\u00a9 2023 wikiHow, Inc. All rights reserved. Tourniquet - Wipe off with alcohol and replace frequently. At least two patient identifiers, such as name and date of birth, are needed. (b) How would you prepare tetracaine from p-nitrobenzoic acid? Regardless of the source of payment, request and receive an itemized and detailed explanation of the total bill for services rendered in the hospital. Erroneous test results may be obtained when the blood is not thoroughly mixed with the additive. B. precautions 2. The antecubital fossa is a collection of veins located within the arm's inner area, opposite of the elbow, where the arm folds in. To enhance students careers, meet the needs of healthcare providers and improve patient care by providing high quality, cost effective phlebotomy education through industry leading curriculum, current technology and extensive hands on experience. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. Here phlebotomists will typically choose from three veins: the median cubital vein, the cephalic vein or the basilic vein. Draw 5 ml of blood and discard before drawing the specimen tubes for testing. if ( prevIframeHeight != zf_ifrm_ht_nw ) { In the case of an accidental stick, immediately wash the area with an antibacterial soap,express blood from the wound, and contact your supervisor. If using a needle and syringe, avoid drawing the plunger back too forcefully. Also found in the antecubital fossa, the basilic vein serves as a last resort for blood draws. C. Iodine A. Edema Proper patient identification MANDATORY. Avoid a probing, traumatic venipuncture. Pediatric Pointers. Center for Phlebotomy Education, Inc. Ernst, Dennis J. and Catherine Ernst. PST (light green top). 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. Patches of purple or yellow may suggest bruising after a recent venipuncture. The use of a tourniquet during a venipuncture procedure makes: A. IV lines are very useful in hospitals because some patients require frequent blood tests. 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. Stress: May cause transient elevation in white blood cells (WBC's) and elevated adrenal hormone values (cortisol and catecholamines). Hematoma formation is a problem in older patients. 5. The hydrostatic pressure causes some water and filterable elements to leave the extracellular space. Date, time and initials of the phlebotomist must be on the label of EACH tube. (Partial penetration may allow blood to leak into the soft tissue surrounding the vein by way of the needle bevel). Blood should NEVER be poured from one tube to another since the tubes can have different additives or coatings (see illustrations at end). Collection tubes can vary in size for volume of blood drawn, appropriate to the tests ordered with sample size required, and vary in the kind of additive for anticoagulation, separation of plasma, or preservation of analyte. Have an assistant stabilize the arm by firmly locking the elbow joint. 10. PDF Collection of Blood Specimens by Skin Puncture 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. www.mlo-online.com is using a security service for protection against online attacks. antecubital fossa What are the best veins for venipuncture? Am J Clin Pathol. 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. are known to vary lab results of some analytes. B. Hematoma 7. Laboratory coats or work smocks are not typically needed as personal protective equipment during routine venipuncture, but an employer must assess the workplace to determine whether certain tasks, workplace situations, or employee skill levels may result in an employee's need for laboratory coats or other personal protective equipment to prevent contact with blood. When wearing gloves, change them between each patient and wash your hands frequently. Tubes with different additives are used for collecting blood specimens for specific types. BD Eclipse green-capped) is used for most routine and uncomplicated venipunctures. } PhlebotomyU offers Certified Phlebotomy Technician (CPT I) courses for aspiring phlebotomists. A. Procedure for Capillary Puncture of the Finger: The best site for a finger puncture is just off the center of the finger pad of. It is an employer's responsibility to provide, clean, repair, replace, and/or dispose of personal protective equipment/clothing. It brings the entire family As a phlebotomist, it is critical to know which vein sites offer stable flows for blood draws. Identify the patient. Use a smaller tube with less vacuum. How can you decrease the risk of hematoma formation? Lightly touch the microtainer capillary collectiondevice (or filter paper) to the LARGE drop of blood. NOTE: The use of post-exposure prophylaxis following blood exposure to HIV has shown effectiveness (about 79%) in preventing seroconversion. Previous puncture sites should be avoided. Do not use the tip of the finger or the center of the finger. Change your approach when dealing with uncooperative patients, such as pediatrics and those with neurodevelopmental or psychiatric disorders. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. 5. Position the infant with the head slightly elevated. This is why a required skill for most phlebotomy jobs is to have excellent people skills with the ability to keep the patient calm during the venipuncture procedure. Also consider adjusting the angle of the needle. Needles - The gauge number indicates the bore size: the larger the gauge number, the smaller the needle bore. ACDA or ACDB (pale yellow top). Wipe away the first drop of blood with a sterile 22 gauze. Diurnal variations associated with some blood components are: Elderly patients often have fragile skin and veins that roll quite easily, When a vein rolls, the needle tends to push the vein aside rather than penetrating through. Sign up for wikiHow's weekly email newsletter. Subcutaneous tissue feels squishy and muscle feels hard. Many drugs will have "peak" and "trough" levels that vary according to dosage levels and intervals. 2011-2023 Phlebotomy Coach. Using the requisition for reference, ask a patient to provide additional information such as a birthdate. Change gloves after each patient or when contaminated. This vein lies close to the surface of the skin and there is not a large nerve supply. Blood is commonly obtained from the median cubital vein on the anterior forearm. 7. What should you do with a CBC or lavender top tube before putting them down? (Assume that the total volume is the sum of the individual volumes and that the density and specific heat capacity of the solution are the same as for pure water.). Apply the tourniquet below the IV site. Am J Clin Pathol. Avoid areas of hematoma. Even if several vials of blood have to be drawn it usually amounts to no more than one ounce. Veins sometimes roll away from the point of the needle and puncture site. Staying safe online: Avoid these types of websites - USWired 2. 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. ROUTINE CAPILLARY PUNCTURE BLOOD COLLECTION GUIDELINES. The median cubital vein is used the most for its accessibility. With risk for blood spatter a face shield provides protection. However, blood samples that are normally taken are actually very small. Stabilize the needle as you're inserting your tubes. Patient identification is critical for safety. Some individuals are afraid of needles, while others are frightened at the sight of blood. Compare and contrast the two major types of neuronal pathways. Diurnal Rhythms: Diurnal rhythms are body fluid and analyte fluctuations during the day. Preanalytical phase of the testing process begins for the laboratory when a: Test is ordered by a patient's physician. Using the smallest acceptable needle size can help reduce the risk of bleeding or hematoma . The Patient's Bill of Rights has been adopted by many hospitals as declared by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). When using a syringe inserted into the line, blood must be withdrawn slowly to avoid hemolysis. C. Scarring Kiechle, Frederick L. So Youre Going to Collect a Blood Specimen: An, Introduction to Phlebotomy, 11th Edition. Remove the first glove so that it turns inside out during removal A phlebotomy technician is preparing to dispose of contaminated sharps. D. Blue, Which of the following conditions should prevent a site from being selected for venipuncture? A. EMLA Procedure for Capillary Puncture of the Heel: A heel puncture is performed on the lateral or medial plantar surface of the, foot. Allow another large drop of blood to form. Wipe away the first drop of blood, which tends to contain excess tissue fluid. site. 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. Properly fill out appropriate requisition forms, indicating the test(s) ordered. Primary effect is hemoconcentration of non-filterable elements (i.e. There are some slight risks associated with venipuncture which may include excessive bleeding, feeling light-headed, fainting, nerve damage, hematoma (accumulation of blood under the skin), and infection. A. in the region of a hematoma 5. } This image may not be used by other entities without the express written consent of wikiHow, Inc.
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