The upper extremity on the side of a previous mastectomy - test results may be affected because of lymphedema. Apply firm pressure. -use correct angle of needle insertion very small or difficult vein, Ch 46 Phlebotomy & Ch 47 Hematology (MULTIPLE, Chapter 47: Phlebotomy and Blood Collection, Positive and negative feedback & examples, Meds Vanessa doesn't need because she sleeps, Medical Terminology: Learning Through Practice, April Lynch, Jerome Kotecki, Karen Vail-Smith, Laura Bonazzoli. Apply blood to the printed side of the filter paper. Hyperextend the patient's arm. Tip: Patients who need regular bloodwork (e.g. 2006;52(5-6):217-30. -obvious skin infection (including newly tattooed areas) -extensive scarring -don't use same side as mastectomy -avoid previous hematoma -avoid arm w/ fistula/cannula -edamtous extremity What is the most common site for blood sampling? IV lines are very useful in hospitals because some patients require frequent blood tests. Am J Clin Pathol. The median cubital vein, a superficial vein that forms a connection point between the cephalic and basilic veins of the arm is large, and therefore easier to see and feel. What equipment is needed for a venipuncture? A variety of techniques can be employed to reduce pain and anxiety. What two things should you make sure you discuss with your patients prior to venipuncture? This is more common in humeral and femoral punctures than radial punctures. Asking the patient about their previous blood draw experiences is beneficial, especially if they are a hard stick and know which area works best. An assortment of needles and syringes of different sizes Tourniquet Alcohol and alcohol swabs Gauze or cotton balls Laboratory forms and blood-specimen labels Transportation bags and sharps container Step 2: Prepping The Patient Once you have the necessary supplies, it's time to ready the patient. Wayne, PA: Clinical and Laboratory Standards Institute; 2008. Normal reference ranges are often noted according to
age. 9. Journal of Exotic Pet Medicine. hemorrhage or hematoma at site of puncture, remove tourniquet The first attempt is the antecubital fossa area, starting with the median cubital vein, then the cephalic vein, and the basilic vein. Puncture no deeper than 2.4mm (approximately 0.1 inches). Potassium A phlebotomy technician is removing his gloves after a venipuncture procedure. The thumb has a pulse and is likely to bleed excessively. finger should be avoided. Precautions include a medical grade face mask. So You're Going to Collect a Blood Specimen: An Introduction to Phlebotomy, 13th Edition (2010), College of American Pathologists, Northfield, IL. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. Hemoconcentration: An increased concentration of larger molecules and formed elements in the blood may be due to several factors: Prolonged tourniquet application (no more than 1 minute). and "What is your date of birth?". Lancets are disposed of in an appropriate sharps container as one unit. Label collection tubes after identification of the patient. This image may not be used by other entities without the express written consent of wikiHow, Inc.
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\u00a9 2023 wikiHow, Inc. All rights reserved. Never draw above an IV site. obvious areas of skin infections D. mandates, The most common antiseptic used in venipuncture is: How can you tell if you are palpating a vein? Include your email address to get a message when this question is answered. B. Betadine Wikipedia. -18, 20, 22 gauge needles. Clin Chem Lab Med. Areas in which two veins join should be avoided where possible, as valves are often present. Gloves are to be worn during all blood collection procedures, and changed betweenpatient collections. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. Venipuncture can also happen when patients have intravenous (IV) lines started. Compared to the standard blood donation which is about sixteen ounces, one ounce is really small. www.mlo-online.com is using a security service for protection against online attacks. Also found in the antecubital fossa, the basilic vein serves as a last resort for blood draws. This requisition form must contain the proper information in order to process the specimen. By holding the needle either by the plastic wings or the hub, phlebotomists can achieve a shallower angle, typically 10-15 degrees. Failure to do this results in an unequal blood-to-additive ratio, making the specimen unsuitable for analysis. Step 3: Venipuncture. Effective communication - both verbal and nonverbal - is essential. Asking the patient about their previous blood draw experiences is beneficial, especially if they are a hard stick and know which area works best. Gloves are to be discarded in the appropriate container immediately after the bloodcollection procedure. Tip: In spite of a difficult draw, remember to invert your tubes. 5. The median cubital creates, The dorsal venous network is the next most common vein site for phlebotomists. Adhesive bandages / tape - protects the venipuncture site after
collection. A. Edema However, blood samples that are normally taken are actually very small. Sign up for wikiHow's weekly email newsletter. Syringes - may be used in place of the evacuated collection tube for special circumstances. therapy is usually associated with acidic or alkaline solutions or solutions that have a high osmolarity. C. placed in the sharps container outstretched or raised A key element for successful venipuncture is choosing the best vein. 2. followed pre-lab instructions. Uman LS, Birnie KA, Noel M, et al. The best locations for fingersticks are the 3rd (middle) and 4th (ring) fingers of the non-dominant hand. Avoid excessive pressure that may squeeze tissue fluidinto the drop of blood. Blood should NEVER be poured from one tube to another since the tubes can have different additives or coatings (see illustrations at end). site. Nursing Personnel. Northfield, IL: College of American, NCCLS. Recognize complications associated with the phlebotomy procedure. A. Syringe Avoid excessive pressure that may squeeze tissue fluid into the drop of blood. 3. B. above an IV line Tip: BD Vacutainer tubes use a translucent stopper to identify short draw variants. Psychological interventions for needle-related procedural pain and distress in children and adolescents. This seats the bevel into the lumen of the vein, and is also the technique used to insert an IV catheter. Blood samples drawn from an IV line should be documented and analyzed with care. Cap, rotate and invert the microtainer to mix the blood collected. Obtain from the practitioner complete and current information about
diagnosis, treatment, and any known prognosis, in terms the patient can
reasonably be expected to understand. Mastering Pediatric Phlebotomy. Center, for Phlebotomy Education, Inc. You may also remove the tube, wait a few seconds for blood flow to resume, and then engage a short drawtube. Proper patient identification procedures. The maximum number of times an individual should attempt a venipuncture on a patient is two, True or False? While most patients veins are compatible with a standard needle gauge, others require a butterfly needle. A. This image may not be used by other entities without the express written consent of wikiHow, Inc.
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\u00a9 2023 wikiHow, Inc. All rights reserved. Tip: If you realize you've collected in the wrong order of draw, remove the tube, insert the correct one, fill it halfway before discarding it, then insert a new tube and fill it completely. f.src = 'https://forms.zohopublic.com/healthservicesacademy/form/RequestCourseInformationCPTIAccelerated/formperma/SBGg-3DTNCwt65i9A6n_zU3SneyGD89SSqM_7F_nCas?zf_rszfm=1'; The first step to choosing the right vein is to select the appropriate needle gauge. The key elements in labeling are: NOTE: Both of the above MUST match the same on the requisition form. 7. -obvious skin infection (including newly tattooed areas). Regardless of the source of payment, request and receive an itemized and detailed explanation of the total bill for services rendered in the hospital. Fill the capillary tube(s) or micro collection device(s) as needed. It may be, necessary, on occasion, to perform a capillary puncture on the toe of a patient, who is severely burned. If a vein feels hard, it may be scarred or sclerosed. A requisition form must accompany each sample submitted to the laboratory. The dorsal venous network is the next most common vein site for phlebotomists. These may include listening to music or a story, watching a video, playing with a toy, having a parent provide distraction with talk or touch, using flash cards, and squeezing a rubber ball. or move it backward (it may have penetrated too far). WHO guidelines on drawing blood: best practices in phlebotomy. 8. A face mask reduces risk for blood culture specimen contamination. Dorsal hand veins are often utilized for intravenous infusions but are viable options for blood draw sites. You must check the timing of these variations for the desired collection point. Make sure the venipuncture site is dry. Keep in mind that elderly patients often have fragile veins. The first step to choosing the right vein is to select the appropriate needle gauge. Procedure for Capillary Puncture of the Heel: A heel puncture is performed on the lateral or medial plantar surface of the, foot. Assess the patient's physical disposition (i.e. After cleansing, allow the venipuncture site to air dry. In this elbow pit, phlebotomists have easy access to the top three vein sites used in phlebotomy: The median cubital vein, also known as the antecubital vein, is the most common vein for phlebotomy. -keep extremity below heart level for a few minutes. Be sure to dispose of the lancet in the appropriate sharps container. -infection at site Lightly touch the microtainer capillary collectiondevice (or filter paper) to the LARGE drop of blood. When working with patients who have undergone a mastectomy, draw from the arm on the opposite side of the mastectomy to avoid edematous tissue. Kiechle, Frederick L. So Youre Going to Collect a Blood Specimen: An, Introduction to Phlebotomy, 11th Edition. What Is Venipuncture? If the tech is not comfortable with any of the veins in the inside elbow area, they may choose a dorsal vein in the hand or, as a last resort, choose a vein in the foot.