hi my name is Desiree I'm a CNN phlebotomy student I have permission to draw your blood okay can please state your name and date of birth okay this Hillerman 0 8 0 399 okay never wash my hands and globe off I'll be right back handy you going to be doing a butterfly hand draw I'm going to be using a BD vacutainer butterfly that you activate outside of the hands or the patient's on okay I'm going to take a look I'm still going to tie the tourniquet four inches above the site regardless of the location so because I'm going in her hand I'm going to tie it four inches above her hand please grab onto the chair there are three different ways you can make a vein pop up you can ask the patient to grab on to the chair as I did we please make a fist you can have them make a fist this makes the vein a little flatter or can you please make a half of a fist and then you can relax their hand this way and this makes the vein looser this way usually is good if the vein is really big so go ahead and make a fist again for me her vein is best that way so I'm going to use this style go ahead and open up your hand going to clean the site wipe down once flip over the alcohol counterclockwise concentric circles moving outward going to open up my packaging this needle is in a plastic so I'm going to remove that and then I'm going to uncoil my tubing I want to be careful when I pull on the tubing because if I pull too hard it will pull the needle in because that's the way it's activated so I'm going to just lightly pull it straight give it a couple tugs that way you can uncoil the tubing I'm going to use an ETS method so I'm going to add a hub you can also use this with a syringe does your hand feel dry going to reapply the tourniquet four inches above the site will you please make a fist again and you can ask the patient to put their wrist down you want to be aware if the patient brings their shoulder up at any time because sometimes I can make their hand anchor higher uncap my needle I'm going to anchor down at the knuckle lay my needle flat a my needle flat and just thread it in I get my flash I grab my hub and let go of the butterfly and make sure that my tubes are upward that way they feel from the bottom up and then I pop my tourniquet once I get a flow are you feeling okay yes this is a hand vein plus it is a smaller needle so it's going to feel slower I just have to be patient with it because I lost my flow I have to either lift up my angle which I got a better flow because the vein went back to normal size once I pop the tourniquet or another way I could have done it is I could have anchored on the skin a little more and it would have came back to the surface so I could have got the flow better so now I'm going to grab the base of this butterfly I'm going to put down my hub just kind of there's not enough space so I have to just let it hang and I'm going to pull out apply pressure and I want to wrap the tubing in my fingers and while I do that I'm going to pull down and push up on the safety device activating it please apply pressure going to discard your doing okay you're going to put the medical record number the date the time my initials and the test I'm going to label each tube accordion accordingly I want to make sure that I don't put it on cricket and the correct test goes with the correct tube I do want any blood thinners no hmm because the patient's not on any blood thinners I would normally use a bandage but because we drew the hand and the hand is used more you would probably want to use Co flex that way you bandage up the patient better in case they do lift anything heavy this is what Co flex looks like comes in a wrap and it sticks to itself you want to make sure that you put it tight but not so tight you're cutting off their circulation tear it and then just rub it to itself and it will self if he's okay are you feeling okay yeah okay you're all done thank you oh I'm sorry can I ask one more question you please verify that this is you yes and your date of birth yes okay so it's your name and date of birth yes okay thank you thank you