The father could just be wrong about why this kid fainted. My ex could faint over an injection never mind a blood draw. If this kid was actually at risk over the tiny amount of blood in four vials he would be getting blood since the draw had to be ordered by the doctor and if the father knows it is risky where did he learn that?

Sounds like the son has some kind of blood-related problem, for the father acted as though it wasn't unusual.

But I'm surprised that either the son or the father hadn't spoken before the procedure.

Or during - I have blood drawn from time to time and if they're taking four, they remove a filled tube and place an empty one into the slot, so I'm surprised that the 18 year old with the needle in the arm hadn't spoken during the procedure.

ole joyful

Sometimes patients are asked to have blood drawn on subsequent days to monitor a condition. In patients with serious health issues, this can sometimes cause a problem, in which case it is wise to request that only the amount needed for the tests be drawn. But the doctor, parent and patient should have been aware and made the situation clear with the lab, if that was the case.

Well, that's unfortunate and scary for the young man. I've worked in several doctor's offices and us, the staff came to the conclusion that males, of all ages and sizes are chronically dehydrated. They don't feel thirst for the most part and never have enough urine for a sample when requested. I once had a young man who had to wait three hours in my office while he created enough urine for a sample. Being dehydrated can cause a blood draw to go awry and cause the patient to feel ill.

Also, there are some people who can/will faint at the sight of needles in their body or at the sight of blood. I've had a few patients who got woozy and nearly fainted at the thought of a blood draw which hadn't happened yet.

While 4 vials seems like a lot, it's rather common procedure if several different test panels are being done. The vials are small and 4 vials is far less than the amount of blood lost during a donation. The young man was likely being investigated for an as yet to be determined health issue.

I have an autoimmune issue and have to get blood draws several times a year. Four vials is the usual for me. DDs have two blood draws a year and they routinely have two vials drawn each time. We always make sure we are slightly over hydrated prior to the blood draws to make the phlebotomist's job easier and we don't feel ill or faint from it.

That's what is bizarre about it. The way the father reacted made me think this has happened before, so why did he not tell them, and why did he stay in the waiting room playing on his phone when they were drawing the blood? Hopefully he's just an over-reactive parent. We were sitting in the waiting room right next to them for 30 minutes and the kid seemed fine, no one seemed worried at all.

My husband did say the man's arm was very, very thin and pale, especially for his age, so it's possible he had a medical condition. I just don't understand why they didn't prepare for this.

The person doing the draw takes the amount of blood that that particular test or set of tests calls for. The four vials represent different tests or sets of tests and sometime they order a generic tube for any test that the results of the others may make necessary and for convenience in that case. Always with orders. The person doing it doesn't decide. While it isn't obvious the vials have stuff in them that mix with the blood, you will see the person shaking certain tubes to mix them. So we can be sure the doctor ordered the four vials drawn. Why the boy fainted is another matter.

Four vials of blood isn't much. My son who is now 32 sometimes faints when he has to give blood. It is not the sight of the blood either. He can lacerate himself and it doesn't bother him. He doesn't have the foggiest idea why he does this and he is quite the opposite of a sissy. He is a big bruising guy. He always warns the lab techs that this could happen. I think the lab just didn't want to deal with the over reactive father. Let the father pay for the ambulance and ER bill than having to deal with him.

Yes, the staff really didn't seem that concerned. I think they called the ambulance out of an abundance of caution (and to save themselves the liability i'm sure!). But the paramedics sure took their time and strolled in at a relaxed pace so I don't think anyone was really concerned other than the dad.

What's interesting is this lab is literally right across the street from the hospital so he could have taken the kid and saved a whole lot of money. He was conscious and drinking water. Oh well, it's their decision.

Probably would be a liability risk if they allowed him to do that and then something really was wrong (no way that they caused it, IMO!)

I believe that all but the first hospital that I have worked at have had the policy that if an incident or injury happens outside of the hospital proper (like on the grounds or in the medical office building or the outpatient center) then 911 is to be called rather than transporting the patient into the hospital to the ED. I think so that no one can claim that the hospital/staff has assumed responsibility before the person is in a controlled environment.

That's interesting, raee. I wonder if that would still be the case in a severe emergency where a few minutes waiting for an ambulance might make a difference in the patient living or dying.

Having worked in the hospital setting for years it was the males that fainted around needles. I seem to remember that the women undergoing fertility treatments would be sent to the hospital on a regular basis for blood work. They'd have six of the largest vials (tiger tops = 15ml) plus several other tubes drawn all at one time and that wasn't a problem. A blood donations is 350-450ml.

Yep! I had to get fertility bloodwork done a few days ago and they took 7 huge vials. I was surprised - I hadn't seen vials that big before but I felt totally fine afterwards.

Chi, certainly CPR, AED, and so forth would be used. In the case of a stroke or chest pain, or a severe trauma, I am not sure! Many outpatient settings, even if part of a hospital complex, might not have the needed equipment or people to transport safely & with appropriate care quickly at hand.

"The person doing the draw takes the amount of blood that that particular test or set of tests calls for."

The phlebotomist draws blood into the tubes that are used for the tests being done. For example, if the doctor orders a CBC (complete blood count), a lavender top tube is drawn. If the doctor orders Electrolytes, a green top tube is drawn, although a red top could also be used. A gray top is used to test for glucose levels. A light blue top tube is used for PT and PTT tests (and, if a PT and/or PTT is ordered, the light blue top tube must be drawn first, unless a blood culture is being done, and, if so, that is drawn first, then the light blue top tube). Multiple tests can be run from a red top tube.

"While it isn't obvious the vials have stuff in them that mix with the blood, you will see the person shaking certain tubes to mix them."

The "stuff" that is in the tubes is anticoagulant. The red top tubes do not have any. They are commonly referred to as "clots". (Some tubs with royal blue tops have an anticoagulant and others don't.) Some tubes have a liquid anticoagulant and others have a "powder." And, no, the phlebotomist doesn't shake them to mix the blood with the anticoagulant. Shaking could cause hemolysis, which would render the specimen unusable. The tubes are gently inverted six to eight times, although some phlebotomists will roll them between their hands (not recommended because it's easier to accidentally drop them).

That 18-year-old male would have somewhere between 1.2 and 1.5 gallons (4.5 to 5.5 liters) of blood in his body. The largest specimen tube holds 6mL. If blood is drawn for a blood culture, then a 10mL bottle is used. So, let's say that he had two blood culture bottles drawn (20mL), and two 6mL tubes (12mL). That's a total of 32mL. When you donate blood, they take one pint, which is approximately 473mL (almost 15 times more than what was hypothetically drawn). And some tubes only need to be about half full to have enough blood to run the required tests.

As for dehydration -- being dehydrated can, and will, affect some test results (notably, CBC and Electrolytes). Also, your veins are much easier to locate and "puncture" if you are well hydrated. Even if you go for a test that requires a 12-hour fast (e.g., glucose level or lipid panel), you are still allowed to drink water. If you know you are going to have your blood drawn tomorrow, for example, then today you should drink at least 64 ounces of water (the recommended daily amount), and then tomorrow drink a glass or two of water before you head to the lab.

Yes, years ago I worked as a phlebotomist in a hospital.

I get blood taken twice a year. My record is 13 vials. We learned a lot from that day. I watched while they filled them all.

They watch me like a hawk when I give blood for tests. My blood pressure drops like a stone and then I do. I can't eat the cookies or milk so I have to sit there for about a half an hour. DH has to drive on those days. They're used to me now. They never call an ambulance.

¯\_(ツ)_/¯ I was just going from my personal experience, where different amounts were drawn for the same tests, but different visits and different person doing the task.

Interesting that they are not to be shaken since I have seen that done with my blood. I do not remember the color of the tube. There was froth in the tube when she was done.

Mai - sometimes blood gives the appearance of having froth at the top when drawn, that's normal. The tubes are clear, the stopper color denotes what type of tube.

Lindsey, It's been a long time since I was in the hospitals, we weren't using gray tops. I do remember the looks on some patients faces when they saw the large Tiger Tops, they were at least 8-10 inches long & I'm pretty sure they held 15ml. I would guess that newer technology requires less blood per test now.

The jaded part of me concluded that perhaps a preplanned medical drama was in progress by the family for the purpose for the purpose of making $, except that perhaps the lab thought so too and simply agreed to the requests in order to ward off the evil litigation spirits.

A friend of mine had her cousin pass out when they were just checking his blood pressure...he's that freaked out at the thought of blood. It happens.

I didn't read any of the responses, but what happened to this young man is a common occurrence for me in my profession. It is called a VAGAL response, which essentially is a precipitous drop in heart rate and blood pressure due to extreme anxiety. It is almost always a male, be it young or old. I would say 99 out of 100 times it is a male. It is nothing to worry about. All you have to do is lower the head of the bed, and if an IV is in place turn it up full bore. The patient will come around within minutes. It usually starts when starting an IV, or even the threat of an IV. It had nothing to do with the amount of blood drawn, but just due to the fact that the young man was punctured with a needle. Calling an ambulance will be an expensive lesson. Drinking water was a good idea.

It happens to me - a female - and it is what sleeperblues said above although it was described to me as a vasovagal response. When I was a child, the dentist we went to was apparently very rough. I fainted in his chair from the pain. My older sister actually bit him when he hurt her and he slapped her face. Fast forward to college and I had a blood draw in a clinic, walked out of the room and fell flat on my face. This has continued to be my response to blood draws ever since and I always tell the phlebotomist ahead of time so they can find a reclining chair for me to wait out the response. (I haven't actually passed out in quite a few years).

My husband said the young man was fine while they got the blood, and then he started groaning and moaning before passing out for about 30 seconds, then regained consciousness but was still kinda out of it. He couldn't hold his own cup.

Every January my rheumatologist runs a massive blood draw on me. 14 vials in one go, one arm.

At one time, I had to have a blood culture done...twice. They filled two bottles that looked exactly like a Tabasco sauce bottle! I couldn't believe how much blood it appeared to be. I don't faint at the sight of blood, but I don't like to watch them put the needle in my vein - lots of "fear" of needles since childhood with a lot of needles. I just put on my "big girl panties" and close my eyes while they insert the needle.

I donate blood. 4 vials is NOTHING.

I've had ten tubes drawn. It wasn't four vials that caused any problems. Maybe he hit his head?

The only time I have issues with a blood draw is when the individual doing it has no clue what they are doing. Blood does not bother me and neither do needles. At all. But I cant take someone digging around in my arm with a needle. It's only happened twice and twice I got nauseous and was dry heaving out of control. I was relieved that I had fasted for 15 hours or so before the draw, or there would have been a mess. I have very easy to hit veins in my left arm. There is no reason to dig around like a groundhog. If you dont know what to do please back away from me and get someone who does. Or at least someone to supervise...

Having veins that roll I sometimes get the nauseous feeling when they have to dig. Chi said her husband could see the young man could not hold a cup. When it was really bad my teeth want to chatter and I shake. The techs seem to be better now but I think it was more the size of the needles and the friable nature of my veins.

Maifleur, my veins roll too! I am very difficult to stick, and it's unusual for someone to get it the first try. My record is 13 sticks with 4 different nurses before finally a doctor had to come do it. :( I had an endoscopy a few months back and no one could get my IV started so I almost had to do it without sedation until finally the gastroenterologist did it. It's funny that both times the doctors had to do it as I've heard they are not as good typically. :)

I don't get nauseous though luckily. It's just super painful when they dig.

My most recent lab work where I had to give 7 vials...I was nervous cause I thought for sure I'd have to get multiple sticks (sometimes even successful ones run dry) but the guy got it on the first try and filled it, and no bruise! I was super impressed and it's a spot they've never used before.

Years ago while at a clinic for blood tests, I was sitting up and made the mistake of watching the blood enter the vials (tubes). I fainted. I had been doing errands in the morning, had chills. Only after I got back home an hour of so later, shaking with chills, did I appreciate that I was coming down with influenza and had a high fever. I have nearly passed out like that at other times, once when I cut my finger badly and the pain and sight of lots of blood made me nearly vomit and pass out simultaneously. I’ll never forget that day.

Veins MAY "roll" if they are not anchored properly during needle insertion. IMHO, too often used (as an excuse by someone less skillful in venipuncture) in an attempt to "blame" the patient.

In addition to preventing the vein from rolling away, pulling the skin taut helps greatly in preventing pain when "stuck" by the needle. The needle should be bevel up, and "popped" through the taut skin quickly. Very few patients will feel anything. Veins do not have nerve endings.

@ Anglophilia, the blood culture vials are already half filled with solution before blood is added.

I am female and have the vasovagal experience as well. The first time it happened at 17 yo, I had blood drawn while sitting on an exam table, hopped up and almost fainted on the spot. I've since figured out that as long as I don't watch the draw, I'm absolutely fine. It makes no sense to me. Cutting myself or dealing with someone else having a cut and bleeding is not a problem, it's something about watching those little viles fill up. I always tell the person doing the draw that I'm just going to turn my head and can't watch, and they are always concerned about it, making sure I look okay to go as soon as we are done (which I am). The original story does sound weird since it's easy to take precautions under usual circumstances, and you would definitely do so under unusual ones...???

The pictures above are interesting and perhaps it is because my arms are short having been just shy of 5 ft all my life but have never had my blood drawn that far down my arm. At most an inch below my elbow which would not allow for the tightening of the skin. Although it is seldom done for me, only twice, my husband normally had his blood drawn from the vein in the back of his hand. The times I have had it done there I had no bruise. One time the vein was distended for several days but at least where the needle went in did not continue to bleed for several days. If I am ever really sick and need more than the annual checkup I will probably look like I have been attacked.

I've also had that vasovagal response. I really don't like needles! I had my OB tell me that if he put his hand behind my head and made me push back against it, it would force the blood back into the head and help alleviate those symptoms.

Having gone through medical issues that call for lots of sampling over the years I have gotten very good at guessing if the person is any good at it. It is something about the way they walk and hold themselves. I still have a purple spot on my arm from a very bad stick that went through the vein. I gather the elderly and infants are the hardest. I have seen nurses bring in paramedics to do a really hard one. They do difficult sticks all day long in the worst circumstances. The clinic where I go these days has a wonderful person. She is really good and careful.

I learned blood draws and IV setups (along with the few types of injections) as part of my medic/corpsman training in the service. As I recall, the draw or venipuncture itself is not that hard most of the time. There were exceptions, as some have shared. Like anything else, it's a "follow the instructions you were given" thing to do, something that of course many who were in the military at the time had trouble doing.

I'll defer to the nurses and mdln and other docs here who have much more experience than I got during my initial training and while actually doing it on duty. I do remember some of the dimmer bulbs seemed to have trouble with it.

I don't know how long plain phlebotomist training is in a vocational program but it can't be very long. There's just not that much to it.

When my mother was in the hospital being treated for terminal brain cancer, a phlebotomist came in to her room to take a blood draw with a student phlebotomist in tow. While we were focused on my mother and the difficulty her collapsing veins were giving the phlebotomist, the student observer crashed to the floor in a dead faint taking the rolling bed/tray table with her. I remember that she hit her head really hard on the floor.

They got her up and hustled her out of the room and the nurse caring for my mother said that was most likely the end of her career in phlebotomy.

My sister faints at the sight of a needle let alone having her blood drawn, but for some reason, she didn't react to the events of that day. Perhaps, because she wasn't the one who was having her blood taken, and her concern for our mother was stronger than her fear of needles. I dunno, but it was a strange afternoon.

Interesting about the anchoring. I can't really remember anyone ever doing it but I'd say 50% of the time, they feel a vein, stick the needle in and get nothing. And they always comment that they can feel it right there. But I don't have veins like the man in the picture at all. Mine are deep and not very visible.

"I don't know how long plain phlebotomist training is in a vocational program but it can't be very long. There's just not that much to it."

To be a certified phlebotomist, you're looking at about 6-8 months of training, then you have to pass the certification exam. The act of drawing blood itself isn't that difficult, unless you have a very dehydrated patient with difficult veins, but you need to know which tubes to use for which tests, the order in which they are to be drawn, etc. Also, there are some lab tests that phlebotomists are allowed to run.

"[I] have never had my blood drawn that far down my arm. At most an inch below my elbow which would not allow for the tightening of the skin."

Quite frankly, I was surprised to see the "two-finger" technique in the photo above. The tourniquet works well to hold the skin in place above the puncture point, and then you just need one finger to hold the skin taut below the puncture point. I would use my thumb, like in this photo, below, and the vast majority of blood draws that I did were in the antecubital fossa, although there were times when I'd have to go to the back of the hand, or the forearm. Drawing blood from babies is the most difficult, though!

"To be a certified phlebotomist, you're looking at about 6-8 months of training, "

Having been through it myself, I can say this is more than enough time to do it a dozen or more times from beginning to end over and again, or more. There's not that much to it. I won't comment on what private, for-profit vocational "schools" do to prolong their programs but if they say that's what's involved, I'll respond, that's ridiculous.

In the case of my military training (which no one could ever accuse of being rigorous or fast-paced), I think we had no more than 4 hours of classroom time. This was in the context of a program teaching basic hospital patient care. We'd have an hour of practice squeezed into the daily schedule here and there thereafter. I would say after about 40 sticks at the most (not more than 10 hours in total, 4 per hour is a slow pace) we all reached relative competence. A few weeks in total.

Nursing and medical students learn how to do this and in the context of the much greater body of knowledge they need to learn, this is really a nothing. Nursing school (leading to an RN) can often be done in something like 18 months. Don't suggest one-third of the time is spent learning how to do a venipuncture.