Phlebotomy Injuries

Written by william norman
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Phlebotomy Injuries
A botched blood draw can cause serious injury. (syringe image by NatUlrich from Fotolia.com)

Phlebotomy, the science of drawing a patient's blood for laboratory purposes, can harm the patient or the phlebotomist if the phlebotomist fails to employ extreme caution. A needle that goes in too deeply or hits a nerve or artery instead of a vein can cause serious injury. However, according to The Washington Post, phlebotomy goes largely unregulated in most states, leading individual institutions to hire phlebotomists at relatively low wages and provide them with minimal training.

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Mechanism

Phlebotomists use a procedure called venepuncture to obtain blood samples from patients. With the patient seated or lying down, the phlebotomist ties off the patient's extended arm with a tourniquet and selects the vein for blood draw. The phlebotomist then inserts a hollow needle into the vein at an angle, draws the sample and quickly removes the needle. According to the University of Utah's Spencer C. Eccles Health Sciences Library, to avoid bruising or other tissue damage the phlebotomist must puncture the vein's centre without digging or probing.

Types

Many phlebotomy injuries take the form of nerve damage. According to The Washington Post, a phlebotomist can miss the vein and inject a nerve instead, causing painful or paralysing damage to the affected limb. Other types of injury occur when the needle goes all the way through the vein, punctures an artery or bruises the vein, any of which can cause serious internal bleeding. According to The Washington Post, phlebotomy patients can receive injuries not directly related to the needle such as passing out and hurting themselves in a fall.

Complications

Nerve damage from an improperly administered blood draw can result in a condition known as "claw hand," according to The New York Times. Fingers on the affected hand begin to curl up, eventually rendering the hand useless. Severe cases can lead to loss of function throughout the arm. According to the Journal of Brachial Plexus and Peripheral Nerve Injury, in some cases patients can experience shooting pains through the arm and numbness to outside stimuli.

Reasons

According to The Washington Post, unlike other medical skills, in many states phlebotomy does not require specialised training. Many medical personnel performing phlebotomy procedures have received little training, leading to incorrect administration of blood draws and injuries to patients. Even an experienced phlebotomist can sometimes have trouble finding or isolating a vein.

Incidence

While no studies of overall injury rates from phlebotomy procedures exist, The New York Times mentions that some advisers have made a career out of teaching health care personnel to avoid getting sued by patients over botched phlebotomy procedures. Medical professionals can also receive injuries from phlebotomy needles themselves. A 2003 EPINet report revealed that 5 per cent of all sharp-instrument injuries in medical facilities occurred from phlebotomy needles, and 94 per cent of those incidents involved needles still filled with blood, posing a risk of infection.

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