Questions about the blood draw conversation

I will try to answer...
I'm going to guess that your veins are constricting, due to your own unique pathophysiology. It's not a common response to being stuck but it does happen and I've witnessed it. Usually vasospasm refers to arteries but it can sometimes happen in veins as well.

The butterfly is a specific type of needle with little flaps to hold onto and help guide the needle. It's not any easier for the person doing the needle to have the flaps, mind you. Typically it works better for a person with small veins because it's a smaller gauge needle, usually 25 or 23, while the other type is often 21 or 22g. What you want is the smaller gauge (like wire, the higher the number the smaller the needle). You most likely need the 25g, that's a common butterfly size. It's not really that the needle itself is any different in the way it works, it's just got the flaps and it's smaller and connected to a bit of tubing.

If you're getting an IV for a procedure, they will want the largest size they can get NOT to hurt you or for their convenience, but so in an emergency fluids can be run much faster. Believe me, when someone codes, you want at least a 20 and if all you've got is a 22 you're going to be looking for better access. A butterfly set is rarely used for an IV but sometimes, for limited infusions or very short-term use, it may be used. It's only rated for 2 hours of use. That's largely for infection control and because you don't normally leave a metal needle in a patient's vein, and that's what you're doing with a butterfly. Normal IVs use a metal needle to introduce a plastic catheter, and the needle is removed after insertion.

There is no bruising on your hand simply because the vein didn't leak any blood. Leaking a bit of blood is generally normal after having a needle in a vein. Large amounts of bruising aren't normal and means the vein blew or you're on blood thinners or whatever. No blood either means she was never in the vein, or it just didn't bleed under the skin when the needle was removed. It's not a sign of anything in particular other than your vein didn't bleed.

What you can tell them: you have a weird thing where your veins spasm when you're stuck, and in the past they've only had success with a small-gauge butterfly needle, so please try that first. If they refuse, they're not worth their salt. Ask for someone else who is willing to try your way. Ask nicely, but ask all the same. It's your body, you know your veins.

It is very hard to get anyone to get blood out of my upper arms. Those veins squirrel away and hide. I have actually had blood drawers dig around in my arm and it is painful.

So I request a draw from my hand. Numourus times I have had someone say, I'm the best I can do it. No, I want it out of my hand. They say it will hurt etc and I have to insist. As Z*G states, you know your body..they can find so one who will do it your way.

This is very true. I also look like a good easy stick but I am not. I know exactly where they can expect success starting an IV and there there will be guaranteed failure. I also speak up and they always listen and that works better for everyone. Of course, now I have a port and that introduces a whole new set of challenges but....

I'm impossible to get blood from, also! I used to have to have blood work done every six months before I had surgery this last time and I SOOO do not miss being a human pincushion and having to sit around while the nurse goes off to find someone else to try. I had major surgery several years ago and ended up with my IV in the vein in the top of my foot because they couldn't get it in my arms or hands.

You can help with the success of blood draws (not necessarily IV placement) by making sure that you are well-hydrated at the time.

This may seem silly, but they had problems getting an IV started on me the last time that I had surgery. How can you guarantee that you're well-hydrated if you are NPO?

You can make sure you drink lots of water the day before surgery up until the cutoff point. That's really the best you can do.

You're brave. I haven't had issues with having blood from my arm. At my last appointment the nurse went right to my hand and I silently whimpered.

I'm weird though. I'd rather have blood drawn out of my arm than in my hand or the WORST is pricking my finger. I really don't want to become diabetic.

Our entire family drinks tons of water all day long but when my daughter is NPO for all of her surgeries, forget it. Her bad veins just get worse.

I am a hard stick too. When I go to get blood drawn for my yearly physical, they are very helpful and listen what I have to say. I have no complaints!

However, the few time I have gone in for surgery, the nurses there do NOT want to listen to what I have to say. One time my mom was in the room with me, I told the nurse I am a hard stick, my mom told her, too. She proceeded to poke and prod me. I had blood all over the place. I thought my mom was going to toss her out!

On another surgery, they tried to get an IV in me prior to operating room but they could not do it. The anesthesiologist came out and said he would put on in after I was out, they would give me gas to go to sleep.

The last time I was in the hospital, the nurse there wanted to get an IV in me. Again, I told him I was a hard stick, he said he is good at finding veins. No problem. After the third stick, I told him he needed to find someone else. I was done. My arms hurt so bad, blood was everywhere. I had to change my gown. I will post one pic to show the bruising (this is will be one arm, the other was the same). When I went to go have surgery, the anesthesiologist was looking at the needle and said they had to get a new, bigger one in. I said, please do that when I am asleep. He knew I was serious by looking at my arms.

So, I can do good for blood draws, but not IVs.