Question

A request for bloodwork was received in the laboratory. A newly hired phlebotomist goes to the patient’s room to collect the blood. She notices a large vein on the left arm and applies the tourniquet. When she palpates the vein, she feels a vibration or “buzzing”. Should she draw from this vein? What is she palpating? What should she have done differently? Why does this patient require dialysis?

Answer 1

Answer and Explanation:

The phlebotomist should not draw blood from the vein that she palpated. The "vibration" or "buzzing" sensation she felt indicates that the vein is an arteriovenous fistula (AVF), which is a surgically created connection between an artery and a vein.

1. What she is palpating:

The phlebotomist is palpating an arteriovenous fistula (AVF). An AVF is created for patients who require dialysis, and it is used to provide access for the removal and return of blood during dialysis treatments.

2. What she should have done differently:

The phlebotomist should have recognized the presence of an AVF and refrained from drawing blood from that vein. Drawing blood from an AVF can disrupt the blood flow required for dialysis and can cause complications for the patient.

3. Why does this patient require dialysis:

The presence of an AVF indicates that the patient requires dialysis. Dialysis is a treatment that is used for patients with kidney failure or end-stage renal disease. It helps filter waste products, excess fluid, and toxins from the blood when the kidneys are no longer able to perform this function effectively.

In summary, the phlebotomist should not draw blood from the palpated vein because it is an arteriovenous fistula (AVF), which is a connection between an artery and a vein created for patients who require dialysis. Drawing blood from an AVF can disrupt dialysis treatment and cause complications for the patient.