Recently this question fell at NRC On the digital doormat: “I once went a blood donor for a few years, but I had to end that because it became a very annoying ‘operation’ with a lot of crop and bruises. Now I sometimes have to give up blood for checks. That is becoming increasingly difficult: one cannot find a barrel, puncture again, or is looking for a vessel. to be traced? ”
An annoying story. It can play with diagnostics or control, with blood donation or the construction of an infusion. How many people are ‘difficult to do’ is not well known and differs per context. Of ‘complex patients’ who need an infusion is Almost 60 percent Hard to puncture, but in healthy people the percentage is much lower.
‘Difficult barrels’ can have various causes, tell Kai-Anne Grotenhuis, donor doctor at Sanquin Bloodbank, and her colleague Dorris Krebbekx, an experienced skewer herself. “There are congenital factors, such as where and how deep the veins are and how narrow they are,” says Grotenhuis. “In the elderly, but also with people with cardiovascular disease or chemo patients, the veins and the tissues around it are less firm. That makes it more difficult. The vein can also ‘roll away’ if you want to puncture it.” Also overweight, veins can make it difficult to find – or muscle mass. Krebbekx: “Last week we had a bodybuilder. That was a challenge.”
Pickers with experience
And then there are temporary factors: the cold, dehydration or voltage can contract and they are more difficult to find. Patients are therefore advised Washing the hands with warm water, staying warm, drinking water and looking for distraction.
Very important is the experience of the skewer, Krebbekx emphasizes. “We quickly make dozens of drops per day,” she says. “It is a matter of feeling very good. Where the vein lies, but also under which corner you puncture and how deep. You can usually prevent ‘rolling away’ a vein by putting the barrel with your other hand tight. I sometimes stand with sweat on the back, but usually it just works.”
People for whom every decrease is hell does not see Grotenhuis, “because our donors are by definition healthy. And if poking still causes problems, they will not stay a donor for long.” Sanquin therefore does not use infrared or ultrasound aids to find the barrels.
But patients who have checks, such as our letter writer, have no choice. “We see few truly difficult cases, less than 0.5 percent,” says Ina Diermanse van Certe, an organization for diagnostics and health care advice. She has not yet heard that patients purchase a device themselves. “In our experience, those tools add little,” she says. “At most with young children. But usually the problem is in the quality of the vessels. You don’t solve that with such a device. And then: they are preciousand which do you choose then? It gives more hassle than it yields something. “
Is there no hope for the letter writer? Yes: some large hospitals have a special puncture clinic for difficult cases. They use Echo as a tool. “In our region I don’t know such clines,” Diermanse notes. But she also knows: “With an experienced skewer it always works.”