Endocrine Abstracts

Background: Prader-Willi syndrome (PWS) is a genetic neurodevelopmental disorder characterized by marked hyperphagia and morbid obesity, together with hormone deficiencies, abnormal behaviour in relation to food (obsessive thinking, food foraging, stealing, etc.). Veins in patients with PWS are difficult to find due to obesity and probably to generalised hypotonia including venous tone. Since treating a patient with PWS often requires the acquisition of blood samples, an experienced nurse is mandatory in the multidisciplinary team.

Objective: On the basis of our experience, we propose some recommendations to be taken into account for blood sample collection in adult patients with PWS.

Methods: Recommendations based on grade E of evidence

Results: The following items must be taken into account: Drink a lot of water the night before, come to hospital with clothes with warm long sleeves, use local heat with hot gel, gain her/his confidence, make her/him to be comfortable, use gloves and double tourniquet 5–10 cm above venepuncture site, use alcohol pads in order to dilate the veins, use butterfly, have all the tubes to be filled near in order of priority, just in case you cannot get enough blood for all. If blood does not come out, put the arm below heart level or raise the forearm o turn the wrist so as to get more circulating blood. If you cannot get a good vein, then proceed to artery puncture (radial). Remember that they do not feel pain (high threshold) or if the patient is afraid of feeling pain, use lidocaine cream. Put an adhesive pressure strip. Use biohazard waste container. Finally, do not forget to draw and keep a map of good veins for every patient so as to check next time she/he comes.

Conclusions: Following a nurse protocol for blood collection and other care issues in adult patients with PWS is essential for the best achievement of clinical assays, investigational projects and also the routine clinical care