If a patient sitting in a chair faints during the venipuncture procedure, you should first:

How to Manage Patients Who Pass Out

Knowing how to prevent fainting during a phlebotomy procedure is critical

When a patient passes out during a venipuncture procedure, this post details exactly what to do and what not to do.

by Dennis Ernst • July 19, 2021

Technical, Safety


If a patient sitting in a chair faints during the venipuncture procedure, you should first:

Anyone who draws blood samples sooner or later has a patient pass out during or following the procedure.  How do you react?  How can you prevent it? Patients have become paralyzed by those who didn't know. Don't be one of them.

Those who draw blood specimens must constantly be aware of the signs and symptoms of an impending loss of consciousness and be prepared to react. Signs can include pallor, perspiration, hyperventilation and/or anxiety. A proper response to such signs is key to protecting the patient from falling and the injuries that can result. However, collectors can prevent an injury before it happens if they take the following precautions:

  • make sure that all outpatients are drawn from chairs with arm rests that can stop a fainting patient from falling to the floor;
  • never draw a patient sitting upright on an exam table or in a chair without side armrests;
  • inpatients should be drawn while recumbent or sitting in arm chairs with arm rests, not upright on the side of the bed;
  • patients with a history of fainting during a blood draw should be drawn while they are in a recumbent position;
  • never turn your back on a patient, especially after you have completed the draw. Some patients give no warning before passing out.
  • do not get more than one step away from a seated patient while he/she is in your care. Should they pass out, you must be close enough to prevent a fall.
  • should a patient become dizzy or lose consciousness during a collection, release the tourniquet, remove the needle, and activate the safety feature at once. Presence of mind must be maintained so that you don’t sustain an accidental needlestick in the process.
  • if the patient loses consciousness, support him/her from falling to the floor and summon assistance. Lower the patient’s head below the level of the heart to facilitate blood flow to the brain. This can also be accomplished by carefully, and with assistance, lowering the patient’s head between the knees or by lowering the patient to the floor, being careful not to allow the patient to fall and sustain an injury.
  • avoid the use of ammonia inhalants. Patients who are asthmatic may develop respiratory distress as a result.

Statistics say 2.5 percent of patients will pass out during or immediately after a blood draw. Being prepared significantly reduces the risk of injury and complications secondary to the loss of consciousness. If you ask if they've ever fainted during a blood draw, the rate goes up to 5.6%. Never mention "faint" or "pass out." The power of suggestion just might make it a reality. Instead, ask patients if they've ever "had problems" with prior blood draws. If they respond affirmatively, explore the nature of the incidents and react appropriately.

Preventing fainting episodes are just as important as knowing what to do when it happens. It's never unexpected by those who are well prepared.

If a patient sitting in a chair faints during the venipuncture procedure, you should first:

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22 Comments

How to Manage Patients who pass out

I had no idea that a fainting Patient could become paralyzed. Very interesting reading.

Dennis Ernst, 08/02/2021 18:02:22

How to manage patients who pass out

The information was on point, because it happens to me more often then not. Thanks.

Dennis Ernst, 08/06/2021 08:33:25

Visit

Fainting does sometimes occur as a result of venipuncture. A patient may experience a feeling of weakness or light-headedness or in severe cases, the loss of consciousness at any time during the venipuncture procedure.

Before the procedure

If a patient is aware that he/she gets light-headed or has in the past fainted while having blood collected, the patient may alert the phlebotomist. The phlebotomist must then take appropriate measures to safeguard the patient during the procedure. For example, the phlebotomist may instruct the patient to lie down instead of sitting upright during the procedure. This practice may lessen the risk of patient fainting and eliminate the possibility of patient injury due to falling or sliding out of a draw chair.

During the procedure

If a patient faints during the venipuncture, immediately abort the procedure by gently removing the tourniquet and needle from the patient's arm, applying gauze and pressure to the skin puncture site, and calling for assistance. If the patient is seated, place the patient's head between his/her knees. A cold compress applied to the back of the neck may help to revive the patient more quickly. The use of an ammonia inhalant (smelling salts) to rouse the patient is considered an unsafe practice. The inhalant may cause irritation and/or anaphylactic shock in some patients. A typical fainting spell is self-limited and usually, the patient comes around fairly quickly. However, the phlebotomist should stay with the patient for at least 15-30 minutes to ensure the patient has fully recovered from the fainting episode.

After the procedure

If the patient states that he/she feels dizzy after the blood collection is completed, again, as stated above, place the patient's head between his/her knees and apply a cold compress to the back of the neck. The phlebotomist should never direct the patient to an alternate location while the patient is experiencing dizziness. There is a great likelihood that the patient will faint while walking and be injured. It is never advisable for the phlebotomist to allow the patient to leave after the procedure until the patient is safely able to do so. A patient who faints should not operate a vehicle for at least 30 minutes after regaining consciousness.

It is important to review your facility's specific procedures and know how to react appropriately if a patient experiences dizziness or faints during a blood collection.

What should be done if an accidental puncture occurs during venipuncture?

If an accidental arterial puncture occurs during the venipuncture procedure: a. discontinue the venipuncture immediately b. remove the needle c. apply direct forceful pressure to the puncture site

How to perform a capillary or venipuncture?

Performing a capillary puncture •Make skin puncture across the finger prints, not parallel to them. •Sterile lancet device is used. •The Lancet should penetrate approximately 2mm into site. Venipuncture •Surgical puncture of a vein, also called phlebotomy. •A phlebotomist is a person trained to perform this procedure. Site selection

What is venvenipuncture?

Venipuncture •Surgical puncture of a vein, also called phlebotomy. •A phlebotomist is a person trained to perform this procedure. Site selection

When obtaining venous blood with a vacuum tube the tip should?

When obtaining venous blood with a vacuum tube, the tip of the needle should be inserted into the vein at a -degree angle 15 Each small line on a 3 mL syringe represents __ mL
The phlebotomist can try using a smaller needle, called a butterfly needle, which is large enough to draw blood but often works well on small veins. 5 It is perfectly acceptable to let staff know you need a smaller needle. Don't hesitate to ask for what you need!

Why is the first drop of blood wiped away from the capillary puncture site?

Wipe away the first drop of blood because it may be contaminated with tissue fluid or debris (sloughing skin). Avoid squeezing the finger or heel too tightly because this dilutes the specimen with tissue fluid (plasma) and increases the probability of haemolysis (60).

When obtaining venous blood with a vacuum tube the tip of the needle should be inserted into the vein at a blank degree angle?

The needle should form a 15 to 30 degree angle with the surface of the arm. Swiftly insert the needle through the skin and into the lumen of the vein.

What should you do if a hematoma begins to form during venipuncture?

a. Hematoma: Blood can leak out of a vein and under the skin during venipuncture. This can cause discomfort and pain and can complicate further collections from that site. As soon as a hematoma is noted, remove the needle and tourniquet and apply pressure at the site for a minimum of 3 minutes.