Arteries pulsate, are very elastic, and have a thick wall. f.src = 'https://forms.zohopublic.com/healthservicesacademy/form/RequestCourseInformationCPTIAccelerated/formperma/SBGg-3DTNCwt65i9A6n_zU3SneyGD89SSqM_7F_nCas?zf_rszfm=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. 2009;18(2):117-139. This is a general guide for troubleshooting a venipuncture scenario in which blood flow is not initially established upon needle insertion. Coagulation tests (protime and prothrombin time), Tube is designed to contain no contaminating metals, Trace element testing (zinc, copper, lead, mercury) and toxicology, Antiglycolytic agent preserves glucose up to 5 days, HLA tissue typing, paternity testing, DNA studies, Inactivates thrombin and thromboplastin; contains virtually no lead. Lippi G, Blanckaert N, Bonini P, Green S, Kitchen S, Palicka V, Vassault AJ, Mattiuzzi C, Plebani M. Causes, consequences, detection, and prevention of identification errors in laboratory diagnostics. Serum red top or amber tube with red top. Lines - Drawing from an intravenous line may avoid a difficult venipuncture, but introduces problems. For all NICU babies, once you have, collected the blood, wipe off the area with a sterile saline wipe, to remove. Expect reasonable safety congruent with the hospital practices and
environment. 12. Once again, please be aware that these are only guidelines for blood draws and nurses should consult with the appropriate hospital personnel regarding performing this procedure on patients. The venipuncture procedure is complex, requiring both knowledge and skill to perform. A. excessive probing with the needle Although the skill set and procedures may apply to both instances, this content is primarily aimed towards venous blood collection using evacuated tube systems (e.g. 4. (function() { B. the needle is inserted into the patient's arm 1. remove needle 9. Venipuncture (sometimes referred to as venapuncture, venepuncture or even venu puncture) is the collection of blood from a vein which is usually done for laboratory testing. 3. The best locations for fingersticks are the 3rd (middle) and 4th (ring) fingers of the non-dominant hand. Patient care following completion of venipuncture. Dispose of items in appropriate containers. 3. Sanders AM, Agger WA, Gray AM, Fischer CM, Kamprud EA. Blood is commonly obtained from the median cubital vein on the anterior forearm. Drawing blood for laboratory analysis is most often a routine and uneventful procedure. Any attempt to repeat a puncture at the same site increases the risk of complications. All other items used for the procedure must be disposed of according to properbiohazardous waste disposal policy. When multiple vials of blood are collected it can seem like a large amount. EDTA and sodium citrate tubes should still be filled to the marked fill line to ensure a correct blood-to-additive ratio. Any microtainerscontaining additives should be tapped to dislodge additives from the walls and top. The recommended location for blood collection on a newborn baby or infant is the heel. Lightly touch the microtainer capillary collection device (or filter paper) to the LARGE drop of blood. Apply firm
pressure for more than 5 minutes. Drawing the patient in a reclined position. Using a sterile lancet, puncture the most medial or lateral portion of the plantar surface of theheel, medial to a line drawn posteriorly from the mid great toe to the heel. https://www.osha.gov/laws-regs/standardinterpretations/2007-10-26 and https://www.osha.gov/OshDoc/data_BloodborneFacts/bbfact03.pdf (Accessed June 13, 2022). Avoid UE on same side of mastectomy (lymphedema) Gloves are to be worn during all blood collection procedures, and changed betweenpatient collections. Certain areas are to be avoided when choosing a site: Extensive scars from burns and surgery - it is difficult to puncture the scar tissue and obtain a specimen. Preferred venous access sites, and factors to consider in site selection,
and ability to differentiate between the feel of a vein, tendon and artery. Perform the venipuncture. In some instances, the legs or feet are required for use, but a physician or doctor should be completing the draw, not a phlebotomist. Check the requisition form for requested tests, patient information, and any special requirements. Select the proper approved lancet: The BD Microtainer Contact-Activated. 8. Several veins in the antecubital fossa provide excellent access. The antecubital fossa is a collection of veins located within the arm's inner area, opposite of the elbow, where the arm folds in. Pre-warm the region of the vein to reduce vasoconstriction and increase blood flow. ; worn to protect the patient and the phlebotomist. While most patients veins are compatible with a standard needle gauge, others require a. . Allow filter paper to air dry for two (2) hours at room temperature. Stabilize the needle as you're inserting your tubes. Occupational Safety and Health Administration, United States Department of Labor. The basic patient rights endorsed by the JCAHO follow in condensed form are given below. The phlebotomist's role requires a professional, courteous, and understanding manner in all contacts with the patient. The patient should either sit in a chair, lie down
or sit up in bed. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. Some individuals are afraid of needles, while others are frightened at the sight of blood. What two things should you make sure you discuss with your patients prior to venipuncture? Specimen Collection Procedure - PERFORMING A VENIPUNCTURE | Akron The most commonly used site for a venipuncture is at the bend of the elbow, also called the antecubital fossa 1. Contains lithium heparin anticoagulant and a gel separator. therapy is usually associated with acidic or alkaline solutions or solutions that have a high osmolarity. Applyan adhesive bandage. A scooping motion to collect blood and strong repetitive pressure (milking) MUST be avoided, as both procedures may result in hemolysis or tissue-fluid contamination fo the specimen. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. Apply the tourniquet below the IV site. Blood collection tubes must be drawn in a specific order to avoid cross-contamination of additives between tubes. You should not perform this technique unless you are certain that the needle is in the immediate vicinity of the vein. To determine the best vein, use both sight and touch. 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. If it is then heated, what can you say about: b) how often the molecules hit the walls of the can. PDF Selecting The Venipuncture Site - Yola The dorsal venous network is the next most common vein site for phlebotomists. Wait 2 minutes before reapplying the tourniquet. chemistries, serology, immunnology, blood bank. Puncture no deeper than 2.4mm (approximately 0.1 inches). 1. Even if several vials of blood have to be drawn it usually amounts to no more than one ounce. If an inpatient is able to
respond, ask for a full name and always check the armband or bracelet for confirmation. When wearing gloves,
change them between each patient and wash your hands frequently. Drawing from these sites can cause blood clotting and hemostasis. Select the appropriate microtainers for the specimens to be collected. 7. -infection at site In the case of an accidental stick, immediately wash the area with an antibacterial soap,express blood from the wound, and contact your supervisor. The infograph below provides a detailed description of the venipuncture steps as found in our how to draw blood resource. 5. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. 13. When finished, clean the site and apply pressure with clean gauze to stop the bleeding. Dry the cleaned area with a dry cotton sponge. (See Use of Band-Aids in the Post Phlebotomy. Tip: BD Vacutainer tubes use a translucent stopper to identify short draw variants. Scan the skin for lines of blue indicating a prominently visible vein. -cotton sponges This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. Kiechle FL. Keep in mind that elderly patients often have fragile veins. Allsurfaces are cleaned daily with bleach. Cap, rotate and invert the microtainer to mix the blood collected. Have the patient drink fluids if dehydrated. Foot veins are a last resort because of the higher probability of complications. All of the following are common types of equipment used for venipuncture EXCEPT: Grasp the patient's arm firmly using your thumb to draw the skin taut and anchor the vein. Individually packaged 70% isopropyl alcohol wipes. True or False? A. in the region of a hematoma 23-gauge needles (e.g. 7. After cleansing, allow the venipuncture site to air dry. Be sure to dispose of the lancet in the appropriate sharps container. d.appendChild(f); Uman LS, Birnie KA, Noel M, et al. IF AN INCOMPLETE COLLECTION OR NO BLOOD IS OBTAINED: Change the position of the needle. advantageous in certain adult populations, such as: those with severe burns, obese patients, those with thrombotic tendencies, and for point-of-care testing, when a small volume of blood is needed. 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. Contains acid citrate dextrose. Potassium A phlebotomy technician is removing his gloves after a venipuncture procedure. D. it is wiped with alcohol, Venipuncture at sites with each of the following could effect the results EXCEPT: 4. This image may not be used by other entities without the express written consent of wikiHow, Inc.
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\n<\/p><\/div>"}, 7 Easy Ways to Figure Out Your Blood Type (With or Without a Test). What is the best position to perform venipuncture in? D. 70% isopropyl alcohol. Mastering Pediatric Phlebotomy. Center, for Phlebotomy Education, Inc. This is very painful, risks damage to underlying structures, and widens the needle hole to prolong bleeding time. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. Make certain that the blood completely saturates all four (4) circles and is visible from bothsides. (b) How would you prepare tetracaine from p-nitrobenzoic acid? C. at a mastectomy site Wipe away the first drop of blood with a sterile 22 gauze. Using the requisition for reference, ask a patient to provide additional information such as a birthdate. This information must be given when requesting microbiology, cytology, fluid analysis, or other testing where analysis and reporting is site specific. 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 patient should make a fist without pumping the hand. The fluid may dilute the specimen, so collect from the opposite arm. The upper extremity on the side of a previous mastectomy - test results may be affected because of lymphedema. After assembling the appropriate equipment, follow the next steps to perform a proper venipuncture. Gloves - can be made of latex, rubber, vinyl, etc. Background: Venipuncture is the most common invasive medical procedure performed by health care providers. finger should be avoided. D. Blue, Which of the following conditions should prevent a site from being selected for venipuncture? A needle is then gently inserted into the vein. This article has been viewed 43,712 times. Do not place too tightly or leave on more than 2 minutes (and no more than a minute to avoid increasing risk for hemoconcentration). The line must be flushed first. 1. if ( zf_ifrm_data.length == 2 ) { Warning: Some phlebotomists use a method of anchoring called the "C-hold", in which the index finger pulls upwards superiorly while the thumb pulls downwards inferiorly.