By Lady of Webs
(Reprinted with permission from Les Vampires.)
[Disclaimer: The information provided here is for educational purposes only and is purely the opinion of the author. This site disclaims all responsibility for reliability or veracity of its content. Should you choose to undertake Any of these practices discussed here you do so entirely at your own risk. Neither the author nor editors advocate any of these practices nor guarantee their safety nor do they promote support or encourage the breach of any applicable laws. This is dangerous and not to be undertaken without proper medical training.]
I’m a registered nurse and have a lot of experience with phlebotomy. I’ve also taught it to quite a few vamps. Donors can do this too if they’re so inclined. Most phlebotomists aren’t licensed, it’s a skill they’ve been taught and improved by experience. Everybody starts somewhere.
Some donors prefer venipuncture because it’s something they’ve experienced before and they know what to expect in terms of pain and/or because it can be easier to conceal than a cut. However, also be aware there are people who are very squeamish about needles. Find a good diagram of veins and arteries and study it thoroughly, although it probably won’t show all the smaller veins in the hand and lower arm, and there are always individual variations.
If someone has little or no experience with venipuncture, I usually recommend they start with a butterfly needle setup. A 23-gauge needle is a good one to learn with. The larger the number the smaller the needle. A butterfly needle has little plastic wings on it and it’s easier to guide. It also has a length of tubing on it that can either be attached to a syringe or used like a straw by the vamp.
Make sure your donor is warm and comfortable, as veins just disappear in cold nervous people, and it’s also a nice thing to do for your donor.
The technique: Most venipunctures are done in the arms, although hands are acceptable. Most people have a large vein in the inner aspect of the elbow called the antecubital vein. You’ll need to feel it as it runs to the side in some people rather than the center. To tap a vein, place the tourniquet just above the elbow. Cross ends of the tourniquet once , then tuck the upper piece back under the lower piece to make like a half bow, so the tourniquet can be released easily with one hand. If you’re going to use a vein below the elbow, you can either put the tourniquet above or below the elbow. Sometimes below makes the lower veins stand out better. You want the tourniquet to be snug but not painful. Also be aware some people have a latex allergy so be sure to ask your donor. There are latex-free tourniquets available.
When you’re starting out, it’s usually good to use a vein that you can both see and feel. After you’ve applied the tourniquet, use either a cotton ball or small gauze pad soaked with alcohol or hydrogen peroxide and stroke the veins as you look. Stroking makes them stand out better. You can also lightly slap the area with the tips of your fingers. When you’re picking a vein, see if it ‘rolls’ easily from side to side. If so have the donor make a loose or tight fist, whichever works. Stay away from anything that pulses. Those are arteries not veins, so don’t mess with them. Also be sure you’re feeling a vein and not a tendon, as sticking a tendon just downright hurts and you won’t get any blood either. Rotating the donor’s wrist gently in either direction, while feeling for the vein with your finger, can move the vein away from a close-by tendon or bone, reducing the risk of hitting something other than the intended vein. Once you’ve chosen a vein, clean the area with alcohol or hydrogen peroxide. If you pefer to use betadine, be sure to clean it off, as it’s irritating to the skin if left on. Hydrogen peroxide is my personal favorite because if there’s any sucking involved, it has the least taste to it.
Uncap the needle and look at the tip and turn it bevel up (like a scoop, longest pointy part on bottom). Don’t touch the needle itself, it needs to stay sterile. For ‘rolling’ veins, you need to pull back on the skin a little behind where you’re going to pierce, to keep the vein steady as you pierce. Pierce the skin at about a 45 degree angle directly on top of the vein, then lower the needle closer to the skin as you go into the vein (a few people prefer to pierce on one side of the vein and then go into the vein, it’s a personal preference). You need to pierce the vein in the direction towards the body (just keep in mind, veins are flowing back to the heart). Don’t be too slow about it but don’t jab either. Just do it in one steady move. If your hand shakes, don’t freak out; after 15 years I still have times when my hand shakes too. Just don’t scare the donor. If you’re shaking too much, best to wait until you settle down a little.
If you’re in the vein, you’ll see a blood return in the needle hub or the tubing. Once you see blood you don’t have to advance very far, just far enough so it won’t fall out, a little under half an inch. You don’t want to take the chance of going through the vein. If you going to be drawing the blood into a syringe or sipping from the tubing, you need to leave the tourniquet on for as long as you’re drawing. You can also put a small piece of tape across the needle or wings to hold it in place. When you’re done, release the tourniquet first, then withdraw the needle as you get ready to apply pressure with another cottonball or piece of gauze. Now we’re talking vampires here, not laboratories, so the vampire may want to suck directly from the site once the needle’s been removed. If so, the tourniquet can be left on for a short time, or the vamp may just prefer to use pressure from his or her hand like a tourniquet.
Another newsflash: For years we were taught to apply the cotton ball and bend the person’s arm up, to hold pressure. Now the standard is just to apply the cotton-ball or gauze and hold pressure a few minutes. I’m told bending actually causes more bruising and breaks up the platelet clot that’s forming. After you’ve released the pressure, check to see if it’s bleeding through the gauze/cotton/band-aid and if so, continue to hold pressure a little longer. Change it if necessary. You can apply a band-aid or a piece of tape over it, but sometimes bandaids cause more bruising when left on. They do on me and then I have a bruise to cover up instead just a small needle mark.
Now what if you make an oops? Don’t feel too bad, everyone does, even the most experienced people now and then. If you just don’t get any blood back, but you don’t see any swelling at the site, then pull the needle back a little, but not out. Feel the vein again, then move forward again in the direction where you feel the vein. If you can’t get it after a few tries or it’s hurting the donor, then take it out and do aftercare. If you remove the needle completely from the skin, don’t reinsert it. You can however, use the same hole again with a new needle, if you just missed and didn’t ‘blow’ the vein. Or depending on the state of your donor, you can try in another spot. Release the tourniquet between tries so the donor’s arm can get some circulation. If you can’t see or feel any veins, you can try a warm wet compress around the arm for 10 or 15 minutes and again be sure your donor is warm and comfortable. Something warm to drink like tea may help too or a glass of wine is also a good vasodilator. If you put the needle in and you see blood come back but the area starts to swell, pull the tourniquet immediately, withdraw the needle and do aftercare. What’s happened is that the vein has ‘blown’. You either went through the vein, or scraped the side of it and it’s bleeding under the skin. Or a few people just have very fragile veins. It’s not dangerous, but be nice to your donor because it will leave a nasty bruise. Warm wet compresses for awhile can give some relief and help the swelling go down. They can take an over-the-counter pain reliever if they need it. If you accidentally hit an artery, which is highly unlikely if you’ve stayed away from anything that pulses and studied your veins and arteries, you’ll know because it will be bright red and the blood will fill the tubing or syringe quickly. Release the tourniquet, withdraw the needle and apply firm pressure with a gauze pad or cotton-ball for at least 5 minutes. Then tape it snugly and check it to be sure it’s not bleeding through. If so, hold pressure longer.
Syringes: If you’re going to draw blood into a syringe, I would recommend a 10cc syringe. That’s the equivalent of 2 teaspoons of blood. You can use a 20cc syringe, but if you do, be sure you’re using a 21 or 19 gauge needle, or it’s just too hard to draw. Pull gently back on the plunger while you hold the needle in place at the hub (or tape a butterfly needle). If the blood’s not coming easily, ask the donor to take some slow deep breaths and relax. When you see the blood coming just give it time with slow steady gentle pulling until it’s full. Too much suction can cause the vein to collapse. Some vamps draw more than one syringe, if they’re experienced enough to switch out syringes and not move the needle. It’s easier with a butterfly setup to do multiple syringes.
Needles: Once you’re prolific with a 23 gauge (I don’t recommend anything smaller or it will be hard to draw the blood), then you can increase the gauge size if you wish to 19g or 21g. An 18g will give a lot of blood quickly, but it does have a bite to it and I recommend it only after the donor (and the vamp) are experienced. And for heaven’s sake, don’t harpoon someone with a 16g or 14g, it’s not recommended unless you’re very experienced and your donor doesn’t complain. You can also use a plain hypodermic needle either with a syringe or just let the blood free-flow down the arm or into a preferred vessel. Try to get your hypodermic needles in the 1 inch length. Anything longer than that is sometimes unwieldy. When ordering needles, for example, a 21g x 1″ is a 21 gauge needle that is one inch long. The butterfly sets come in gauges with different lengths of tubing usually 6 or 12 inches. You really shouldn’t ever reuse needles, even the butterfly ones. Use a new sterile one each time. And if you have to pull the needle completely out of the skin, don’t reinsert the same needle. And please dispose of needles safely in something like an empty plastic soft drink or water bottle with a screw-on cap.
Where do you find supplies? Asking around is usually your best source. Most items can be purchased online. More on supplies will be found on Les Vampires’ Needful Things page.
Lancets: I’ll mention lancets here as they are a way of drawing blood. Lancets may be found at any store that carries diabetic supplies. You can use them on the tips of the fingers (I like to call it fingerfood), the forearms or other areas. For the purposes of bloodletting, it will usually take more than one puncture. There are some new lancets on the market that slice rather than puncture and yield up more blood with one application; however, they are considered a specialty medical product and may be harder to find.
~Be Safe and Feed Well~