If a phlebotomist does not find the vein on the first stick, what should they do next?

Withdrawing the needle slightly and changing the angle is a common technique used by phlebotomists when they cannot readily access a vein during venipuncture. This method allows the phlebotomist to potentially encounter the vein at a different point, which can increase the chances of successful blood draw without having to completely remove the needle and start a new attempt.

The approach involves making a slight adjustment to find the vein while still keeping the needle in the arm, which can be more comfortable for the patient compared to having the needle fully removed and reinserted. It is a practical strategy that can demonstrate the phlebotomist's skill and ability to handle difficult situations.

In some instances, stopping to reassess the situation or requesting the patient to reposition their arm could also be appropriate, yet these options may not provide the immediate solution needed in a situation where the vein is difficult to locate. Calling for help might be warranted in complicated cases, but it is generally preferable to first attempt a slight adjustment in angle or depth when feasible.