Case Study

case study
hematoma formation
Mrs. M.S. is a large, overweight, elderly woman who needs blood drawn for electrolytes, CBC and a prothrombin time. Mimi is a new phlebotomist at the local blood drawing center who must collect the blood sample from Mrs. M. S.   Mimi correctly verifies the identification of the patient by asking Mrs. M.S. her name and date of birth. Mimi then selects the tubes she needs, prepares the vacutainer, and selects the optimal site for venipuncture. Mimi carefully palpates the antecubital area of Mrs. M.S.’s left arm and is only able to locate the cephalic vein. Because Mrs. M.S. has very large arms, Mimi can only feel a small portion of the vein, and she therefore enters the vein at a larger angle than normal. Blood slowly enters the tube. Mimi also notices a raised area is forming around the needle. Mimi has only one more tube to collect and therefore fills the third tube before withdrawing the needle from the vein.

Note: If you find any information from the internet or any other source that is helping you answer the questions, be sure and cite your source (website). Remember, this is your own work! The appearance of plagerism must be avoided.

  1. This phlebotomist drew the cephalic vein. What would you have done with this situation regarding vein selection?

      If I was unable to locate the median cubital of Mrs. M.S. arm then the next choice would have to be the cephalic vein or possible a dorsal side of her hands and wrist (if better located.) Now because Mimi can only feel a small portion of the cephalic vein then I would have used a butterfly needle or a smaller straight needle because it would be less painful for the patient and possibly easier in this sort of situation for me.

  2. What other veins in the antecubital area are acceptable for venipuncture? Name the vein and their relative location. What is the order of preference of these 2 veins and the cephalic vein that she drew?

      The other veins in the...