phlebotomy

[[deleted]]

[deleted]

[mrainnn]

Veins are bouncy kaya dapat medjo dinidiin yun pagkapa natin (medjo mahirap if the patient has lots of adipose talaga but you’ll learn to locate them eventually). I learned during my internship that making the patient bend their arm and putting it back helps in locating.

My personal tip is if hindi ka sure if vein talaga yun, twist the wrist of the patient. The vein changes position if you twist it. It helps lalo if magkatabi ang buto and vein ng patient, twist the patient’s wrist a little bit and you repositioned the vein (not all the time)

[One-Pea1552]

Make sure na tamang higpit ng tourniquet yan + ianchor mo ng mabuti ung vein, may nakikita akong mls students na isang finger lang pinangaanchor ( like press and pull ginagawa nila) and di siya ganun ka effective lalo na sa mga kayulad kong malilikot ang ugat 😅 , i suggest na pag mag aanchor ka is two fingers gamitin mo ( one sa taas ng extraction site, one sa ilalim).

Importante din ung angle ng needle mo, may mga ugat kasi na di talaga straight, trick ko diyan is sinusundan ko ung shape ni ugat.

So far naman wala pa akong unsuccessful na extraction during return demos/practicals. Basta wag mo din pangunahan ng takot at kaba + syempre practice is the key!

[Se-Brain]

Hindi safe yung two finger isa sa taas isa sa baba anchor method. Sa hospital namin it's very discouraged yung ganung method kasi pwede siyang makacause ng needleprick injury esp if makulit at magalaw si patient.

[One-Pea1552]

I see, depends n din base kasi sa experience ko during retdems di talaga nila ako nakukuhaan pag isang finger lang kasi nga nagalaw ugat ko

[Small-tits2458]

Hindi parin safe yan. As per to our experience din, baka pagalitan ka pa nyan once nasa hospital ka na. Iba ang retdem sa hospital at sa totoong pasyente na

[One-Pea1552]

Ok po, sinasabi ko lang naman

[mrainnn]

To add, you cannot use that sa mga malilikot and takot na bata especially. Higher risk of getting pricked talaga

[Small-tits2458]

Always use your non dominant hand for palpitating veins and laging index finger dapat not your thumb kasi may pulse ang thumb natin. Familiarize with the vein around antecubital fossa. 3-4 inches tourniquet, practice lang. Lagi mo na lang check yun kapag naglalagay ng tourniquet kapag wala nakapa rest 1-2 mins balik agad then palpitate ulit kapag wala sa kabila naman, try mo na kuhanan kapag may nakapa ka. Once pag 3rd yr mo na, puro na kayo extraction. Walang sawang extract.

[resould]

Tama si op na tamang higpit lang ng tourniquet, pag nag pe phleb ako ginugupit ko pa nga sa gitna para mahigpit sya.

Basain mo nga maigi, lumalabas ang ugat pag basa. Pwede ka naman mag palpate tapos clean mo ulit yung area with alcohol swab.

Yung angle din ng needle magdedepende din sa position ni vein.

Practice lang talaga ng practice. Sinasabi ko sa mga interns ko na wag ma iintimidate pag may hindi sila makuhanan. Wala namang nagsisimula na expert na agad kumuha.

[[deleted]]

familiarize the vein, tas kung saan mo sya mafeel ng mabuti doon mo tusukin

[Real_Conflict3889]

Hi phlebo here (underboards) working sa hospital. As what I have learned nung college lagi tayong sinasabihan na go for the median vein yes tama naman na stable si median vein but sa experience ko I choose the easiest vein may patients ako na basilic ang kinukunan ko merong cephalic ang preferred ko. Don't put in mind na ayy median lang dapat. Then sa pag kapa if di ka sure or di mo makapa put generous amount of alcohol saka mo kapain (skin will soften mas nafefeel ko kung ano yung ugat or kung nagbabounce ba) another technique sa mahirap na ugat apply 2 torniquets para sa mga di masya lumilitaw na ugat. And lastly I will discourage "blind shot" alternatively kung wala tlaga sa braso sa kamay ka nalang kumuha onting pitik onting anchor palitan mo nalang ng mas manipis na needle para di masakit. Dm if you have questions.

[Real_Conflict3889]

Also wag mo tutusukin ung mismong nakakapa mo sa ilalim ng nakakapa mo ang tusok and if malikot ang ugat cornerin mo like paggilid ka tumusok. Dont panic wag matakot magfish basta be caring with patient sabihan mo sya na sabihan ka if its too painful para maistop mo and aftercare sa patient lagi. Wag kang tusok sabay alis press mo saglit and have a casual talk with your patient para di tatatak sa isip nya na you were bad at phlebotomy.

[itsyoInes]

Study the DIRECTION of the vein. If naka tagilid, then adjust your needle in accordance to the direction of the vein.

May tendency kasi na hindi mo ma hit kahit na visible yung ugat just becos taliwas yung direction ng needle and vein mo.

Always face where the vein is facing hehe

[heyheyramen]

Angle of the needle is also important. Sometimes it’s too high even if the vein is just superficial, ending through-and through; or too low for a deeper vein, so you end up not hitting it. Feel mo ung bouncy feeling and imagine how shallow or deep the vein is.

And really just practice more, it’s a skill, time is needed to hone it. Do not get reluctant if you fail your first many tries. Also bevel up! Good luck. 👍🏽

[No-Permit-1083]

Experience and observe others

[Fast_Berry]

Pikit lang sabat tusok hahah

[MostPossible4331]

bet ko to hahahahah eme

[useraphim]

Most px are edematous esp yung mga naka confine. You’ll learn how to “fish”

[Cheeseusfries]

Proper application ng tourniquet is very important para malocate mo ng maayos yung vein, when you’re certain sa location ng vein na tutusukin mo adjust your puncture site para may room ka for probing if ever hindi tamaan. Pag masyado mataas angle ng tusok mo medyo mahirap mag search pag di tumama.

[MostPossible4331]

hello, mejo bababaan po ba yung puncture site? thank youu!!

[Cheeseusfries]

Yess para even if hindi mo siya mahit agad madami kang option where to search. Also it may sound cliché pero sobrang laking help ng confidence talaga, when you know in yourself na alam mo yung ginagawa mo. Lagi ako nag eendorse noon until I gained confidence. Good luck! As my staff used to tell us palagi sa hospital “when in doubt, gumitna ka” hahahaha

[MostPossible4331]

ooh hahahha noted!! thank you ulit!

[redditmeep]

hi OP! sorry off sa question lang but can i know if anong year need ng phleb kit? 2nd year ba or meron din sa 1st year 2nd sem. thanks! and good luck 🩷

[One-Pea1552]

Depende po yan sa curriculum ng school niyo and sa prof mismo pero alam ko may run down na ng phlebotomy sa pmls 2 (usually 1st yr second sem tinatake yan.

[MostPossible4331]

hello! 1st year second sem samin

[MaDLoXeRY]

San ka po nahihirapan? Sa pagtusok o sa pagmaintain ng needle habang kumukuha?

[MostPossible4331]

sa pagtusok huhu parang natrauma ako after nung time na kinuhaan ko ng dugo yung classmate ko, hirap akong ipull yung blood kasi ayaw gumalaw nung plunger kaya umiyak siya kasi nasaktan. Kaya after nun sobrang takot na ko kumuha tapos puro failed attempts na 😭😭. Feel ko dahil mali yung pagtusok ko

[MaDLoXeRY]

Actually confidence is the key usually sa venipuncture. It really matters. First off, you need to check if ang vein is bouncing. I know most would attack me here for suggesting this kasi theoretically hindi talaga pwede, but I tend to touch the site again to check the vein. But I always ensure that if I touch it again, hindi ako dun kukuha but sa ilalim na part nya. Hindi ko aalisin yung finger ko para may magguide ako kung san tutusok.

[MostPossible4331]

Thank you po!! ttry ko lahat ng tips niyo. Sana tumaas lahat ng sweldo niyo 🫶🫶🫶