A haematoma is a collection of blood under the skin. This can be painful and can potentially cause nerve damage. If a haematoma begins to form while blood is being withdrawn, needle must be removed immediately and pressure maintained over the site. An incident form must be completed and medical / nursing staff informed.
Causes of haematoma
1 Small fragile vein, needle too large.
2 Excessive probing to find vein.
3 Removing needle prior to releasing tourniquet.
4 Needle going all the way through vein.
5 Needle only partially entering vein, allowing leakage.
Inadequate cleansing or poor technique can lead to infection.
C. Nerve damage.
Inappropriate sites or excessive probing may lead to nerve damage. Patient may complain of severe pain. Procedure must be stopped immediately. If pain persists, incident form must be completed and medical / nursing staff informed.
While some discomfort is to be expected, the needle must be removed immediately if the patient complains of excessive or severe pain. If pain continues, medical/nursing staff must be informed and an incident form completed.
E. Arterial Puncture.
Failure to properly identify the vein by lack of pulse and by collapse on removal of tourniquet can result in inadvertent arterial puncture.
Where this occurs pressure must be maintained on the site for at least 5 minutes by the phlebotomist.
Nursing / medical staff must be informed and an incident form completed.
Should the patient complain of weakness or suffer a syncope, the phlebotomist must immediately withdraw and dispose of the needle. If appropriate, sips of water can be given and patient should be reassured.
Phlebotomy chair should be fully reclined or patient lowered to supine position.
Phlebotomist stays with patient until he/she recovers.
Patient may be advised/ transferred to E.D. according to hospital protocol.
If Syncope occurs, incident form must be completed and medical/nursing staff informed.