with this question better than I.

I want to be a lab tech, but I have to take a phlebotomy coarse. The trouble is giving blood or doing blood work makes me nauseous. Do you think this will be an issue?

Asked by Ryab almost 7 years ago

Hi Ryab,  Well, to be honest, it could be a problem.  We had a gentleman in my military class that would sweat profusely and faint during the "first trials".  He eventually was pulled from the class and reassigned.  It's possible on the civilian side you could ask for counseling, but I'm guessing at best.  To my knowledge, most lab techs have to be phlebotomy certified.  Check with your program to see what your options are.  Good luck in your endeavors!

Hello can u tell me how fasting for Ramadan (no food or liquids for 16 hours) affect my blood work test if at all. And how soon after finishing the fast (i.e. 2 weeks after resuming a regular diet) will it go back to normal. Looking for results for:
•. CBC
· GLYCEMIA
· UREA
· CREATININE
· TGO
· TGP
· TP
· TPT
· HIV
· HBSAG
· HVC
· BHCG
· EXAMINATION OF URINE
· BLOOD TYPE
Also is there anything I can do while fasting to maintain health levels let me know as we eat a pre-dawn meal and eat after 8pm-4am
Thanks

Asked by Umm Habeebah about 8 years ago

Hi Umm,  Sorry it took so long to answer your question, I had a family emergency near the beginning of the year.  Ok, the short answer:  a physician would be the one to ask this question because the over all answer would likely depend on your situation, activity levels, age, history, etc.  The longer answer I will give is a generalization that could apply to anybody.  Most of the tests you listed (except for "glycemia" - perhaps you meant glycohemoglobin?) would not be affected by a 16 hour fast from food and drink.  In general, though, if you were severely dehydrated it is possible that your CBC could show a falsely elevated hemoglobin, meaning that if you are anemic, it could show that you are normal (as one example).  Your urine could possibly show a higher myoglobin (if I remember correctly), meaning you are dehydrated.  Overall, a 16 hour fast shouldn't affect lab results negatively.  As for questions about your health during and after the fast, you would have to consult with a physician.

Hello, I have a question about UA results

Asked by Justin over 7 years ago

Hi Justin. Go ahead and ask away. I'll do my best.