Plasma donation centers always thoroughly examine donors’ elbows during the screening process before allowing them to donate. But why do phlebotomists pay such close attention to elbows when preparing people to donate plasma? There are some very important reasons these checks are done.
Understanding the purpose behind elbow inspections can help plasma donors appreciate the value of this step. It highlights the commitment to safety and care taken at plasma collection facilities.
In this comprehensive guide, we will explore the key reasons phlebotomists carefully inspect elbows of potential plasma donors.
An Overview of Plasma Donation
Before diving into the specifics on elbow checks, let’s briefly go over what plasma donation involves.
What is Plasma?
Plasma is the largest component of blood, making up about 55% of total blood volume. It is a straw-colored liquid that contains water, proteins, nutrients, and clotting factors. Plasma transports red blood cells, white blood cells, platelets, electrolytes, hormones, and nutrients throughout the body.
Why Do Patients Need Plasma?
Plasma contains antibodies and other proteins that help fight infections and diseases. Donated plasma is processed into lifesaving medical therapies that help treat a variety of conditions. These include:
- Immunodeficiencies
- Bleeding disorders like hemophilia
- Burn victims
- Shock and trauma patients
- Organ transplants
Plasma-based therapies are also used to treat rabies, tetanus, hepatitis B, and respiratory illnesses. The antibodies in plasma can be processed to create immunoglobulin therapies.
How is Plasma Collected?
Plasma is collected through a process called plasmapheresis. Blood is drawn from the donor and processed through an automated machine that separates the plasma from the other blood components. The red cells, platelets, and plasma are then returned to the donor, while the collected plasma is kept and sent for processing.
Importance of Donor Screening
All plasma donation centers follow rigorous screening protocols to protect donor health and safety. Potential donors must pass an initial phone screening, then undergo medical history review, physical examination, and testing for infectious diseases on their first visit.
Regular donors are also screened every time they come in to donate. Vital signs are checked, health updates are collected, and the donor’s arms are examined before starting the donation process.
Why Do They Check Your Elbows Before Donating Plasma?
With this background on plasma donation, let’s get to the reasons phlebotomists pay such close attention to donors’ elbows.
Finding the Best Veins for Venipuncture
The primary purpose of the elbow check is locating suitable veins to insert the needle and collect plasma. The antecubital area of the arms contains large, superficial veins that are ideal for venipuncture.
These vessels include:
- Basilic vein: Runs along the inside of the arm near the elbow. This is the preferred site.
- Cephalic vein: Runs along the outer part of the arm near the elbow. May be used if the basilic vein is unsuitable.
- Median cubital vein: Connects the basilic and cephalic veins. Usually avoided for donation.
Phlebotomists will apply a tourniquet and examine the elbow to see where the veins are best visible and palpable. They assess if the size and position of the vessels are appropriate for inserting the venipuncture needle.
The inspector will also look for potential issues like scarring, bruising, or thrombophlebitis that could interfere with getting successful access.
Checking Vein Health
In addition to finding accessible veins for plasma collection, the elbow assessment aims to verify the veins are healthy.
Phlebotomists will check that the veins:
- Are well anchored under the skin
- Have good resilience when pressed
- Refill quickly when released
- Lack leaks, thinning, and other signs of damage
This helps determine if the veins can withstand the pressure of blood flowing during the donation process without collapsing or infiltrating.
Identifying Skin Conditions
The skin check over the elbow area has a few purposes:
- Look for rashes, wounds, dermatitis, psoriasis and other skin conditions
- Check for scabs and openings that could allow bacteria to enter
- Identify moles, lesions, etc that could interfere with needle placement
Skin assessments ensure the venipuncture site is intact. Compromised skin can increase infection risks. Certain conditions like dermatitis may get inflamed or infected from needle sticks.
Avoiding Nerves and Other Anatomy
The antecubital area contains arteries, nerves, and tendons that must be avoided during venipuncture. Proper vein selection and site inspection help prevent accidental contact.
Key anatomy phlebotomists try to avoid includes:
- Brachial artery: Runs just medial to the biceps tendon in the antecubital fossa. Puncturing it could cause severe bleeding.
- Median nerve: Found at the medial angle of the elbow next to the brachial artery. Hitting this can cause sharp pain.
- Ulnar nerve: Runs posterior to the medial epicondyle. Striking it leads to numbness and tingling.
Checking exact vein position minimizes chances of nerve or arterial damage. It also reduces patient discomfort.
Detecting Signs of IV Drug Use
Unfortunately, some people attempt to donate plasma solely for monetary compensation, even if they engage in intravenous drug use. Plasma centers must prevent drug users from donating to maintain a safe donor pool.
Phlebotomists thoroughly inspect elbows because this is a common injection site for IV drug users. Signs they look for include:
- Track marks: Linear scars from repeated injections into the same vein
- Pitting: Punctures that create small dents in the skin
- Bruising or redness: Can indicate recent IV drug use
- Sclerosis: Hardened veins from chronic injections
Most reputable plasma collection organizations will ask about IV drug use history during screening. But the elbow check provides further validation that donors do not currently inject drugs intravenously.
Evaluating Previous Donation Impact
For repeat donors, phlebotomists also visually assess the elbows to see effects from previous donations. Signs may include:
- Scarring: Can make veins less visible or cause bruising with subsequent donations
- Thickening: Repeated venipuncture sometimes leads to scar tissue formation
- Bruising: Residual bruises may require changing the collection site
Noting impacts from earlier donations allows proper precautions to be taken to prevent excessive discomfort or difficulties donating.
What to Expect During the Elbow Assessment
When you go in to donate plasma, the inspector will follow a careful process to examine your elbows.
Exposure – They will first ask you to expose your elbows by pushing up your sleeves. It’s best to wear short or loose sleeves for easy access.
Cleaning – The antecubital areas will be wiped down with an antibacterial sanitizing agent. This preps the skin for visualization and needle insertion.
Pressure application – A latex tourniquet will be tied around your upper arm to increase venous pressure and make the veins below more visible.
Visual inspection – The inspector will visually scan your elbows to choose the best vein and site. They assess the size, depth, straightness and resilience of potential vessels.
Palpation – The phlebotomist palpates the soft tissue around veins to further evaluate resilience and note any scarring or infiltrations.
Second arm – They will repeat the process on your other elbow in case the first side is problematic or to verify neither has issues.
Skin check – A close skin inspection checks for rashes, wounds, skin conditions, track marks, or bruises.
Why Proper Elbow Screening Matters
While having your elbows closely examined may feel strange or seem excessive at first glance, this check is incredibly important for your safety as a plasma donor.
Lowers Infection Risk
Careful assessment helps avoid using any compromised skin or veins. This reduces the chance of infiltration, bleeding, or infection that could occur with improper site selection and technique.
Prevents Nerve Injury
Thorough inspection minimizes the risk of the phlebotomist accidentally hitting nerves, arteries or tendons near veins used for venipuncture. This protects you from nerve damage and other injuries.
Ensures Successful Draws
Choosing the most appropriate site based on visible, palpable veins prevents failed needle sticks and prolonged draw times that are uncomfortable for the donor.
Allows Modifications if Needed
If the evaluator finds any concerns, they can modify the process. Examples include using a smaller needle, changing the draw site, or deferring donation if necessary.
Provides Reassurance
The careful assessment should give you confidence in the skills and attention to detail of the phlebotomist. You can see first-hand how focused they are on your safety and comfort.
