Last month's image (right) depicted a patient bending his arm up after the draw. This goes against the CLSI standards because merely bending the arm up is not an adequate substitute for pressure. Hematomas can result due to inadequate pressure against the puncture to the vein. Instead, the phlebotomist or patient should apply direct pressure. If the patient is unable to provide adequate pressure, the healthcare professional should assume the responsibility.

How can you tell if pressure is enough? One trick is to observe the nail beds of the finger applying pressure. If they blanch white, it indicates pressure is sufficient. If the nail beds remain pink, pressure may not be enough to prevent blood from leaking into the tissue.