O. Y. Buowari / Advances in Bioscience and Biotechnology 4 (2013) 126-128 127
venepuncture site.
Haematoma complication can occur as a minor com-
plication of venepuncture 1. The haematoma forms under
the skin adjacen t to the puncture site [6]. When it occurs
release the tourniquet immediately, withd raws the needle,
and apply firm pressure [6]. Haematoma occurs when the
area around the puncture sites begins to swell indicating
that blood is leaking into the tissues, wh ich will result in
a bruise [2,4] due to partial insertion into the vein 4. If
this happens, immediately remove the needles apply
pressure for two minutes and recheck to ensure bleeding
has stopped [4]. To avoid haematoma formation from
venepuncture, puncture only the uppermost wall of the
vein just under the skin, remove the tourniquets before
removing the needle, use the major superficial veins,
make sure the need le fully penetrates the uppermost wall
of the veins because partial puncture may allow blood to
leak into the tissue just und er the skin and ap ply pressure
to the puncture site. Haematoma is formed when blood
leaks into the tissue surrounding the insertion site after
failure to penetrate the vein properly during insertion [8 ].
Haematoma is a collection of blood under the skin [9]. If
a haematoma begins to form while blood is being with-
drawn, the needle should be removed immediately and
pressure maintained over the site [9]. Some of the causes
of haematoma formation after venepuncture are small
fragile veins, needle too large, excessive probing to find
vein, removing the needle prior to releasing the tourni-
quest, needle going all the way through the vein, needle
only partially entering the vein allowing leakage, apply-
ing pressure to gauze before the needle is removed [9].
2.2. Infection
This may be localized giving rise to thrombophlebitis or
systemic leading to septicemia. The infection may be
localized or systemic. However, peripheral intravenous
cannula infections are more commonly associated with
localized than systemic infection [10]. Inadequate clean-
sing or poor technique can lead to infection [9]. Infection
can cause phlebitis and thrombus formation [8]. It is
prevented by good aseptic technique and keeping any
dressing over the venepuncture site clean [8,11]. Phlebi-
tis is an acute inflammation of the intima of the veins [8].
It is caused by mechanical and chemical irritation or by
microscopic particles that may contaminate infusion flu-
ids’.
2.3. Nerve Damage
Hematoma formation following venepucture can be pain-
ful and can potentially cause nerve damage [2,9]. Among
complications associated with phlebotomy, nerve injury
is relatively rare, but is potentially serious and often re-
sults in malpractice lawsuits [12]. Patient may feel sharp
electric tingling if a nerve is hit. Immediate discontinue
that venepuncture and the patient may need physical
therapy [4]. Inap propriate sites or excessive probing may
lead to nerve damage [9]. Patient may complain of se-
vere pain and the procedure should be stopped immedi-
ately [9].
2.4. Haemoconcentration
This can result from prolonged tourniquet application. It
can be caused by prolonged tourniquet application, mas-
sageing, squeezing or probing a site, long-term intrave-
nous fluid therapy, scleroses or occluded veins, dehydra-
tion and certain diseases [4]. Haemoconcentration may
cause false increase in potassium ion, phosphorus, am-
monia and total protein [4]. Intravenous line complica-
tions can result in morbidity and increased health care
costs from prolonged hospitalization, extended use of
intravenous antibiotics therapy and surgical intervention
[7].
2.5. Extravasations
Extravasations occurs when a cannula pulls out of the
vein or becomes partly occluded by venous construction
causing backflow of the infusate through the puncture
site into the surrounding tissues [8]. The patient may
complain if tightness, burning and discomfort around the
intravenous site and th ere may be swelling and b lanch ing
of the tissues [8]. In extravagation, the cannu la enters the
tissues rather than the vein [11]. In this condition, flush-
ing will be difficult and swelling/pain may be noted the
cannula should be removed immediately.
2.6. Syncope and Fainting
Patients may become dizzy and faint at the thought or
sight of blood [6]. It is caused because of rapid fall in the
blood pressure and it is an autonomic nervous system
reaction (psychomatic trigger) usually based on fear [6].
Syncope and fainting can procure during venepuncture
[1,4].
2.7. Petechiae
Petechiae may occur following venepuncture. This may
be due to coagulation problems or abnormalities [4,6].
The patient may bleed excessively after blood collection;
make sure bleeding stops prior to leaving the patient.
2.8. Excessive Bleeding
Excessive bleeding after venepucture can occur. In-pa-
tient on anticoagulants, on drugs such as aspirin medica-
tion or drugs that decrease the number of platelets [4].
The patient should not be left alone until bleeding has
stopped.
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