Complications during blood collection and Treatment
Complications during blood collection and Treatment
- There may be various types of complications of blood collection.
- Following are some of the possibilities:
Complications during blood collection:
Fainting during the collection of the blood:
- The patients feel dizziness, which may happen during or after blood collection.
- There is a sudden decrease in blood pressure, and sometimes the patient may temporarily lose consciousness.
- The reason is:
- This is due to vasovagal syncope.
- Please don’t leave the patient alone and don’t allow them to drive for another 30 minutes.
- Immediately lie down on the patient’s flat and raise the legs.
Hematoma:
- There is a leak of blood from the site of the venipuncture site.
- There may be a bruise formation.
- Hematoma forms when:
- The needle goes into the small vein.
- It may pass through the vein.
- The needle is partially in the vein.
- The needle was removed when the tourniquet was still there.
- Not adequate pressure was applied after the venipuncture.
- Blindly searching the vein.
- Apply the pressure bandage to the area.
- The patients on anticoagulant therapy:
- These patients have more chances of bleeding.
- These patients keep the pressure on the venipuncture site and don’t leave them until there is a complete stop of the bleeding.
- Allergies:
- There may be reactions to the antiseptic or band-aids or bandages or latex.
- If it happens, give some antiallergic medication.
Hypersensitivity Reaction:
- Some patients may develop Type I hypersensitivity reactions just seeing their own blood.
- The patient will have a typical picture of hypersensitivity reaction type 1.
- All symptoms are due to histamine or histamine-like substances produced in this hypersensitivity reaction.
- The patient may have an anaphylactic reaction, and this may be:
- Localized.
- Or a systemic reaction.
Infections:
- The infection is more common in immunocompromised patients.
- Advise the patient to look after redness, pain, swelling, or tenderness.
Pain due to nerve involvement:
- The patient may feel a sharp pain and tingle due to the involvement of the nerve.
- It is best to take out the needle.
- Sometimes permanent damage may take place to the nerve.
Phlebitis:
- This is a rare complication after blood collection.
Sepsis:
- This is another rare complication of blood collection.
Skin puncture:
- The skin puncture is done in the pediatric group and the diabetics.
- The common sites are fingertips, heels, and ear lobes. Heels are common sites in children.
- Fingertips are used in adults (diabetics) and small children.
- Earlobes are used for arterial blood as a possible substitute for arterial blood to assess pH, pCO2, and pO2.
Presentation (sign/symptom) of the patient:
- Nervousness.
- Itching of the skin.
- Feeling of confusion.
- Nausea, vomiting, and diarrhea.
- Abdominal or back pain.
- There will be flushing, pallor, or cyanosis.
- Urticaria.
- Laryngeal edema leads to stridor.
- Tachycardia.
- There is low blood pressure.
- Convulsions.
- Respiratory depression.
- Bronchospasm leads to an asthmatic attack.
- Treat the patient for a type1 of hypersensitivity reaction.
Treatment
- Treatment of blood collection complications:
- If the patient becomes faint, stop the blood-taking procedure and lie down the patient with raised foot end.
- Remove the needle and give assurance to the patient.
- Talk to patients.
- Please don’t allow him to drive for another 30 minutes.
- Offer juice or water to the patient.
- Ask the patient to breathe slowly (deep breathing).
- If hematoma appears, remove the needle and apply pressure for two minutes.
- Remove the tourniquet.
- In patients with petechiae, make sure that there is no bleeding before the patient leaves the lab.
- In such patients, there are coagulation problems.
- There may be excessive bleeding in patients on aspirin or anticoagulation therapy.
- Don’t leave the patients until there is a complete stoppage of the blood from the venipuncture site.
- If the patient feels sharp electric pain, immediately remove the needle.
- In case of an arterial puncture:
- Immediately remove the tourniquet.
- Hold pressure at the site for at least 5 minutes or till bleeding stops.
- Check the pulse and blood pressure.
- In case of hypersensitivity reaction, give antihistamines.
- Can give steroids.
Question 1: If the patient becomes faint, what you should do immediately.
Question 2: If a patient gets sharp pain, what you should do.
I have had several blood draws in the past couple weeks and my blood squirts and gushes out after the needle withdrawl, all over me , the floor and the wall! Phlebotimost insists I must be on anti-coagulant, but I am not. When I was on a blood thinner years ago, I never had excessive bleeding. Could this be an indication of a medical problem? Normally, I have one tiny spot on the cotton and never bleed anymore. It happened tonight in the ER and then, when I stood up after 2+ hours, it gushed again out from under the bandage that had been tightly wrapped and was all over me and the floor. They added an additional wrap on the site. This is extremely unusual for me and I have been ill recently; tonight my entire body was hugely swollen, including all extremeties, face, abdomen, etc. I weighed 18 bls more than I did on hosp discharge a week ago and have eaten very little because I have had an infected, tender tooth. I have been on 800 mg Amoxocillin and 500 mg Ibuprofin. I’m sorry to go on, but I can’t get anybody to tell me why this would happen and I am concerned. This has NEVER happened before. A response would be appreciated and directing me to the proper kind of doctor to find out what is going on. At the ER, I was told nothing is wrong on any of the lab, x-ray, ultrasound and CT, but the Dr never listened to my heart, never touched any of the huge swelling to see how long it takes the indentation to come back. With the 18 lbs, you can imagine how swollen I am. I have now developed sores (pussy) on the top of my feet; one very pussy so far. (Help! please) I need to know what to do. Thanks for “hearing” me. Oh, I am a 74 yr old female with many problems.
I will suggest doing a bleeding profile like CT, Bleeding time, PT, APTT, INR, and platelet count, including a complete blood picture. Also, do ANF to rule out autoimmune phenomenon. Next, consult a good hematologist. I hope these investigations will help to reach the cause of the problem.
Sorry to hear about your illness. I will suggest to workup for bleeding profile like bleeding time, clotting time, APTT, INR, Complete blood count, including platelets count.
Also, consult some good hematologists.
Hello
During blood drawing, when you feel a burning sensation on your forearm radiating to your wrist is needle touching a nerve. Does the nerve heal after? When do you usually get symptoms after such incident?
Thank you
I will suggest that as the patient feels pain and tingling, please take out the needle immediately if there is damage to the nerve, as the nervous system does not regenerate. Ideally, take out the needle immediately.
Hi, Is it normal to have lump and redness around puncture site?
No, it looks like the inflammatory process has started.
Hi, I inadvertently punctured the artery while doing a venipuncture. I immediately removed the tourniquet and applied pressure. There was no bleeding and the patient is fine. Should I be concerned?
Hi, If you inadvertently punctured the artery while doing a venipuncture and immediately removed the tourniquet and applied pressure. Hence, there was no bleeding and the patient is fine. Should you be concerned?
Definitely you have to look after the patient. Keep the pressure for as long as you are sure that there is no bleeding. Better keep the patient in the lab until you are sure there is no bleeding. Before the patient leaves the lab, apply a pressure bandage and then send him.
Hi there
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