Draw Blood Faster With Less Complications

Entrepreneur aims to end voluminous venipuncture.

By Kevin RR Williams

HEALTH Dr. McCoy in Star Trek demonstrated the optimal noninvasive diagnosis method—wave a medical tricorder over the patient for comprehensive feedback. That sci-fi reality has been stalled for over 3,000 years by the ubiquitous venipuncture. Suspect arthritis? Draw blood to test for inflammation. Fever? Draw blood to test for Ebola. A patient with many symptoms may easily have a half dozen vials of blood removed (up to 2.5% of total blood volume). During a blood draw, a needle is guided through the path of a vein. Blood flows into a connected vial. In some cases, a fresh vial may be required for each blood test, so as one is filled, a series of vials are attached.

In July 2016, Theranos received sanctions from the Centers for Medicare & Medicaid Services (CMS) including the revocation of its CLIA certificate and prohibition of the owners and operators from owning or operating a lab for two years. Theranos announced that it would close its laboratory operations and wellness centers to work on miniature medical testing machines in October 2016.

I Want My Arm Back

Have you ever handed your arm over to an inadequately trained phlebotomist? In five U.S. states (CPT 1) certification or license is required (California, Florida, Massachusetts, Nevada and Washington). Perhaps you have less than prominent veins that require trial and error to locate. Multiple punctures may unsuccessfully locate an artery that, in a small number of cases, lead to patient injury. Sometimes, a nurse might overshoot a vein, causing the needle point to anteriorly pierce its walls—commonly called a “blown vein.” Bruising, hematoma, or transient pain are considered minor complications that resolve completely and without medical intervention.

Serious complications include diaphoresis, syncope, seizure, and temporary arrhythmias. Nerve injury can occur as a result of direct trauma or because of compression as a result of hematoma. When patients show evidence of direct nerve trauma (shock-like pains, burning pain, pins and needles, especially when it involves the distal arm and fingertips), the attempt should be stopped immediately.

Draw Blood Faster With Less Complications

Dennis Ernst, director of the Center for Phlebotomy Education, says the risks of the procedure can include nerve injuries and chronic pain syndromes that may render you disabled for life. Arm surgeon Dr. Trevor Lynch at the Southern California Orthopedic Institute explained that a needle can go through a vein and cause dangerous but invisible bleeding lasting months after the procedure. As a precaution, it may be best for patients to surrender their non-dominant arm for blood draws.

A false aneurysm (or pseudoaneurysm) is a hematoma in a breached or dilated blood vessel. A pseudoaneurysm can form after an artery or heart chamber is injured, causing blood to leak and pool outside the artery's wall but contained by the adventitia or surrounding perivascular soft tissue. This sack appended to an artery can be confirmed with duplex ultrasonography and is sometimes corrected with medication or a 30-minute outpatient surgical procedure.

Ending the Torture

Elizabeth Holmes, 30-year-old billionaire founder of Theranos, says, “I really believe that if we were from another planet and we sat down to put our heads together on torture experiments, the concept of sticking a needle into someone and sucking their blood out would probably…qualify as a pretty good one.” She aims to reduce the risks associated with blood draws by making it possible to perform many lab tests from a single drop of blood—essentially a pin prick similar to what a diabetic is used to. Her technology will soon be rolled out in every Walgreens across the United States.

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Theranos technology and the host of smartphone add-on devices available from other manufacturers will dramatically change the course of phlebotomy. Boldly going where no man has gone before may involve walking into a local drugstore for lab tests. This brings us closer to a new frontier in care, where we can have answers about our health, live long, and prosper without the risks associated with voluminous blood draws.

Tags: cardiovascular, catherization, dangerous, nurses, side-effects, ultrasound

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