Should You Make a Fist When Getting An Injection?

Almost all of us have experienced injections and blood draws, but it seems that everyone has the same doubts about this most basic inspection and treatment operation:

"During the injection, the nurse asked me to clench my fist for a while, and let me loosen it for a while. Why?"

"Sometimes the hands are fine after a few days of injections, but sometimes the skin will be bruised for several days after just one injection. Is this related to the level of the nurses who gave the injections?"

"What should I do when I get an injection so that it can be fast, accurate, and painless?"

We consulted Jenny, a relevant medical staff. She said that venipuncture (injection) is one of the most basic operations in nursing. For the nurses, the puncture is successful if the infusion/blood pumping is smooth, without blockage, and the patient has no obvious pain.

"Generally, when the vein is punctured on the back of the hand, we will ask the person to be punctured to clench his fist, which can tighten the skin and fill the vein, thereby improving the success rate of the puncture; after the puncture is completed, the puncturer will let the puncturer loosen his fist." She said. introduced.

However, for elderly patients, especially those who are overweight, due to their age, the blood vessels are collapsed, small and brittle, and there are almost no blood vessels in their forearms, so they are more difficult to puncture. At this time, if you make a fist, the skin will be highly tense, the blood vessels will become flat, and the needle will easily penetrate the blood vessels during puncture, causing subcutaneous bleeding in the patient; Faced with this situation, the nurse will use the method of not making a fist, that is, let the puncturer's hand be placed naturally, and use the left hand to fix the patient's punctured hand into a cup-shaped hand with a raised back and an empty palm. This hand shape can make the back of the patient's hand The blood vessels are fully exposed and easy to puncture, reducing the pain of the patient.

"Some patients found bruises (subcutaneous bleeding) on ​​the local skin around the needle hole after venipuncture infusion. In fact, this is related to insufficient pressing after venipuncture." She informed that venipuncture will actually cause two "needle holes" "One is the needle hole that we can see piercing the skin, and the other is the needle hole that we can't see piercing the blood vessel wall.

After the needle enters the skin, it will move a small distance parallel to the outside of the blood vessel before entering the blood vessel. There is a certain distance between the two "needle holes". After the puncture, the nurse will instruct the patient to press the needle hole, but the patient often only presses the visible "needle hole" on the skin, but does not press the "needle hole" on the blood vessel. Therefore, after the nurse pulls out the needle, the range of pressing should be extended to around the blood vessels along the puncture site.

In addition, there is a close relationship between the duration of pressing the needle hole and the occurrence of subcutaneous congestion. "In clinical work, it takes at least 5 minutes to press the needle hole after pulling out the needle, and patients with blood coagulation disorders need to prolong the pressing time." She reminds that patients should not use force prematurely after venipuncture, because It takes a certain amount of time for the blood vessel wall to repair. If the limbs are forced too early during the repair process, blood will overflow through the damaged blood vessel, causing subcutaneous congestion and causing skin bruises. Therefore, within half an hour after the needle is pulled out, the arm should not hang down, grab objects, or clench the fist, so as to prevent further bleeding.