Does anybody has a protocol that says to rotate venipuncture site for patients requiring frequent phlebotomies by venipuncture? I see nothing of that nature in the INS standards of practice, found nothing when searching litterature and nothing in the infusion nursing - an evidence-based approached.
The rational of the nurses doing so is to save the veins and prevent scarring. I wonder if this is evidence based and if there is usefulness to doing so.
Thanks a lot,
France Paquet, RN, MSC
McGill University Health Center,
Montreal, Quebec, Canada
Are you talking about a direct venipuncture for drawing a blood sample or drawing a sample from a peripheral catheter? Both are addressed in the INS SOP. Basic injection practices of all kinds requires site rotation. There may be no published research on this issue but the evidence can be found in basic anatomy. Every time a venipuncture is made, there will be damage to the vein wall. The tunica intima is disrupted and a clot forms. Within a short period after hemostasis has occured the body destroys that clot. It is conceivable that frequent venipunctures in the same location will produce scarring in the for of stenosis, sclerosis, etc. Any piece of literature on IM and SC injections states to rotate sites, so I think this would apply to venipuncture as well. Am I missing something in your question? Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
I was talking about direct venipuncture, not blood drawn from a catheter. This practice (rotating vein used for blood work) is done for patients on certain chemotherapy who come weekly for blood works during their treatment.
France Paquet, RN, MSC, VA-BC(TM), CVAA(c)
Clinical Practice Consultant, IV therapy and Vascular Access
Transition support office
McGill University Health Center
Montreal, Quebec, CANADA