Saturday, March 5, 2011

Blood Draws and I.V.'s

This is how Idaho midwives get to their patients!

As Maid Elizabeth draws nearer to her planned mission trip to the Philippines, she has ramped up her acquisitions of medical skills.  Today she learned the very essential skills of drawing blood and starting and administering I.V.'s.  One of the wonderful things about her training for midwifery is that she is becoming proficient in numerous techniques not only needed in midwifery, but in any medical situation.  And we have the added benefit of learning along side her (and sometimes being her Guinea pig!).  

And this is how we spend our weekends....

Maid Elizabeth and her precepter midwife
getting ready to begin blood draws
Teacher and Student

Starting with a "dummy" arm
Cleaning the site (always practice like
it's "for real")
Applying the tourniquet
Instruction on choosing a vein
Placing the needle
Inserting the vacutainer
Removing the needle, having released
the tourniquet
Now, it's Sir Knight's turn!
The tourniquet is in place, now it is time
to insert the needle
The needle slides right into the vein

She hit paydirt (as you can see from
the blood flowing through
the tube)
And the sharps go in the sharps container
This is what I call "Home School"!

As a side note, Maid Elizabeth went to her first prenatal as a Primary midwife later in the afternoon.  She preformed her first blood draw flawlessly!  What a testament to both teacher and student!


  1. Practice, practice and more practice. Practice on folks with thicker and darker skin types. A blind man could have hit those veins on the guy pictured. If you've ever looked at someone and said great veins, you might be in EMS, and I am. Most folks don't have veins that good. I do 10-15 a night at the ER. She may wish to invest in a vein light ems. I use this all the time as I have poor feeling in my finger tips. I'm the go to guy for hard sticks as a result of its help.

    Keep up the great work both of you.

    Ken Lowder

  2. High FIVE Maid Marion! You GO Young Lady!

  3. Wow, Sir Knight is very brave and obviously trusts his daughter. That is truly home educating. I look forward to following her on her experiences as a midwife. (I have wanted to be a midwife for years).

  4. Love it! Always enjoy seeing these updates:) I'm one of those people that have horrible veins in my arms. Just can't find them! Unless someone is really experienced, things don't go well. On the flip side-my hands have great veins!I always tell them in advance, but you wouldn't believe how many techs insist that they can draw blood from my arm "let's just try it,I know what I'm doing"....
    So,if you don't mind a suggestion, definitely practice a lot learning the standard approach-looks like you've got it mastered:) but also familiarize yourself with alternative sites.

  5. Haven't ever seen homeschool lessons like that. That is an extensive education. I'll be praying for her mission trip ~ thats exciting. I've been to Honduras 3 times and my husband is going to Haiti this summer.

  6. How can an average Joe get equipment to do person-to-person blood transfusions? I have a place in the mountains and a few folks to join me. But if someone is injured and needs blood (I know everyone's type) I need a way to get it from one person to another. Any ideas?

  7. Even in the most austere environment scenarios, the administration of whole blood, directly from one person to another is considered HIGH RISK and is discouraged and is not condoned by medical professional practice standards.
    There are health and safety criteria issues which make it high risk.
    Some of these are:Infectious diseases being passed, Hep B, C and D., HIV, incompatibility of blood types or the presence of unusual, atypical antibodies present causing anaphylaxis, coagulation factors, and the requirement of a narrow range of thermodynamics for human blood in transfusion.

    In emergency situations in an austere environment with significant blood loss, prevention or reversal of hypovolemic shock is best accomplished with IV rehydration with a rapid bolus of sterile IV fluids of Ringer's Lactate or N/S, as the recommended choices. These bags or bottles can be procured from a MD or from a VET. Supply Co. The fluids do have expiration dates to adhere to.

    Of primary importance: Consider your experience and skill level before EVER performing a procedure as described above. Rule of thumb is if you have NEVER performed a venous puncture with sterile equipment before, then you would want to obtain the skill to do these procedures long before you have to ever use the skill in an emergency situation!
    Volunteer at a Blood drive and get some visual observation time logged assisting with these procedures being performed. Seeing is not the same as Doing this yourself, ALONE. If you want to learn more, Take an EMT course, taught by a Paramedic or an RN. Take a Wilderness First Aid Course.
    Search the web for "administering blood in austere"
    and you will find some other useful suggestions.

  8. Anonymous;

    Thank you so much for answering the person to person blood transfusion question! I wouldn't even know where to start. My understanding has always been that it is very dangerous - you really need to know what you are doing. Thank you for tackling that sticky question.


  9. Reply to anon, Mary. I've really need to be around the elbow or higher. Blood draws can be in the hand. Emt's and paramedics start iv's. If a cat scan is ordered or drugs are given you need to use a larger vein with a larger cath. That is why they look in the elbow area. Your vein is there, it's just deeper than in your hand and harder to feel and find. That's why I find my vein light very useful.


  10. Don't know if this is possible anymore, as I trained as a medic in the ANG and a paramedic back when the earth was formed and dirt was new. However, we had access to both the ER and the morgue and were allowed to "draw" blood on the deceased. It was not done out of disrespect, but if someone is in trouble, you're going to have a HARD time finding a good vein in many people. If you can start an IV on a cadaver, you can start it on just about any one. It takes practice, a knowledge of anatomy and a sense of touch. I've started IV's in the dark on a person in cardiac arrest and successfully hit that big vein in the antefossa area. However, note that some people (like me that have had a vein completely blow out due to a medical procedure) won't have a vein there to stick. So you then have to move laterally to get the next biggest vein.

    If you have and ER or paramedics in your area, they may have some suggestions about where you can go to get practice on real people. Because in the end, it's the practice, practice, practice that does the job.

    Good job on your sticks Maid Elizabeth. I wish you well on your mission. (And I would envy your use of a fake arm before having to do live sticks. Back "in the day", we had to just practice on each other - and we did it without gloves! Scary now to think about doing THAT!)