How else can a phlebotomist lessen my pain, on top of using a baby needle?

Question

My grandpa's specialist has ordered quarterly blood tests for him. Most of LifeLabs' phlebotomists (in Ontario, Canada) venipuncture very painfully.

Though he didn't mention algophobia, he chanced on a kinder phlebotomist yesterday who was canny enough to sense his needle phobia and introduced him to the baby needle, which every phlebotomist in his life (to his memory) failed to do.

He already drinks much water and gets blood pumping. Thus what else can a phlebotomist do?

Answer 1

Most people do not know that you are an active participant in getting blood drawn or IVs started. The skill differences among those who are poking you include their skill in getting you to do the right thing. My tips:

• drink plenty of fluids and avoid caffeine the day of the draw
• keep your arm warm. I leave it in a sweater until the last minute. I also rub the inside of my elbow while waiting for them to get all their tubes ready etc. When I was getting IV treatments they would wrap my arm in a heating pad
• relax, breathe slowly, try not to tense your mouth, in fact try opening your mouth a little. Make sure your entire arm is relaxed except for your hand if they've asked for a fist. This takes practice. Focus on it.
• support your elbow with your other hand to keep it at a good angle and to stop yourself from jerking backwards as the needle goes in
• keep your eyes open. Closing my eyes slows blood flow (learned this from a chemo nurse and would not have believed it but several experiences have shown it is true for me) Don't look at the puncture site or watch the blood if it upsets you. Focus on something behind the poker -- wall art, a clock, their computer, etc.
• tell them to use the smallest needle. If you have scar tissue from a lot of draws and tests, tell them so
• after they swab with alcohol, ask them to wait a moment until it evaporates. The burning sensation you sometimes feel as the needle goes in is alcohol. It's not necessary to endure that, just some pokers don't wait
• if there is a spot that hurts more or that often fails, tell them not to try that spot
• follow their instructions about making a fist etc
• pay attention every time, and when you have a "good" draw remember all the things you did, then do them next time whether the poker asks you to or not

I learned these tips from good phlebotomists and nurses. They have dramatically reduced the pain and bruising of both blood draws and IV starts. They also reduce the number of failed attempts. I have had a vein spasm shut once the needle is in, and been walked through a relaxation process that got it to open again. Opening both your eyes and mouth is key to this. Another time, when it spasmed shut with a different person, I convinced them to leave the needle and let me try getting it open. It worked and they said "I did not know that was possible." Neither did I until I learned to do it.

Actively work on learning what you can do to make the pain and difficulty less. People will tell you that you have nothing to do with it, but they're wrong. It's your arm, your muscles, your heart rate and blood pressure. You can make it go better.

[will add links if I find some]

Answer 2

This isn't the best suggestion in the time of a respiratory pandemic as we have now with COVID-19 but the cough trick is quite effective at pain reduction during venipuncture

We tested the effectiveness of the cough trick (CT) as a method of pain relief during peripheral venipuncture (VP) in a crossover study. Twenty healthy volunteers were punctured twice in the same hand vein within an interval of 3 wk, once with the CT procedure and once without it. The intensity of pain, hand withdrawal, palm sweating, blood pressure, heart rate, and serum glucose concentration were recorded. The intensity of pain during VP with the CT procedure was less than without it, whereas the other variables changed insignificantly. The easily performed CT was effective in pain reduction during VP, although the mechanism remains unclear.

Implications: The effectiveness of a cough trick for pain reduction during peripheral venipuncture was tested in a volunteer study in which each subject served as his own control. The easily performed cough-trick procedure was effective for pain reduction, although the mechanism remains unclear though is blocked by Naloxone. It is more effective than distraction by cognitive-motor tasks.

The cough trick is to turn ones head away from the phlebotomist and cough at the time of venipuncture. It somehow distracts the brain from pain perception.

Reducing Venipuncture Pain by a Cough Trick: A Randomized Crossover Volunteer Study https://pubmed.ncbi.nlm.nih.gov/14742367/

https://www.hindawi.com/journals/prm/2019/9459103/