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Flutter Fearless: Butterfly Needles for Gentle Phlebotomy Mastery

Mastering the art of phlebotomy requires a deep understanding of various needle types and their unique applications. While a standard needle efficiently navigates most blood draws, it can be daunting for individuals with delicate or hard-to-reach veins. This is where butterfly needles, aptly named for their distinct winged design, emerge as champions of sensitive veins.

Butterfly Needles: Gentle Giants for Sensitive Veins

Key Takeaways:
Butterfly needles are smaller and thinner than standard needles.
They are especially beneficial for infants, children, and the elderly because their veins are more fragile.
Butterfly needles reduce pain because they are thinner.
They also reduce the risk of vein damage.
The wings on the butterfly needle help to stabilize it and make it easier to insert into difficult veins.
Butterfly needles are ideal for situations where only a small amount of blood is needed.

Delving into the Butterfly’s Anatomy:

Imagine a shorter and thinner version (gauge size 18-27) of your standard needle, clad in stabilizing wings. This is the essence of a butterfly needle. Designed to minimize discomfort and reduce the risk of vein damage, these needles are especially beneficial for infants, children, and the elderly whose veins are more fragile. The wings provide exceptional stability, allowing for precise placement even in challenging situations.

Unveiling the Advantages:

Beyond their gentle nature, butterfly needles offer several key benefits:

  • Reduced Pain: Patients often report significantly less discomfort due to the significantly thinner needle diameter. Imagine a smaller prick, leading to a more positive phlebotomy experience.
  • Enhanced Vein Safety: For individuals with fragile or rolled veins, the risk of damage is minimized, ensuring a safer blood draw. No more tears or anxieties surrounding the procedure.
  • Precision Control: The stabilizing wings provide exceptional control, allowing for accurate needle placement even in hard-to-find veins. Bid farewell to missed punctures and unnecessary discomfort.
  • Ideal for Small Blood Volumes: For infants, children, and specific test requirements, where only small blood volumes are needed, butterfly needles are the perfect choice. No more struggling to fill large tubes with limited blood flow.

When the Butterfly Needles Shines:

phlebotomy now school - butterfly needles

Phlebotomy Now School – Butterfly Needles

Butterfly needles aren’t one-size-fits-all, but they excel in specific situations:

  • Difficult Draws: When veins are rolled, collapsed, or elusive, the butterfly’s precision and control shine through, ensuring a successful blood draw.
  • Fragile Veins: Protecting the delicate veins of infants, children, and the elderly is paramount. Butterfly needles minimize discomfort and the risk of vein damage, making the process gentler for these vulnerable populations.
  • Small Blood Volume Needs: For specific tests requiring limited blood collection, the butterfly’s slower flow rate enables accurate sample acquisition without exceeding volume requirements.

Balancing the Scales: Considerations and Safety:

While advantageous, it’s crucial to understand the limitations of butterfly needles:

  • Slower Blood Collection: Due to the smaller diameter, blood collection takes longer, requiring patience and adjustments in protocols.
  • Limited Blood Volume: Large blood volumes are challenging to obtain with butterfly needles, making them unsuitable for specific tests requiring significant blood.
  • Increased Hemolysis Risk: The narrower needle can increase the risk of red blood cell rupture (hemolysis), requiring careful handling and proper technique.
  • Cost Factor: Butterfly needles are typically more expensive than standard needles, necessitating cost-benefit analysis for each use case.

Wielding the Butterfly Needles with Expertise:

Skilled phlebotomists follow meticulous protocols to ensure safe and efficient use of butterfly needles:

  • Impeccable Hygiene: Maintaining hand hygiene and using sterile gloves are paramount for aseptic technique.
  • Secure Connection: The needle must be securely attached to a vacuum tube or collection bag.
  • Tourniquet and Vein Location: A tourniquet aids vein location, followed by careful selection of a suitable vein.
  • Disinfection and Insertion: Meticulous disinfection of the site precedes the needle insertion at a precise 30-degree angle.
  • Blood Flow Confirmation: Observing blood flow freely into the tube ensures successful placement.
  • Tourniquet Removal and Bandaging: Gentle tourniquet release and pressure applied to the puncture site are crucial.
  • Safe Disposal and Labeling: Proper needle disposal and accurate sample labeling are essential for safety and traceability.

Different sizes of butterfly needles

Butterfly needles come in a variety of sizes, typically ranging from 21 gauge (the largest) to 25 gauge (the smallest). The size of the needle chosen will depend on several factors, including:

  • Patient’s vein size: For patients with larger veins, a larger gauge needle (e.g., 21 or 22 gauge) can be used. For patients with smaller veins, a smaller gauge needle (e.g., 23 or 25 gauge) is preferred.
  • Blood viscosity: If you are collecting thick blood (e.g., from a dehydrated patient), a larger gauge needle may be necessary to ensure adequate blood flow.
  • Blood volume required: If you only need to collect a small amount of blood, a smaller gauge needle may be sufficient. However, if you need to collect a larger volume of blood, a larger gauge needle will be necessary.

Choosing the right butterfly needles 

Here are some tips for choosing the right butterfly needle size:

  • Assess the patient’s veins. If the veins are visible and feel plump, a larger gauge needle can be used. If the veins are small or feel fragile, a smaller gauge needle is preferred.
  • Consider the blood viscosity. If you suspect the blood may be thick, choose a larger gauge needle.
  • Determine the amount of blood needed. If only a small amount of blood is required, a smaller gauge needle may be sufficient.

Proper insertion of butterfly needles: 

To avoid complications when inserting a butterfly needle, follow these steps:

  • Apply a tourniquet to the upper arm to locate a vein.
  • Clean the venipuncture site with an antiseptic solution.
  • Anchor the vein with your thumb below the intended insertion site.
  • Stabilize the butterfly needle holder with your non-dominant hand.
  • With your dominant hand, hold the needle bevel down and gently insert the needle into the vein at a low angle (15-30 degrees).
  • Once the needle is inserted, flashback (pull back on the plunger) to ensure proper placement within the vein. If you see blood return, slowly advance the needle a bit further. If you do not see blood return, adjust the needle angle or try a different location.
  • Once the needle is properly inserted, secure the needle hub with a winged infusion set or tape.
  • Release the tourniquet and begin blood collection.

Safety Precautions with Butterfly Needles

While butterfly needles are known for their gentle touch, safety remains paramount for both the phlebotomist and the patient. Here are some key safety considerations when using butterfly needles:

  • Minimizing Needle Sticks: Phlebotomists should prioritize techniques that minimize the risk of needlestick injuries. This includes using sharps containers properly, avoiding recapping needles, and employing single-handed techniques whenever possible.
  • Sharps Safety: Hospitals and clinics typically have specific protocols for sharps safety. These protocols should be strictly followed to ensure the safe handling and disposal of used butterfly needles.

Alternatives to Butterfly Needles

Butterfly needles are not always the most suitable choice for blood draws. Here’s a quick mention of some alternatives:

  • Straight Needles: Standard needles are suitable for patients with easily accessible veins. They are also less expensive than butterfly needles.
  • Micro Lancets: These tiny needles are used for fingerstick blood draws, which are common for blood sugar testing.

Potential Complications with Butterfly Needles

Even with proper technique, there can be occasional complications during blood draws with butterfly needles. Here are two common ones:

  • Infiltration: This occurs when the needle unintentionally punctures through the vein and enters the surrounding tissue. Infiltration can cause discomfort, bruising, and even tissue damage.
  • Hematoma: This is a collection of blood that escapes from the vein and accumulates in the surrounding tissue. Hematoma formation is more likely if the phlebotomist nicks the vein while inserting the needle.

Why Butterfly Needles Cost More

Several factors contribute to the higher cost of butterfly needles compared to standard needles:

  • Complexity: Butterfly needles have a more intricate design with additional components like wings and tubing, which increases manufacturing costs.
  • Sterility: Butterfly needles undergo a rigorous sterilization process to ensure patient safety. This adds to the overall cost.
  • Convenience: The features of butterfly needles, such as wings for better stabilization and flexible tubing for patient comfort, contribute to their higher price tag.

CPT Codes for Butterfly Needle Use

For medical billing purposes, specific Current Procedural Terminology (CPT) codes may be associated with butterfly needle use. These codes vary depending on the specific procedure performed. However, including this information might be more relevant for medical professionals.


Butterfly needles are used for what?

  • Butterfly needles are used to draw blood from patients, especially those with small or fragile veins, children, and the elderly.
  • They can also be used to administer medication or fluids intravenously (IV).

What are the advantages of using butterfly needles?

  • Butterfly needles are less painful than regular needles because they are thinner and shorter.
  • The wings on the needle holder make it easier to stabilize the needle during insertion.
  • The flexible tubing allows for more movement of the patient’s arm without dislodging the needle.

What are the disadvantages of using butterfly needles?

  • Butterfly needles are more expensive than normal ones.
  • The smaller size of the needle can make it more difficult to draw blood quickly.

Which factors are important to consider when selecting butterfly needles?

  • The size of the needle (gauge) is determined by the size of the patient’s veins and the amount of blood needed.
  • The length of the needle is determined by the depth of the patient’s veins.
  • The presence of a safety feature is important to prevent needlestick injuries. 

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