1. Failure to bring the collection site (usually the patient’s forearm) to a good position for precision work, usually elbows at side, wrists in neutral extension at or near waist height. Often the blood draw chair has a broken (patient) armrest height adjustment.
2. Failure to position supplies in a convenient spot, leading to overreaching and inefficient hand switching. Often a blood draw chair has the supply table on the wrong side.
3. Syringe holding and pulling techniques that reduce upper extremity stabilization and increase both awkward postures and forceful holding exertions
Consider these recommendations:
In a “tight” clinic or lab setting,
a. An adjustable height sit-stand stool for the phlebotomist .
b. A blood draw chair with adjustable height armrest and supply table that can be switched to left or right of patient (contact your pathology lab supplier).
In a hospital patient room, duplicate the phlebotomist position recommended in #1, above, by raising or lower the height of the bed and,or the phlebotomist.
I have also recommended referral to occupational therapy for habit re-training in non-stressful upper extremity use when placing, stabilizing, holding and pulling the syringe.