As a vet student and vet tech, venipuncture is a pretty routine part of my day. Jugular, accessory cephalic, and saphenous veins are all fair game, although I’m best at hitting the accessory cephalic vein, because often I can see and feel the vessel. I’m trying to get better at hitting the jugular vein, but between the extra skin, the long hair, and the fact that I’m both holding off and performing the venipuncture means there’s a lot more for me to get distracted by. But always, I’m amazed that our patients are so good for blood draws. Multiple people holding them in strange positions and then fussing with necks or legs—it’s amazing to me how patient dogs and cats are with us crazy humans.
Today I was in the same boat as my patients, in a way. Before shopping, I stopped by a local blood drive. Apparently, my normal donating arm had the smallest of blemishes—personally I think they mistook a freckle for a scab or something—so they went for the left arm. By now I know where my veins are, and so I warned the phlebotomist that my veins were super deep, super straight, and right next to the tendons. Sure enough, he found the superficial peripheral vein, and gleefully marked it out with his purple pen, utterly ignoring me as I tried to tell him that that vein has a valve in it, which a phlebotomist has hit before, and that he’s better off aiming for the deeper albeit harder to feel vein… But it was as if he couldn’t hear me, as the large-bore needle inevitably struck the valve and blood refused to creep down the collecting tubes. Ahhh I sure felt sympathetic with my patients then, an unwilling participant in an uncomfortable endeavor. At least I knew what was happening!
Because of my experience with venipuncture, the resulting hematoma and the floating blood clots in the collection tubes came as no surprise. What I didn’t expect was the reopening of the puncture site after carrying around some clothes from Old Navy, or the strange pain inside my elbow, even where the needle never went; apparently blood is still pooling inside layers of tissue. So next time I draw blood from a patient in the clinic, I’ll make doubly sure to find the vein well before giving a poke, and to hold off the site for the prescribed 90 seconds, to avoid leaving them with a large bruise, like the 4-inch purple one currently decorating the crook of my elbow. Next time, if they can’t use my right arm, I’m outta there!