Describe common signs of a vasovagal reaction during phlebotomy and the recommended initial actions.

• A. Signs include dizziness, sweating, pallor, nausea, and fainting; initial actions are to stop the draw, have the patient lie down, loosen tight clothing, monitor, and provide reassurance.
• B. Signs include fever and rash; initial actions are to call the physician.
• C. Signs include chest pain and shortness of breath; initial actions are to begin CPR.
• D. Signs include redness at the site and warmth; initial actions are to continue the draw.

Answer: (C)

Vasovagal reactions during phlebotomy show up as dizziness or lightheadedness, sweating, pale or ashen skin, nausea, and sometimes fainting. This reaction is a reflex that can slow the heart and drop blood pressure in response to needle stimulation or anxiety. The best initial actions are to stop the draw, have the patient lie flat, and elevate the legs if possible to improve blood flow to the brain. Loosen tight clothing, monitor vital signs, and provide reassurance. If symptoms continue or the patient loses consciousness, seek help and be prepared to start CPR if there’s no pulse. Do not continue drawing while the patient is symptomatic. Other signs like fever and rash suggest an allergic reaction, chest pain and shortness of breath point to a more serious medical event, and redness at the site indicates a local reaction—not a simple vasovagal response.