Lesson 7 – Troubleshooting and Complications

While we hope that nothing goes wrong during our appointments we have to be prepared for all kinds of situations. In this lesson, we will focus on troubleshooting and handling complications that may arise during phlebotomy procedures. It is essential for phlebotomists to be able to identify common complications and know the appropriate actions to take. Additionally, we will discuss how to respond to adverse reactions or emergencies during phlebotomy. Let’s begin!

I. Identifying Common Complications and Appropriate Actions:

1. Hematoma:

• Definition: A hematoma is a localised collection of blood outside the blood vessels, resulting in a raised and discoloured area.
• Causes: Hematomas can occur due to inadequate pressure or premature removal of the needle, causing blood to leak into surrounding tissues.
• Identification: Observe for swelling, pain, and discoloration at the puncture site.
• Actions to Take:
  • Immediately remove the tourniquet and needle.
  • Apply firm pressure to the site with a sterile gauze pad to prevent further bleeding.
  • Instruct the patient to keep the area elevated and apply a cold compress to reduce swelling.
  • Document the incident and notify the appropriate healthcare professional.

2. Vein Collapse:

• Definition: Vein collapse occurs when a vein collapses during or after venipuncture, hindering blood flow.
• Causes: Vein collapse can be caused by excessive suction or negative pressure applied during blood collection.
• Identification: Look for a sudden loss of blood flow, difficulty advancing the needle, or a decrease in flashback.
• Actions to Take:
  • Release the tourniquet and remove the needle.
  • Apply gentle pressure to the puncture site to stop any bleeding.
  • Assess nearby veins and attempt venepuncture at an alternate site.
  • Communicate the situation to the patient and document the incident.

II. Responding to Adverse Reactions or Emergencies:

1. Adverse Reactions:

• Symptoms: Adverse reactions may include dizziness, fainting, nausea, sweating, or palpitations.
• Actions to Take:
  • Ensure the patient’s safety by quickly removing any equipment and protecting them from potential falls or injuries.
  • Lower the patient to a supine or semi-supine position to promote blood flow to the brain.
  • Loosen any tight clothing around the neck or chest to facilitate breathing.
  • If the patient regains consciousness, reassure and observe them until they fully recover.
  • Document the incident and report it to the appropriate healthcare professional.

2. Needlestick Injury:

• Definition: A needlestick injury occurs when a phlebotomist accidentally punctures themselves with a used needle.
• Actions to Take:
  • Stop the procedure immediately and assess the extent of the injury.
  • Encourage bleeding at the puncture site to help flush out any potentially contaminated blood.
  • Wash the affected area thoroughly with soap and water.
  • Report the incident to the supervisor or follow the facility’s protocol for needlestick injuries.
  • Seek immediate medical evaluation and follow-up as necessary.

In this lesson, we discussed troubleshooting and complications during phlebotomy procedures. We covered the identification and appropriate actions for common complications such as hematoma and vein collapse. Additionally, we explored how to respond to adverse reactions or emergencies, including fainting or needlestick injuries. By being prepared and knowledgeable, you will be able to handle these situations effectively and ensure the safety of both themselves and the patients.