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Newbie Questions - Is there a smaller size needle for venesection? (UK, needle phobic)

Posted , 7 users are following.

moonstruck
moonstruck

Hi there

Re: needle phobic

My husband has recently been diagnosed as H - and had his first vensection at NHS Hospital in Kent.  He absolutely hated the experience (not as if anybody's going to enjoy it, mind!) and the huge needle which I must admit made me shudder, just watching - for now, he will need fortnightly venesection.

Has anybody in the UK managed successfully to have their blood drawn with a smaller needle? 

We understand the venesection pack comes complete (Macopharm supplier) and the large size needle (16 or 18?) is attached.

The phelbotomy nurses at the Hospital Clinic said there's just the one size needle pack - and no other option.

From research, I've discovered there is a Macopharm Leur Lock venesection pack - to which a different (smaller) size needle can be attached, has anybody had a smaller needle?

Would there be issues with clotting if a smaller needle was used - and what's the smallest that can be used on an adult not taking any blood thinning med?

With many thanks for any advice, we're just starting out on this road.

0 likes, 12 replies

12 Replies

  • samantha27302
    samantha27302 moonstruck

    Posted

    Hi there, 

    Would the hospital be The new Tunbridge Wells one by any chance ? 

    • moonstruck
      moonstruck samantha27302

      Posted

      Hi Samantha27302 - it's Darent Valley - although we are in the process of moving and Tunbridge Wells will be our new hospital ... what's it like there?

  • eric89660
    eric89660 moonstruck

    Posted

    I hope you can find out and enlighten us. They tend to prefer the juiciest vein,so try to get them to rotate. I’ve Only got one good one,so the majority of my 34 pints have come from there.
  • me2key
    me2key moonstruck

    Edited

    I started biweekly phlebotomys in feb and had the same concerns...the large 16gauge needle is fused to the tubing and once inserted drains a pint of blood in 10-15 min...(i believe there is something like heparin in the pack and tubing to prevent clotting.)  Like many of you, i have one good vein ( my right anticubital) that they go for every time though i have requested they alternate sites but those efforts have,thus far,failed and i end up getting poked twice!!! This last phlebotomy they offered to inject 1% lidocaine before the “big poke” and although it involves another ( superficial) injection the small gauge needle feels like a feather in comparison - i barely felt it when they inserted the large gauge needle-just a little pressure. I’m going to insist they use lidocaine before every phleb from now on. There is also an lidocaine cream (Emla) that can be applied to the skin before venipuncture but it takes 30 to 60 min to take effect, so no one uses it much. 
    • moonstruck
      moonstruck me2key

      Edited

      Hi All - thanks for replies.  

      As well as the needle phobia there is the bigger, long term concern of preserving the integrity of the veins - and that huge tube needle shoved into the arm fortnightly creating scar tissue can't be anything but worrying.  What on earth does it do over time - and into old age.

      Surely a smaller needle with the Leur Lock could be used - think I know the answer already though - it's a blanket NHS approach with no choice or exceptions, one size huge needle, like it or lump it .... what about the frail and elderly ....?

  • marie86421
    marie86421 moonstruck

    Edited

    Hello Moonstruck

    There is definitely an alternative to that javelin of a needle.   I am also a needle phobe and have had more than 90 venesections using a smaller needle, a blue cannula to be precise.  It is tiny in comparison to the standard pack.  The reply you got is standard and I was told exactly the same.  I have no clotting issues with a smaller needle, although the nurses will tell you that your blood will clot using one.  It takes roughly twenty minutes to collect 350ml of blood.  I was having fortnightly venesections until I got to maintenance.  It took three and a half years of fortnightly blood draw to get there.  You have got to look after your veins. 

    Good Luck

    Marie

    • moonstruck
      moonstruck marie86421

      Edited

      Hi Marie

      Thanks for the reply and useful information.  My goodness, 3.5 years!  What a journey you have been on, how brave, you have my sympathies.  Can't imagine how difficult that was/is to cope with psychologically.

      Are you in the UK - do you mind me asking, how did you manage to have use of the blue cannula, did you have to make a case through the Consultant?   The clinic nurses have said point blank there is just the one size, fits all venesection kit.  A blue is a 22g whereas the standard kit is 16g or 18g.  From the layman's point of view, the 22 has got to be better for preserving veins.

      I find it astounding that the larger sized needle is used as a matter of course and long term - I don't see how anybody can be okay with that straw-sized needle.

       

    • marie86421
      marie86421 moonstruck

      Edited

      Hi Moonstruck

      Yes, I am in the UK.  My first venesection was at the University College Hospital London where a blue cannula was used straight away.  The next one was there as well but a different nurse attempted to use the standard venesection pack and I just panicked and became so distressed that I was taken to a small room and had a smaller needle.  My consultant is at the UCLH but I don't live in London, so now my venesections are carried out at my local hospital.  I have attended two local hospitals since my first vensection and both hospitals said that there was only one way to do it and that was by the standard vs pack.  I refused treatment and contacted my consultant to let him know that I could not go through with the treatment as the haematology department at my local hospital would not use a smaller needle.  I was asked to give him the name of the head of the department and he wrote to them explaining my problem.  They were reluctant at first but once they knew how to do it they were OK with it.  The hospital that I attend now will also do the venesection with a blue cannula.  All they need to do is attach a bag to the cannula, easy peasy.  My veins are small and I am trying hard to protect them as much as possible.

      All the nurses where I go know that I have the blue cannula and are happy to use it.  I think you need to contact your consultant as he/she can instruct the haematoloy department as to how you should receive your treatment.

      I had the venesection pack used once at my local hospital in the early days and as soon as I saw the needle I was in tears and so distressed that they had to call my husband in to calm me down.  They had refused to use a small needle point blank.  It took 45 minutes to get 175ml of blood and they had to give up in the end.  Can you imagine 45 minutes with that think in your arm!  I had a huge lump for two days afterwards and cried all weekend and said to my husband that I could not go through with it again.  That was when I contacted my consultant and things got sorted out.  My ferritin was at 5000 so I had to have the venesections.

      I have learnt to accept the smaller needle and it does not stress me out.  I even ask for a smaller needle at blood tests and most nurses are happy to oblige.

      I hope you manage to get something sorted because there is another way.

      Best wishes

      Marie

    • moonstruck
      moonstruck marie86421

      Edited

      Hi Marie

      Thank you for your email and taking the time to explain everything - this will be useful information to many others too.  I really feel for you, what a long road of endurance with so many vs to get to the prize of 'maintenance'. Yikes I can't imagine how awful it was to have the huge needle stuck in your arm for 45 mins - and of course all the other times, albeit smaller ones, you are made of strong stuff!  Life certainly does bring its challenges.

      It just goes to show that there IS a choice of needle - although you have to go through the mill in order to get it.  Wonder why there isn't choice of needle freely available for all, if there are no clotting issues then surely it has to got to be beneficial.  Maybe the drawback is that, for some people, the smaller needle may take longer to draw less blood, resulting in  more vs, more needle use, who knows, def not me.

      Will try and engage the nurses at hub's next vs and see if we can request the blue canula - not really expecting to get anywhere there, so armed with this info, will now plan to go back to the consultant.

      Thanks again, wishing you well.

    • lynnsk1
      lynnsk1 marie86421

      Posted

      Marie, wow ! I have no idea what size needle they use, I was 2000 but 5000 phooo brave. I have cirrhosis thru being undiagnosed what did you get?? 
  • miller.jones
    miller.jones moonstruck

    Posted

    the needles are not that big and trust me on this the bigger the better they cause less impact plus it makes the flow far better smaller needle will clot which is not good and dangerous (there is many other reasons as well)

    Don't look if the size worries you get something to distract yourself taking some one with you or speaking to the nurse. 

    If your problems are a pain thing then you can ask them for the spray (they will know what it is) it numbs the area but I warn it is very cold which can be a bit of a shock first time.

  • anne30922
    anne30922 moonstruck

    Posted

    i am a breast cancer survivor so can only use one arm for venesection consultant advised small needle to preserve veins Venesection clinic refused I will now have to travel over 80 miles each way to consultants clinic I am going to contact the PALS team at my local hospital This is disgraceful

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