If the thought of getting a blood test fills you with dread, you may be surprised to learn that, when done properly, a blood draw—or venipuncture as it’s called in the medical world—should feel like nothing more than a small pinch. But if you’ve had your share of uncomfortable—if not downright painful—blood draws, you know that’s not always the case.
Why this matters: When it comes to blood draws, fear of needles can have significant effects on health if it prevents individuals from obtaining necessary blood tests related to such chronic conditions as diabetes, cancer, heart problems, kidney disease, thyroid disorders and asthma.
Fear of needles also can be a reason why some patients fail to get recommended vaccinations. In a survey of 100 US physicians, 71% said this fear played a role in patients not getting a tetanus vaccination, and the same percentage said that it was a likely factor for those who skipped a flu shot, according to research published in The American Journal of Medicine.
Blood-collection procedures are not without risk. Bruising is the most common but is seldom more than just an unsightly mark on the skin that soon fades. However, one study found that one out of every 6,300 blood donations leads to nerve injury. Most of these injuries eventually resolve, but some become permanently disabling.
As we grow older, it is more difficult to get blood from a vein. That’s because our veins lose elasticity, shrink or are fragile. But that doesn’t mean you have to put up with pain. What to do…
To ensure that your blood draw will be as painless as possible, you should take action before the blood test…
Ask for a phlebotomist. When you’re being taken back to have blood drawn, ask if a phlebotomist is available. Surprisingly, most nurses learn to draw blood “on the job,” because most nursing schools don’t teach this skill. Phlebotomists, on the other hand, are health professionals who are trained to draw blood. Because they draw blood all day every day, phlebotomists are more likely to perform a less painful blood draw. You’ll find phlebotomists at most hospitals, some health-care practices and most testing centers, such as LabCorp and Quest Diagnostics.
Always ask whether a phlebotomist is certified. Only four states require it, but many phlebotomists get certified on their own initiative, and some hospitals require it even if their state doesn’t. Respected certification organizations are the National Center for Competency Testing, American Medical Technologists and the American Society for Clinical Pathology.
What you may not realize: In major US cities, phlebotomists may be available to perform blood tests in your home. To find a phlebotomist who can do this, search “mobile phlebotomists” on the Internet. Check with your insurer beforehand to see if this service will be covered.
Hydrate well. In addition to your usual water intake, drink two extra eight-ounce glasses of water about eight hours before the test. You need this much time to increase blood volume in your veins, making a vein easier to find. If you’re not scheduled for a test that requires fasting, be sure to eat normally. The low blood sugar that can result from skipping a meal can contribute to feeling faint after your blood draw.
Once you’ve rolled up your sleeve for your blood test, be sure to…
Speak up. Having a friendly chat with the technician can be a good distraction. But also be sure to let the technician know about your past experiences—especially if you’ve found that it’s easier to get blood from one arm instead of the other or if you’ve ever experienced side effects, such as nausea or fainting. If having more information puts you at ease, also ask questions, such as how many vials are needed.
Don’t be shy about sharing how you’re feeling, whether that’s nervous or even terrified. This will alert the technician (whether it’s a phlebotomist or a nurse) so that he/she can try helpful strategies, such as having you lie down instead of sitting in a chair…using an ice pack to numb the area…and showing an abundance of compassion and patience so that the procedure unfolds calmly—rushing only increases anxiety.
Important: If you’ve had a mastectomy, always mention that. A blood draw should not be performed on the side that was operated on (changes in lymph flow could affect test results and make the limb more susceptible to infection) unless your doctor gives written permission. If you had a double mastectomy, the draw might be performed from a foot or ankle.
Use the best position. You should either lie down or sit in a chair with arm rests. If you sit upright on an exam table or in an armless chair, you could easily fall if you faint or feel dizzy. Be sure to hyperextend your arm to make veins easier to see—lowering the arm and locking the elbow helps bring your veins to the skin surface.
Watch out for this common mistake: The technician likely will have you make a fist, but do not pump it—this commonly used practice can temporarily raise your blood level of potassium, leading to a falsely elevated result. If finding a vein is difficult, the technician may ask you to pump your fist to locate the vein but should then release the tourniquet and wait two minutes for your potassium levels to return to normal before performing the draw.
Ask about using cold and vibration. Together, these sensations scramble brain sensors and can keep you from feeling the needle going in. The technician usually can provide a cold pack, and there are commercial products available, such as Buzzy, which combines a mini ice pack with a vibration device. It’s marketed to health-care professionals and patients to use mainly for kids, but it works for any age.
Try antianxiety approaches. What works best…
Use applied muscle tension. With this technique, you tighten and release certain muscles, such as leg muscles or muscles in the arm not being used. Tighten for 10 to 15 seconds, then relax for 20 seconds and repeat.
This sends a signal to your heart to engage your circulatory system and raise blood pressure, lessening the likelihood that you’ll faint. It also gives you something else to concentrate on besides the blood draw, reducing your anxiety. Communicate what you’re doing since it may not be obvious to the technician.
Engage your mind elsewhere. Close your eyes, and visualize yourself frolicking on a beach or soaking in a warm bubble bath. If you prefer to keep your eyes open, count all the letters on a poster hanging on the wall. Distract yourself by humming, for example, or bring someone along to engage you in a distraction activity, such as quiet conversation, during the draw.
When the blood draw is complete, it’s important to…
Get up slowly. Patients who faint during or after a blood draw do so because they have a vasovagal reaction—a primal and natural reaction of the nerves to fear and anxiety that reduces blood flow to the brain. Because it often comes without warning, take your time before standing up. Once you’re on your feet, wait a few seconds before walking. Make sure you’re not feeling light-headed before taking any steps. Tell the technician if you feel even the slightest light-headedness so that you can be monitored.
Helpful: If you were instructed to fast before the blood test, bring a snack, such as a protein bar or some nuts, that you can eat following the blood draw.
Important: Always be sure to follow up on your blood test results, via the patient portal or in a phone call to the doctor’s office.
