Phlebotomy Questions & Answers

1.  What's the best way to locate a vein?  Palpate to locate.  There's a new palpation method for locating a vein - 100% of the time.  You FEEL for one.  No more guessing.  No more relying on a vein diagram.  No more struggling with a vein finder tool that 50% of the time doesn't help you find a suitable vein.  P.S.  Not all veins are created equal - this means you need to 'feel' it to determine if it is a suitable vein for your procedure.  See the "Locate a Vein" page on this website or click on the button to your right.
2. Do Vein Finder tools really work?  Unfortunately, vein finder tools only work about 50% of the time.  Vein finder tools only penetrate so far beneath the skin and into the SQ tissue.  About 50% of veins are deeper than the infrared light can penetrate to.  And you have to juggle a needle, the patient's arm, and a vein finder tool while you try to insert a needle into that vein.   What's the best way to locate a vein - use the new palpation technique - it works 100% of the time - and for more than just locating a vein.  Click on the tab to your right.
3.  Why do veins rupture when inserting the needle?  For a couple of reasons: 1) if the vein is too fragile, the wall is too thin, it will rupture like when you insert a needle into a water balloon.  And there is a new palpation technique for 'Grading The Vein' to determine the integrity of that vein wall.  And 2) speaking of a water balloon - the vein is almost identical to that long skinny 'not-over-distended' water balloon,  So, if you over distend that vein - by using a tight tourniquet to 'dilate a vein' - then the vein stands a 50% chance of rupturing upon venipuncture.  So, how can you avoid that over distention and that vein rupture, replace that "old" tourniquet with the new veniCuff - it supports the vein, it does NOT distort the vein like the tourniquet does.  Click on the tab to your right for the veniCuff info.
4.  Why do they tell you to release the tourniquet as soon as you see blood in the first tube?  Because the tourniquet cause the venous system to leak - because the vein is over-distended, and the wall thins (like a blown up balloon 'wall' thins).  And this leakage results in falsely elevated lab values for certain tests.  (Think of a cup of sugar water.  If just water is leaking out (not the sugar),is the water left behind getting sweeter, or not?  The answer is yes, the water left behind is sweeter.  The water is more concentrated with sugar.)  This is called hemoCONCENTRATION.
5.  Does the Tourniquet cause injury?  Yes, the Tourniquet causes SIDE EFFECTS!  We all know that Side Effects are NOT usually good things.  Here are the Side Effects to that tourniquet usage:  1) Pain, 2) Pain causes fear and fear can cause vasoconstriction, 3) a tourniquet cuts off the flow of ARTERIAL blood, and we need arterial blood to make venous blood - or you may not be able to fill all the tubes that you need to, 4) the tourniquet cuts off the return flow of venous blood and this contributes to the OVER distention ('dilatation') of the vein with blood, and thins the walls, and either results in that leakage problem - that falsely elevates lab test results -  or in that vein rupture problem,
Is there anything else that can be used instead of that tourniquet?  Yes, the veniCuff.  Click on the tab to the right. 
6.  Is the Tourniquet even necessary?  No.  In fact, the tourniquet was DESIGNED to prevent bleeding to death, to cut off the flow of arterial blood.  It never was designed to 'dilate a vein'.   The tourniquet falsely came to be used because 'coincidentally' it causes the vein to over-distend - and they all thought that this would make it easier to 'locate a vein' if the vein was over-distended.  As we all know, failing to locate a vein is still THE BIGGEST PROBLEM in venipuncture blood draw.  And the Tourniquet causes so many SIDE EFFECTS.   Is there a solution to this problem?  Yes, the veniCuff.  It is gentle and SUPPORTS the venous system, for even those patients who don't need it.
​See the info by clicking the tab on your right.
7. Have there been any new advancements in the Phlebotomy procedure?  YES, yes, yes!  By now you have all heard of STEM (Science, Technology, Engineering, & Math.  
8.  How does the STEM-based method differ from the traditional method?  ALL the other methods are trial-n-error based, stick and hope you hit something and keep sticking until you do, pick up a needle and stick - with no specific skill instruction or science education.  The STEM-base method is ALL built upon the principles in Anatomy, Physiology, Neuroanatomy, Neurophysiology, Chemistry, Physics, Math, and Engineering.  Every step is scientifically analyzed, detailed, and described - with a matching clinical instruction.
9.  Can you really locate a vein with just your sense of touch?  How does a blind man read?  So, yes, you can SEE something with your sense of touch.  Try it.  Take the pad of your dominant hand index finger, find another human's arm (not your own), and GENTLY (barely touch) press you way across the bend in the arm and feel for a long skinny water balloon bounce.  There you go.
10.  What does a vein "FEEL" like?  A vein feels like a long skinny, not over-distended, water balloon.  So, visualize the water balloon.  THINK about how gently you must touch it so as not to 'collapse' it.  FEEL the water rebound bounce against your finger - this requires that the pad of you dominant hand index finger remain in CONSTANT CONTACT with the surface of the skin.  
11.  What does a tendon "FEEL" like?  A tendon feels like the largest guitar string on a guitar - in your arm.  
12.  Do hospitals and doctor's office still do on-the-job training for phlebotomy?  Yes they do.  Because there is NO LEGAL requirement that you be trained professionally, by anyone.  Hospitals, doctor's offices, independent labs...whomever, can hire who they want, and under any circumstances that they want.  They can also choose to require that you be trained in a 'program'.  It is personal preference on their part.
13.  Is there a 'state law' that requires that phlebotomists must be trained in a designated training program?  No.  4 states in the United States require state certification if you are going to drawing blood.  But the training component is not regulated.  An OTJ/self-trained person will still need to take a 'state' written exam to determine (not that you are actually 'skilled') if you have KNOWLEDGE.
14.  Is Phlebotomy a 'state licensed' entity?  There are only 4 states in the United States that 'state certifies' phlebotomists.  CA, LA, NV, WA.
15.  I see lots of people holding that needle differently - is there a specific way that the needle should be held and inserted?  YES, but only Vein Access Technologies teaches and trains in this specific manner.  All other programs just say - 'pick up the needle and stick'.
16.  Why do some blood draws hurt like heck, and with others there is no pain, at all?  It's all in the TECHNIQUE.  All VAT trained individuals are taught the specific technique that works.  The rest of the venipuncture personnel are depended upon - natural born talent or NONE.
17. Is there a specific way to insert the needle so that the patient feels NO pain?  Yes.  See the VATmethod for that exact instruction.  There are many components to this.
18.  Can a vein be OVER 'dilated'?  Yes.  Veins are over distended on nearly every venipuncture.  And depending on how TIGHT that tourniquet is applied determines how over distended the vein is.  And P.S., is it not a 'dilatation' - it is a forced over distention.
19.  What is the greatest advancement in the practice of medicine this century?  The venipuncture procedure in Nursing, Radiology & Laboratory Medicine.  STEM has improved this procedure dramatically.  
20.  Which is an achievement made in healthcare in the 21st century?  The STEM analysis of the venipuncture procedure for Nursing, Radiology, & Laboratory Medicine.  And the STEM analysis of the POC blood collection for point-of-care blood analysis.
21.  Have there been any medical breakthroughs in the venipuncture blood draw and the point-of-care blood collection procedures?  Yes.
22.  What is the biggest 21st century medical advancement?  The STEM-based venipuncture procedure for Nursing, Radiology, Laboratory Medicine & EMS.
24.  What is the number 1 problem for all Paramedics?  The venipuncture - the  IV and blood draw venipuncture - procedure.
25.  What is THE most frequently performed invasive procedure in the practice of Medicine?  The venipuncture.

IV Questions & Answers

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X-ray Injection of Contrast Questions & Answers

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