The page below is a sample from the LabCE course Minimizing Pre-Analytical Variability During Venipuncture and Urine Sample Collection Processes. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Traumatic Draw

Phlebotomists are trained to avoid or minimize the practice of "fishing" for the vein if the initial attempt to insert the collection needle into the vein is missed. In addition to this "fishing" process being painful to the patient, it could cause tissue and vascular damage at and around the phlebotomy site. Further, the underlying damaged tissues release chemicals called cytokines, which, along with blood that may pool in the surrounding tissue, may be drawn into the vacuum of the collection tube, resulting in a fluid that is not truly representative of the circulating blood. Such mixtures of vascular blood and tissue fluids are also more likely to be hemolyzed.