Hamilton listed several clinical findings that may be encountered in a patient with a needle phobia. The author is in private practice in Louisiana.
Patient selection: before or during a venipuncture
Past medical and family history:
(1) self-report of long-term fear of needles, which the patient may acknowledge as unreasonable
(2) anticipation of and/or actual needle exposure triggers immediate anxiety or panic attack
(3) avoidance of medical situations due to fear of needles
(4) significance interference with healthcare due to fear of needles
(5) significant occupational disability because of a fear of needles
(6) presence of needle fear in a first-degree relative
Clinical findings:
(1) symptoms of syncope, near syncope, light-headedness, or vertigo upon needle exposure
(2) autonomic symptoms of pallor, diaphoresis, and/or nausea
(3) drop in blood pressure and/or pulse with or without initial rise in one or both
(4) onset of ECG changes
(5) elevation in serum stress hormones
The fear of needles may overlap with or be distinct from blood phobia.
