\u00a9 2023 wikiHow, Inc. All rights reserved. Examples of labeled collection tubes are shown below: THE FOLLOWING ARE NEEDED FOR ROUTINE VENIPUNCTURE: Evacuated Collection Tubes - The tubes are designed to fill with a predetermined volume of blood by vacuum. Document that the venipuncture was performed distal to (below) an infusion site. Date, time and initials of the phlebotomist must be on the label of EACH tube. Tip: In spite of a difficult draw, remember to invert your tubes. Peripheral Intravenous Catheter Insertion - Video - JoVE Which element has the highest ionization energy? Blood Specimen Collection and Processing Ask the patient orcaregiver to state the patients name and date of birth. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. CLSI document H04-A6. BD Vacutainer), rather than IV catheter insertions. Wipe away the first drop of blood with a sterile 22 gauze. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. Switch to the other arm if you can't find anything. The fluid may dilute the specimen, so collect from the opposite arm. Antiseptic. Using the requisition for reference, ask a patient to provide additional information such as a birthdate. If a vein feels hard, it may be scarred or sclerosed. It brings the entire family When finished, clean the site and apply pressure with clean gauze to stop the bleeding. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. Identification errors in pathology and laboratory medicine. 2013 Oct 10;(10):CD005179. Predict a possible value of the thickness of the soap bubble. If using a syringe, make sure the needle is fitted securely on a syringe to avoid frothing. This type of venipuncture procedure is a little different, and sometimes can be a little more involved. In the case of an accidental stick, immediately wash the area with an antibacterial soap,express blood from the wound, and contact your supervisor. Am J Clin Pathol. Provide for their comfort as much as possible, and gain the patient's cooperation. Certain other sites should also be avoided. Allsurfaces are cleaned daily with bleach. Asking the patient about their previous blood draw experiences is beneficial, especially if they are a hard stick and know which area works best. Arteries pulsate, are very elastic, and have a thick wall. A needle is then gently inserted into the vein. Unlike the cephalic and basilic veins, the median cubital vein is not near major nerves or arteries. PDF Collection of Blood Specimens by Skin Puncture 1. Best practices in capillary blood collection - Medical Laboratory Observer -keep extremity below heart level for a few minutes. The area where the blood is to be drawn from is first cleaned with a germ-killing solution. The dorsal venous network is the next most common vein site for phlebotomists. If superficial veins are not readily apparent, you can force blood into the vein by massaging the arm from wrist to elbow, tap the site with index and second finger, apply a warm, damp washcloth to the site for 5 minutes, or lower the extremity over the bedside to allow the veins to fill. If just a routine coagulation assay is the only test ordered, then a single light blue top tube may be drawn. Since newborns do not often bleed immediately, use gentle pressure to produce a rounded drop of blood. What are the gray top containers used for? 2. Fill the microtainer tube(s) as needed. 4. prevent falls, should the patient lose consciousness. Cochrane Database Syst Rev. When there is an IV line present, blood can be drawn from this line. What are the contraindications to venipuncture? 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. Question. (b) the power developed by the output shaft. What are the complications that can occur when performing a venipuncture? IF AN INCOMPLETE COLLECTION OR NO BLOOD IS OBTAINED: Change the position of the needle. Proper patient identification MANDATORY. When the last tube to be drawn is filling, remove the tourniquet. https://www.osha.gov/laws-regs/standardinterpretations/2007-10-26 and https://www.osha.gov/OshDoc/data_BloodborneFacts/bbfact03.pdf (Accessed June 13, 2022). A. in the region of a hematoma 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. Cleanse the fingertip of the 3rd (middle) or 4th (ring) finger with an alcohol prep. Wipe away the first drop of blood with sterile 22 gauze. What Is Venipuncture? While most patients veins are compatible with a standard needle gauge, others require a. . This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. Allow another large drop of blood to form. Have an assistant stabilize the arm by firmly locking the elbow joint. Apply an adhesive bandage. If the patient is sitting in a phlebotomy chair, make sure they are sitting upright with their back against the chair. var d = document.getElementById("zf_div_SBGg-3DTNCwt65i9A6n_zU3SneyGD89SSqM_7F_nCas"); 9. 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. The use of a tourniquet during a venipuncture procedure makes: The most common site(s) for the venipuncture procedure is/are the following: The tourniquet should not be left on a patient more than 1 minute when performing a venipuncture because it is uncomfortable and causes: The needle should always be inserted at the puncture site with the: The correct needle position for a venipuncture is a ______ degree angle with the bevel facing _____. })(); The cephalic vein is a safe secondary option if the median cubital vein is not working. Top Vein Sites Used in Phlebotomy | PhlebotomyU | CPT1 Course McCall, R. E., & Tankersley, C. M. (2016). EDTA and sodium citrate tubes should still be filled to the marked fill line to ensure a correct blood-to-additive ratio. This is especially important when collecting EDTA (lavender top) or heparin (green top) tubes. 1. Matt Garcia is an experienced phlebotomist in Vancouver, Canada. For children over 6 months and adults, the finger is punctured. 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 antecubital fossa is a collection of veins located within the arm's inner area, opposite of the elbow, where the arm folds in. Use a butterfly to compensate for patient movement. What is the most common complication of venipuncture? This information must match therequisition. Potassium A phlebotomy technician is removing his gloves after a venipuncture procedure. Preanalytical phase of the testing process begins for the laboratory when a: Test is ordered by a patient's physician. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. B. Betadine The median cubital creates less bruising and pain than other draw sites. If blood is not obtained, change the position of the needle carefully by moving it forward or backward. 1-kg of R-134a initially at 600 kPa and 25C25^{\circ} \mathrm{C}25C undergoes a process during which the entropy is kept constant until the pressure drops to 100 kPa. Therefore, your anchor should be gentle but firm to prevent the vein from moving away from you. Using a sterile lancet, puncture the fingertip in the fleshy part of the finger, slightly to the sideof the center and across (perpendicular to) the grooves of the fingertip. Blindly maneuvering the needle within the skin is painful to the patient and you run the risk of hitting a nerve, tendon, or artery. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. Most commonly, venipuncture will be performed on the Antecubital Fossa, or the inside of the elbow. Email is the #1 attack vector cybercriminals use to lure you into a malicious website. 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. Follow institution's guidelines regarding treatment and follow-up. Lightly touch the microtainer capillary collectiondevice (or filter paper) to the LARGE drop of blood. 1. (a) the electric power required. Alcohol not dry in the required amount of time B. Veins less prominent and less filling C. Veins more prominent and easier to puncture D. Blood stop flowing to arteries but not veins A The most common site (s) for the venipuncture procedure is/are the following: Adapted from Phlebotomy for Nurses and. BD Eclipse black-capped) have a smaller diameter and may be more suitable for smaller veins. f.src = 'https://forms.zohopublic.com/healthservicesacademy/form/RequestCourseInformationCPTIAccelerated/formperma/SBGg-3DTNCwt65i9A6n_zU3SneyGD89SSqM_7F_nCas?zf_rszfm=1'; -laceration of vein Additionally, a hematoma may compress the nerve and lead to long-term damage. Scan the skin for lines of blue indicating a prominently visible vein. Individually packaged 70% isopropyl alcohol wipes. Factitious biochemical measurements resulting from hematologic conditions. Do not use alcohol for prepping the site when drawing a blood alcohol sample. 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. Phlebotomy NHA flashcards Flashcards | Chegg.com PROBLEMS OTHER THAN AN INCOMPLETE COLLECTION: A hematoma forms under the skin adjacent to the puncture site - release the tourniquet immediately and withdraw the needle. He holds a Diploma in Medical Laboratory Assistance and is certified under the British Columbia Society of Laboratory Science. Apply the tourniquet approximately 4-5 finger-widths above the planned venepuncture site. 9. Fill the capillary tube(s) or micro collection device(s) as needed. Failure to do this results in an unequal blood-to-additive ratio, making the specimen unsuitable for analysis. var f = document.createElement("iframe"); Firmly grasp the flanges of the tube holder to avoid advancing the needle further into the vein as you change tubes. Patients in these populations are often nervous and may flail their limbs. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. Phlebotomy is not a one size fits all; each patient is different and may have their blood drawn at other sites with varying needle sizes. An outpatient must provide identification other than the verbal statement of a name. 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. While the median cubital, cephalic, and basilic veins are the most popular draw sites for blood draws, phlebotomists may resort to other draw sites if their ability to draw is restricted. f.style.transition="all 0.5s ease"; The patient has the right to refuse participation in such activity. 70% isopropyl alcohol As a countermeasure, phlebotomists anchor the vein with their hand to stabilize it for the draw. performing a capillary puncture is as follows: 1. Needles - The gauge number indicates the bore size: the larger the gauge number, the smaller the needle bore. Have the patient hold a small gauze pad over the puncture site for a couple of minutes to stop the bleeding. Label the specimens before leaving the patients bedside. } Procedure for Capillary Puncture of the Finger: The best site for a finger puncture is just off the center of the finger pad of, the 3rd (middle) or 4th (ring) finger of the hand. Cleanse the heel with alcohol prep, then dry with a sterile 22 as alcohol can influence testresults. This article has been viewed 43,712 times. Allow filter paper to air dry for two (2) hours at room temperature. -test tubes