For our medical staff; a blood flow question

[Jersey mike]

As I mentioned recently Barbara and I had our antibodies tested about 2 weeks ago.

When they tried to do the blood draw on Barbara they couldn’t get the blood to flow from her arm and had to go into the hand. We didn’t think much of it, I asked if she was dehydrated and she didn’t think so, she does drink a ton of water every day.

On Thursday she had a bi-lateral injection @ L-3/L-4 with sedation. There were issues accessing her vein, the first attempt the nurse blew it out so the went to the hand again. This time the fluids would not flow with her hand resting and flat, a flow would only happen with her wrist bent down in a limp position. There was also an incident where I believe she said the bold seemed to flow out of the area where the needle was inserted. 4 weeks ago she had the same procedure except at L-4/L5 with no issues at all.

She is on high blood pressure meds.

I waited a day and suggested she see our doctor or her cardiologist about this issue which she admitted crossed her mind because 2 incidents is not a isolated situation. I have not found too much on the web for a good answer or reason which is why I bring the topic here for our medical community and some reasonable explanation.

I will keep on her to see the doctor and she does stay hydrated, at least 1/2 gallon of water a day.

Any thoughts would be appreciated.

Thanks,

Mike.

[scooperhsd]

My veins are not transparent on my arms(they are REALLY DEEP) - when someone wants a blood draw out of me - it's ALWAYS in the back of the hand.

[Jersey mike]

I did not know blood would not flow out of a vein when a needle was inserted to draw blood.

I know the hand is used for some IV use.

[Bret SD]

As I mentioned recently Barbara and I had our antibodies tested about 2 weeks ago.

When they tried to do the blood draw on Barbara they couldn’t get the blood to flow from her arm and had to go into the hand. We didn’t think much of it, I asked if she was dehydrated and she didn’t think so, she does drink a ton of water every day.

On Thursday she had a bi-lateral injection @ L-3/L-4 with sedation. There were issues accessing her vein, the first attempt the nurse blew it out so the went to the hand again. This time the fluids would not flow with her hand resting and flat, a flow would only happen with her wrist bent down in a limp position. There was also an incident where I believe she said the bold seemed to flow out of the area where the needle was inserted. 4 weeks ago she had the same procedure except at L-4/L5 with no issues at all.

She is on high blood pressure meds.

I waited a day and suggested she see our doctor or her cardiologist about this issue which she admitted crossed her mind because 2 incidents is not a isolated situation. I have not found too much on the web for a good answer or reason which is why I bring the topic here for our medical community and some reasonable explanation.

I will keep on her to see the doctor and she does stay hydrated, at least 1/2 gallon of water a day.

Any thoughts would be appreciated.

Thanks,

Mike.

My ex was a phlebotomist working in Children's hospital NICU mostly, she was good at drawing blood from babies with tiny arteries while being in the pressure cooker of having the parent(s) right there watching.. I'd be sweating bullets.

Drinking water without some salt in it won't hydrate the body very well, pink or natural sea salt to the tune of 1/2 teaspoon in the 1/2 gal of water will do wonders. Those salts are ~40% sodium.

It doesn't make sense she bleeds from capillaries yet not from an artery or vein, that would preclude there being too high blood viscosity I would think? Maybe the person drawing blood just missed?

[old2soon]

        Even at 76 year when I go to the V A blood draw from me easy peasy from that vein in the crook of the elbow. Has She got really restricted veins? NO I am Not a Dr. but I've been around a lot of Doctors. Hope tou and Mama git this all sorted out. All else fails make an appointment for Her and take her there. Course that be me and may Not work for you. RIDE SAFE.

[Robert]

I did not know blood would not flow out of a vein when a needle was inserted to draw blood.

I know the hand is used for some IV use.

You should see an artery when cut it can shoot out a feet maybe more and yes it will flow out of the vein also. On a vein it will flow fairly steady out but on an artery it will pulse out on the beat of the heart.  Cold, low blood pressure, nervous, hidden veins, a little excess fat all lead to a hard time drawing blood. Also some have small veins that also make it a problem to draw blood. Probably not a real issue but ask the doc.

[f6gal]

Some people are just a difficult stick for a number of reasons, such as small or deep veins, rolling veins, dehydration, collapsing veins, constricted vessels, etc.  

I tend to be a difficult stick, as well.  Here are a few tips that may help:
     Before the needle stick, apply a warm compress to dilate the blood vessels.
     No caffeine or nicotine before the stick to avoid constricting the vessels.
     Drink room temperature or warm water (not cold) before the stick.

Barbara's issues were different each time, so it's unlikely that she has any serious problem.

1) Couldn’t get the blood to flow from her arm.  The clinician probably just missed; perhaps due to issues noted above.

2) The nurse blew it out.  The nurse either went through the vessel or was not in it completely.  

3) The fluids would flow would only with her wrist bent down in a limp position. This is known as a positional IV; the flow is being restricted in a certain position, perhaps due to size of the vessel, needle against the vein wall or against a valve, etc. Whatever the reason for the restriction, repositioning resolves the problem.

4) Blood seemed to flow out of the area where the needle was inserted.  The needle was not completely in the vein.  Unlike a blown IV, it's a slow leak rather than a blow out.  

[RP#62]

I'm hit or miss.  Most times its no problem.  One time after 7 tries (which I vowed never again), they had to get the ultra sound machine to fine a suitable spot.  One time, they put the IV in my neck. 

-RP

[Jersey mike]

As I mentioned recently Barbara and I had our antibodies tested about 2 weeks ago.

When they tried to do the blood draw on Barbara they couldn’t get the blood to flow from her arm and had to go into the hand. We didn’t think much of it, I asked if she was dehydrated and she didn’t think so, she does drink a ton of water every day.

On Thursday she had a bi-lateral injection @ L-3/L-4 with sedation. There were issues accessing her vein, the first attempt the nurse blew it out so the went to the hand again. This time the fluids would not flow with her hand resting and flat, a flow would only happen with her wrist bent down in a limp position. There was also an incident where I believe she said the bold seemed to flow out of the area where the needle was inserted. 4 weeks ago she had the same procedure except at L-4/L5 with no issues at all.

She is on high blood pressure meds.

I waited a day and suggested she see our doctor or her cardiologist about this issue which she admitted crossed her mind because 2 incidents is not a isolated situation. I have not found too much on the web for a good answer or reason which is why I bring the topic here for our medical community and some reasonable explanation.

I will keep on her to see the doctor and she does stay hydrated, at least 1/2 gallon of water a day.

Any thoughts would be appreciated.

Thanks,

Mike.

My ex was a phlebotomist working in Children's hospital NICU mostly, she was good at drawing blood from babies with tiny arteries while being in the pressure cooker of having the parent(s) right there watching.. I'd be sweating bullets.

Drinking water without some salt in it won't hydrate the body very well, pink or natural sea salt to the tune of 1/2 teaspoon in the 1/2 gal of water will do wonders. Those salts are ~40% sodium.

It doesn't make sense she bleeds from capillaries yet not from an artery or vein, that would preclude there being too high blood viscosity I would think? Maybe the person drawing blood just missed?

Interesting about the salt in the water, thanks for that info.

[Jersey mike]

Some people are just a difficult stick for a number of reasons, such as small or deep veins, rolling veins, dehydration, collapsing veins, constricted vessels, etc.  

I tend to be a difficult stick, as well.  Here are a few tips that may help:
     Before the needle stick, apply a warm compress to dilate the blood vessels.
     No caffeine or nicotine before the stick to avoid constricting the vessels.
     Drink room temperature or warm water (not cold) before the stick.

Barbara's issues were different each time, so it's unlikely that she has any serious problem.

1) Couldn’t get the blood to flow from her arm.  The clinician probably just missed; perhaps due to issues noted above.

2) The nurse blew it out.  The nurse either went through the vessel or was not in it completely.  

3) The fluids would flow would only with her wrist bent down in a limp position. This is known as a positional IV; the flow is being restricted in a certain position, perhaps due to size of the vessel, needle against the vein wall or against a valve, etc. Whatever the reason for the restriction, repositioning resolves the problem.

4) Blood seemed to flow out of the area where the needle was inserted.  The needle was not completely in the vein.  Unlike a blown IV, it's a slow leak rather than a blow out.  

Thanks for taking the time to write up all that information, it sounds like things aren’t as strange as we thought. She was pretty concerned when blood would not flow at the blood test.



BTW...how’s your foot healing up?  Hopefully you’re doing well.

[f6gal]

Some people are just a difficult stick for a number of reasons, such as small or deep veins, rolling veins, dehydration, collapsing veins, constricted vessels, etc.  

I tend to be a difficult stick, as well.  Here are a few tips that may help:
     Before the needle stick, apply a warm compress to dilate the blood vessels.
     No caffeine or nicotine before the stick to avoid constricting the vessels.
     Drink room temperature or warm water (not cold) before the stick.

Barbara's issues were different each time, so it's unlikely that she has any serious problem.

1) Couldn’t get the blood to flow from her arm.  The clinician probably just missed; perhaps due to issues noted above.

2) The nurse blew it out.  The nurse either went through the vessel or was not in it completely.  

3) The fluids would flow would only with her wrist bent down in a limp position. This is known as a positional IV; the flow is being restricted in a certain position, perhaps due to size of the vessel, needle against the vein wall or against a valve, etc. Whatever the reason for the restriction, repositioning resolves the problem.

4) Blood seemed to flow out of the area where the needle was inserted.  The needle was not completely in the vein.  Unlike a blown IV, it's a slow leak rather than a blow out.  

Thanks for taking the time to write up all that information, it sounds like things aren’t as strange as we thought. She was pretty concerned when blood would not flow at the blood test.



BTW...how’s your foot healing up?  Hopefully you’re doing well.

The foot is doing pretty well.  Unfortunately, I think some of the dissolvable sutures didn't dissolve.  Eventually they'll reject, but in the meantime, they are quite irritating.