Blood test and needle use, was this correct?

[RealLifeClanger]

I have just read that a needle shouldn't be inserted twice but when I had a blood test yesterday the nurse couldn't get any blood out on the first go so she took the needle out and tried a different vein with the same needle. Is this normal? I'm a bit concerned now as she seemed to fumble around generally with what she was doing and also used the keyboard and mouse with her gloves on before she took my blood, which I thought wasn't very hygienic but I was too stressed at the time to say anything.

No, I’ve always been told that once it has broken the skin it should be disposed of. This is because it is duller and could bend / hook or cause more pain etc and you have a small infection risk.

The gloves, meh, gloves give a false sense of hygiene anyway, as long as she cleaned your skin and didn’t stick her fingers in her mouth I wouldn’t be too worried.

I would moan to the blood test service about reusing a needle that had already pierced your skin.

@FurForksSake It said on my blood test results that the sample was slightly haemolysed. I wonder if that had something to do with it.

When you say infection do you mean in the skin or like a blood infection? I have anxiety so worry about these things :/

Gloves - not bothered. Reuse needle? Absolutely not and I’d make a strong complaint to the practice manager. That said, any risk is extremely low.

its not a massive problem at all so long as they were using an appropriate no-touch technique. Gloves are for her protection more than yours.

@Greybeardy I'm not sure what the no touch technique is but she touched my arm to feel for the vein.

@RealLifeClanger it’s a tiny tiny infection risk and it would be mitigated by the fact they cleaned the skin before they put the needle in both times. The needle will have been completely sterile so it would be a tiny, tiny risk.

If (and you won’t have done) you did pick up an infection it would be from skin bacteria so a bacterial skin infection, cellulitis or an abscess would be the outcome. She didn’t enter a vein and even if she did she’d be infecting you with your own blood so you’re not at risk of anything blood borne.

I suspect the using a needle twice is more common than you realise. It’s not good practice and shouldn’t be done but the actual infection risks are low.

Try not to worry about becoming unwell, but you can keep an eye out for your skin in that area becoming red, hot and inflamed and flu like symptoms. But again, very, very low risk.

Thanks @FurForksSake she did clean the skin but then touched the area herself with the gloves on to feel for the vein. I'm really hoping her keyboard and mouse were clean 😬

You will be fine, honestly try not to worry.

National guidelines say you don't have to clean the skin for venepuncture only cannula

Yes officially shouldn't reuse a needle but I've seen many colleagues do without issue

Haemolysed blood is unrelated. Just either means tourniquet was on a bit long or the blood took a while to drip out so some of thr cells got a bit squished

The risk of infection is microscopic, wouldn't even cross my find as an anaesthetist if happened to me

I think that ideally you shouldn't, but I think if she just couldn't get the vein and was just trying again with same patient in same session that isn't a problem. It's not what they mean by reusing needles.

@Destiny123 interesting that it isn’t national guidelines, but it is many local guidelines. This isn’t my trust and I actually don’t work in a role any more that cannulates etc but when I did we very much followed very very similar guidelines. https://www.uhbw.nhs.uk/assets/1/23-778_blood_culture_sop2_redacted.pdf

@RealLifeClanger I hope you are reassured. As we’ve all said, tiny risk. Perhaps not best practice but not unusual and risk is absolutely minimal.

that guideline is for blood cultures - different process for fairly obvious reasons (skin contaminants will affect the results)

Ahhhh I didn’t even notice. Ffs. Ignore me.

https://www.ncbi.nlm.nih.gov/books/NBK138655/ well the link may have been to cultures, but I’ve now found in the phlebotomy guidance the cleaning of skin. I know advice changes, but it is recommended and I’d say common sense to clean the skin. Even if risks are low and I doubt many of us have had a blood test where they haven’t cleaned the skin.

Whatever. Risks are low. Don’t worry.

I recently had a blood test at my surgery and the nurse was pressing the veins with her hand to find a good one, no gloves and didn't wash her hands before or use alcohol gel, and didn't clean the skin with an alcohol wipe. She also used the computer before doing the test, and opened and closed the door when I came in, so obviously lots of bacteria on her hand from the door handle!

It did cross my mind that maybe standards have dropped or possibly nurses not getting the correct training, but probably just downright lazy.

@Wonderlandpeony that's crazy. I'm guessing you were still fine?! I'm hypervigilent with hand hygiene and possibly have ocd tendencies so I think I would have had to speak up in that instance. I'm going to have to start overcoming my social anxiety to appease my medical anxiety at this rate.

Honestly, @RealLifeClanger you will be fine, you are probably at more risk from a door handle than this. However, please do feel free to ask questions of medical professionals, they will be happy to explain and answer anything. The chances of an infection are super, super low to be negligible.

@FurForksSake thank you, I really appreciate the reassurance. It does help calm me down. I think it's best I explain my anxiety at these appointments in future and hopefully they'll understand.

Yeah I always do anyway cos the cleaning swabs are everywhere in theatres but in medical school we were taught if the skin is visibly clean you don't need to (same as u don't clean the skin for intramuscular injections)

You've Quoted guidelines for blood cultures looking for blood stream infections which 100% need skin cleaning and aseptic technique, we are talking about normal venepuncture here