When wearing gloves, change them between each patient and wash your hands frequently. Capillary Specimens may be collected on filter paper and sent to lab for testing for. (See Use of Band-Aids in the Post Phlebotomy. 9. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. What are the complications that can occur when performing a venipuncture? In the case of an accidental stick, immediately wash the area with an antibacterial soap,express blood from the wound, and contact your supervisor. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. puncture site downward and gently applying intermittent pressure to the surrounding tissue (or proximal to the puncture site when the blood is obtained from a finger). Be careful not to withdraw the needle completely or else you risk losing the tube's vacuum and starting a hematoma when the bevel exits the skin. When finished, clean the site and apply pressure with a clean gauze to stop the bleeding. 2. Prepare the patient's arm using an alcohol prep. If another site is not available, collect the specimen distal to the hematoma. -tourniquet World Health Organization. The antecubital fossa is a collection of veins located within the arms inner area, opposite of the elbow, where the arm folds in. Dispose of contaminated materials in appropriate waste receptacles. Press down on the gauze once the needle is out of the arm, applying adequate pressure to avoid formation of a hematoma. Sign up for wikiHow's weekly email newsletter. Cephalic vein. Change your approach when dealing with uncooperative patients, such as pediatrics and those with neurodevelopmental or psychiatric disorders. If a patient has an IV giving them fluids in their right arm which arm should be your first choice to draw blood out of? As a countermeasure, phlebotomists anchor the vein with their hand to stabilize it for the draw. Include your email address to get a message when this question is answered. Perform the venipuncture. C. laws What are the best veins for venipuncture? Select the proper approved lancet: The BD Microtainer Contact-Activated. For operation at steady state, determine for the motor, each in kW\mathrm{kW}kW How can you decrease the risk of hematoma formation? Joslin JO. Hold equipment firmly and place fingers against patient's arm, using the flange for leverage when withdrawing and inserting tubes. In some cases, a phlebotomist may have to switch sites if they find the blood is not properly flowing from the vein. IF AN INCOMPLETE COLLECTION OR NO BLOOD IS OBTAINED: Change the position of the needle. It is large and near the skins surface, making it easier for phlebotomists to see before anchoring the vein. ROUTINE CAPILLARY PUNCTURE BLOOD COLLECTION GUIDELINES. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. If using a needle and syringe, avoid drawing the plunger back too forcefully. 3. Summarize the problems that may be encountered in accessing a vein, including the procedure to follow when a specimen is not obtained. Otherwise, satisfactory samples may be drawn below the IV by following these procedures: Turn off the IV for at least 2 minutes before venipuncture. Move it forward (it may not be in the lumen). Because most laboratory specimens contain bacteria, it is not necessary to wash hands before collecting them, The tourniquet applied prior to venipuncture is removed: B. the insertion site has stopped bleeding Label collection tubes after identification of the patient. The median cubital creates less bruising and pain than other draw sites. prevent falls, should the patient lose consciousness. Such terms as "needs to," "must," "require" and "should" are used to explain how medical professionals should perform capillary blood collection procedures. What are the contraindications to venipuncture? The patient should either sit in a chair, lie down or sit up in bed. Proper patient identification MANDATORY. Loosen the tourniquet. 2. While hand veins may be utilized for blood draws and intravenous infusions, veins in the feet and legs should be avoided for adults. Allow the blood to soak through and completely fill the pre-printed circle on the filter paper. Sites to avoid: Extensive scarring from burns or surgery The upper extremity on the side that a mastectomy was performed. Adjust the height and swivel the chair to ensure your body is in line with the vein. Answer. Venipuncture requires good skills in order to perform the procedure not only correctly, but also painlessly. The blood is normally drawn from a vein on the top of the hand or from the inside of the elbow. What sites should be avoided when drawing blood? This information must match therequisition. Take enough time to assess the vein before beginning the venipuncture procedure. 6. Collect drops of blood into the collectiondevice by gently massaging the heel. (a) the electric power required. D. 70% isopropyl alcohol. Be sure to dispose of the lancet in the appropriate sharps container. Therefore, your anchor should be gentle but firm to prevent the vein from moving away from you. An electric motor draws a current of 10 amp with a voltage of 110V110 \mathrm{~V}110V. The output shaft develops a torque of 10.2Nm10.2 \mathrm{~N} \cdot \mathrm{m}10.2Nm and a rotational speed of 1000 RPM. Individually packaged 70% isopropyl alcohol wipes. Since newborns do not often bleed immediately, use gentle pressure to produce a rounded drop of blood. The median cubital creates, The dorsal venous network is the next most common vein site for phlebotomists. The venipuncture procedure is complex, requiring both knowledge and skill to perform. Veins on the underside of the wrist should be avoided. A. Syringe Watch for formation of a hematoma. Phelan MP, Reineks EZ, Berriochoa JP, Schold JD, Hustey FM, Chamberlin J, Kovach A. Tip: When using a butterfly and sodium citrate is the first to be collected in the order of draw, a discard tube must always be filled first to purge the air from the tubing. Reassure the patient that the minimum amount of blood required for testing will be drawn. 7. ACDA or ACDB (pale yellow top). A. standards Cleanse the heel with alcohol prep, then dry with a sterile 22 as alcohol can influence testresults. https://www.osha.gov/laws-regs/standardinterpretations/2007-10-26 and https://www.osha.gov/OshDoc/data_BloodborneFacts/bbfact03.pdf (Accessed June 13, 2022). This requisition form must contain the proper information in order to process the specimen. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. wikiHow is where trusted research and expert knowledge come together. Inadvertently nicking a nerve causes intense pain. Do not attempt a capillary puncture more than twice. Blood Specimen Collection and Processing The patient has the right to refuse participation in such activity. -18, 20, 22 gauge needles. 1. Phlebotomy Exam Questions - TAU Place labeled specimens in zip lock bag and deliver to the laboratory as soon as possible. 2011-2023 Phlebotomy Coach. Tetracaine is a substance used as a spinal anesthetic. Allow another large drop of blood to form. www.mlo-online.com is using a security service for protection against online attacks. Begin by selecting the proper, approved lancet, such as: BD Microtainer Quikheel Lancet, 2.5 mm for full-term babies (green), BD Microtainer Quickheel Preemie Lancet, 1.75 mm for neonatal, Unistick2 Neonatal 18G, 1.2mm Lancet for neonatal babies less than, Prepare the heel by cleaning it with a Chlorhexadine wipe. 5. jugular) or a central venous catheter is out of the scope of practice of a certified phlebotomist and should only be performed by a physician or advanced nurse. 10. Puncture no deeper than 2.4mm (approximately 0.1 inches). })(); The cephalic vein is a safe secondary option if the median cubital vein is not working. Adhesive bandages / tape - protects the venipuncture site after collection. -infection at site This article has been viewed 43,712 times. 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. This is more common in humeral and femoral punctures than radial punctures. A commercial heel warmer may be used. Remove the first glove so that it turns inside out during removal A phlebotomy technician is preparing to dispose of contaminated sharps. (a) How would you prepare tetracaine from the corresponding aniline derivative, ArNH2_22? Avoid excessive pressure that may squeeze tissue fluid into the, mix the blood. Dispose of needles immediately upon removal from the patient's vein. -use correct angle of needle insertion 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. However, drawing blood from the hand is affiliated with higher levels of pain and less control. Clin Lab. Wikipedia. Antiseptic. The vein may have collapsed; resecure the tourniquet to increase venous filling. Which of the following actions should the technician take? Reasonable informed participation in decisions involving the patient's health care. Remove the needle from the patient's arm using a swift backward motion. Position the patient so that the hand is easily accessible. Fill the capillary tube(s) or micro collection device(s) as needed. How should you have the patient position their arm after the venipuncture is complete? Nursing Personnel. Am J Clin Pathol. Have the patient drink fluids if dehydrated. Diagn Microbiol Infect Dis. What equipment is needed for a venipuncture? Stop the procedure if a hematoma occurs. 5. Not making it mobile friendly. 4. Hold a gauze pad over the puncture site for a couple of, minutes to stop the bleeding, and then tie gauze around the foot. Common Venipuncture Sites | Healthfully These items include: This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. Feel for the median cubital first, the cephalic vein second, and the basilic vein third. Promptly send the specimens with the requisition to the laboratory. Use a butterfly to compensate for patient movement. Avoid puncturing a finger that is cold or cyanotic, swollen, scarred, or covered with a rash. A warm compress or heel warmer should be used to warm, fingers and heels that are cold, or if a capillary blood gas is being drawn, to. Identify the additive, additive function, volume, and specimen considerations to be followed for each of the various color coded tubes. 2017;50(10-11):568-573. outstretched or raised 6. 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. Needles should be placed in a proper disposal unit IMMEDIATELY after their use. Psychological interventions for needle-related procedural pain and distress in children and adolescents. For a detailed breakdown of each step of the venipuncture test scroll down. What is the procedure to draw blood from an arm with an IV in it? This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. Scan the skin for lines of blue indicating a prominently visible vein. If this is not successful, remove the needle, take care of the puncture site and redraw at another site. Why? Effects of Exercise: Muscular activity has both transient and longer lasting effects. All of the following are common types of equipment used for venipuncture EXCEPT: Am J Clin Pathol. While venipuncture is considered to be reasonably safe, the present study investigated the incidence of serious complications occurring in an outpatient setting. 3. Predict a possible value of the thickness of the soap bubble. Discarding the first set minimizes the effects of any potential additive contamination. Erroneous test results may be obtained when the blood is not thoroughly mixed with the additive. Copyright 2023 - PhlebotomyU | Website Design & SEO by, Phlebotomy: 5 Tips on Finding Difficult Veins. Document that the venipuncture was performed distal to (below) an infusion site. Allow thefinger to dry or wipe dry with a sterile 22 gauze. Follow institution's guidelines regarding treatment and follow-up. What are the red top containers used for? 1. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. the 3 rd (middle) or 4 th (ring) finger of the hand. Get instant access to our latest tools and our must-read site updates: What Certifications Are Used For Higher Pay For Phlebotomists? Phlebotomy NHA flashcards Flashcards | Chegg.com Clin Lab Med. Proper Handling of an Uncooperative Patient in an Outpatient Setting Akron. When there is an IV line present, blood can be drawn from this line. Squeeze puncture site to promote bleeding. Patient care following completion of venipuncture. The 2nd (index) finger tends to have thicker, callused skin. A. Edema finger should be avoided. The performance of routine vascular access procedures by skilled phlebotomists requires, at a minimum, the use of gloves to prevent contact with blood. 8. Compare and contrast the two major types of neuronal pathways. Other draw sites, particularly below the waist, are rarely used. Clean the site to be punctured with an alcohol sponge. B. above an IV line Do not use a previous puncture site. When do you release the tourniquet during venipuncture? Venipuncture Flashcards | Quizlet var zf_perma = zf_ifrm_data[0]; This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. PST (light green top). 4. PDF Collection of Blood Specimens by Skin Puncture While most patients veins are compatible with a standard needle gauge, others require a. . Lightly touch the microtainer capillary collection device (or filter paper) to the LARGE drop of blood. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. To prevent hemolysis (which can interfere with many tests): Mix tubes with anticoagulant additives gently 4-6 times, Avoid drawing the plunger back too forcefully, if using a needle and syringe, or too small a needle, and avoid frothing of the sample. Sites that should be avoided include areas with extensive scarring, healed burns, inflamed sites, edematous sites, previous puncture sites, earlobes and thumbs. Drawing blood from major vessels (e.g. Finger - Usually the third or fourth finger is preferred in adults and children. When using a syringe avoid drawing the plunger back too forcefully. if ( zf_ifrm_data.length == 2 ) { Effective methods use distraction. A. the tubes are filled and properly labeled Avoid UE on same side of mastectomy (lymphedema) A variety of techniques can be employed to reduce pain and anxiety. Failure to do this results in an unequal blood-to-additive ratio, making the specimen unsuitable for analysis. An outpatient must provide identification other than the verbal statement of a name. Consult a specialist at the patient's own request and expense. This complication of peripheral I.V. Potential source of test error, particularly from hemolysis, Most lines are flushed with a solution of heparin to reduce the risk of thrombosis, Discard a sample at least three times the volume of the line before a specimen is obtained for analysis. This image may not be used by other entities without the express written consent of wikiHow, Inc.
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