what sites should be avoided when performing venipuncture quizletwhat sites should be avoided when performing venipuncture quizlet

Firmly grasp the flanges of the tube holder to avoid advancing the needle further into the vein as you change tubes. What are the complications that can occur when performing a venipuncture? Wipe away the first drop of blood with sterile 22 gauze. It is not as close to the skin surface as the median cubital and cephalic veins, which poses a greater risk of damage to the median nerve and brachial artery. The index finger can be calloused or sensitive and the little finger does not have enough tissue to prevent hitting the bone with the lancet. Remove the needle from the patient's arm using a swift backward motion. Please enable JavaScript on your browser and try again. It is large and near the skins surface, making it easier for phlebotomists to see before anchoring the vein. CLSI document H04-A6. % of people told us that this article helped them. Capillary Specimens may be used immediately for point-of-care testing. PhlebotomyU offers Certified Phlebotomy Technician (CPT I) courses for aspiring phlebotomists. Smaller collection tubes for sample sizes of 2 mL or less may be appropriate in situations where a smaller amount blood should be drawn, as in pediatric patients, or to minimize hemolysis during collection, or to avoid insufficient sample volume in the collection tube. increase the circulation of blood to the area. Each phlebotomist generally establishes a routine that is comfortable for her or him. Proper Handling of an Uncooperative Patient in an Outpatient Setting Akron. Tubes with different additives are used for collecting blood specimens for specific types. Label the specimens before leaving the patients bedside. Be informed of the hospital rules and regulations regarding patient conduct. Gloves are to be discarded in the appropriate container immediately after the bloodcollection procedure. 4. 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. f.style.transition="all 0.5s ease"; When wearing gloves, change them between each patient and wash your hands frequently. Grasp the patient's arm firmly using your thumb to draw the skin taut and anchor the vein. Lightly touch the microtainer capillary collectiondevice (or filter paper) to the LARGE drop of blood. You may also remove the tube, wait a few seconds for blood flow to resume, and then engage a short drawtube. Because of contacts with sick patients and their specimens, it is important to follow safety and infection control procedures. Sharps Disposal Container. Then the medical technician or phlebotomist will wrap a flexible band on the upper part of the arm to apply some pressure to that area making the vein enlarge with blood. performing a capillary puncture is as follows: 1. The diagram below indicates in green the proper area to use for heel punctures for blood collection: Prewarming the infant's heel (42 C for 3 to 5 minutes) is important to obtain capillary blood gas samples and warming also greatly increases the flow of blood for collection of other specimens. However, do not use too high a temperature warmer, because baby's skin is thin and susceptible to thermal injury. The service requires full JavaScript support in order to view this website. This article was co-authored by Matt Garcia. 12. Areas in which two veins join should be avoided where possible, as valves are often present. Blood samples drawn from an IV line should be documented and analyzed with care. Avoid excessive pressure that may squeeze tissue fluidinto the drop of blood. 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. 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. Re-anchor the vein. 1. Basilic vein. Previous puncture sites should be avoided. -use correct angle of needle insertion As a countermeasure, phlebotomists. Avoid bruising the infants heel when obtainingblood. Draw 5 ml of blood and discard before drawing the specimen tubes for testing. (b) the power developed by the output shaft. Remove the first glove so that it turns inside out during removal A phlebotomy technician is preparing to dispose of contaminated sharps. 1. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. What are the red top containers used for? Contains acid citrate dextrose. The needle should form a 15 to 30 degree angle with the surface of the arm. Pediatric Pointers. Center for Phlebotomy Education, Inc. Ernst, Dennis J. and Catherine Ernst. This seats the bevel into the lumen of the vein, and is also the technique used to insert an IV catheter. Capillary specimens are collected in microtainers with colored caps that are used to. When would you use a butterfly/infustion set? Proper labeling procedures and completion of laboratory requisitions. Wipe away the first drop of blood, which tends to contain excess tissue fluid. Adjust the height and swivel the chair to ensure your body is in line with the vein. Blood collection tubes must be drawn in a specific order to avoid cross-contamination of additives between tubes. 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. Allsurfaces are cleaned daily with bleach. Allow it to air, Grasp the finger, and using a sterile lancet, press firmly against the finger. Greet the patient and identify yourself and indicate the procedure that will take place. Avoid trauma and excessive probing. site. Any microtainerscontaining additives should be tapped to dislodge additives from the walls and top. Patients who are dehydrated, obese, terminally ill, or hard sticks often get their blood drawn in other locations rather than the antecubital fossa. Perform the venipuncture. 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 blood is not obtained, change the position of the needle carefully by moving it forward or backward. Avoid UE on same side of mastectomy (lymphedema) Re-secure the tourniquet to increase venous filling. 2017;148(4):330-335. -use a smaller gauge needle wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. Stop the procedure and remove the needle if: Thanks to all authors for creating a page that has been read 43,712 times. Avoid the side of the finger where there is less soft tissue, where vessels and nerves are located, and where the bone is closer to the surface. 3. What are the gold top containers used for? The fifth finger tends to have less soft tissue overlying the bone. In other words, there is no need for another venipuncture procedure. 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. Filter paper should touch only the blood and not the heel or finger. Most reference ranges are based on normal laboratory test values for: Healthy people in a basal state. If using a needle and syringe, avoid drawing the plunger back too forcefully. If this is not successful, remove the needle, take care of the puncture site and redraw at another site. The median cubital creates less bruising and pain than other draw sites. Cap, rotate and invert the collection device to mix the blood collected. The essential elements of the requisition form are: Patient's surname, first name, and middle initial. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. ; worn to protect the patient and the phlebotomist. f.src = 'https://forms.zohopublic.com/healthservicesacademy/form/RequestCourseInformationCPTIAccelerated/formperma/SBGg-3DTNCwt65i9A6n_zU3SneyGD89SSqM_7F_nCas?zf_rszfm=1'; Swiftly insert the needle through the skin and into the lumen of the vein. If using a syringe, make sure the needle is fitted securely on a syringe to avoid frothing. 7. Select a vein other than the one with the IV. Never leave a tourniquet on for more than two minutes. proteins). Clean the site to be punctured with an alcohol sponge. 2. Stabilize the needle as you're inserting your tubes. Place blood collection equipment away from patients, especially children and psychiatric patients. When using a syringe and needle, avoid drawing the plunger back too forcibly. To request course information, contact PhlebotomyU today. Sometimes you may get initial blood flow, but then it stops when you change tubes. 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. Wipe away the first drop of blood with a sterile 22 gauze. 2. The Patient's Bill of Rights has been adopted by many hospitals as declared by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). Edematous extremities with swollen tissue alter the results. Needles should be placed in a proper disposal unit IMMEDIATELY after their use. Why? Be methodical in your search for a vein. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. 11. Blood is collected into an attached vial or tube that is airtight and the flexible band is then removed from the arm. 1. What are the best veins for venipuncture? Venipuncture can also happen when patients have intravenous (IV) lines started. 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. All rights reserved. 3. If possible, speak with the patient during the process. 9. 2. A requisition form must accompany each sample submitted to the laboratory. 2009 Feb;131(2):195-204. How can you decrease the risk of hematoma formation? 3. Am J Clin Pathol. Cleanse in a circular fashion, beginning at the site and working outward. Cap, rotate and invert the microtainer to mix the blood collected. Blood Collection Techniques in Exotic Small Mammals. Expect reasonable safety congruent with the hospital practices and environment. 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. All approved lancets utilized at Akron Childrens are for single use and feature, Heel punctures are performed on infants less than 6 months of age, or on, older premature infants who are the approximate size of a full-term 6 month, old. Patches of purple or yellow may suggest bruising after a recent venipuncture. What sites should be avoided when drawing blood? Applyan adhesive bandage. Take enough time to assess the vein before beginning the venipuncture procedure. Wash hands in warm, running water with an appropriate hand washing product, or if notvisibly contaminated, with a commercial foaming hand wash product before and aftereach patient collection. 8. Collect the drops of blood into the collection device by gently massaging, Avoid excessive pressure that may squeeze tissue fluid into the drop of, When full, cap and then gently invert the collection device 5-10 times to, Hold a gauze pad over the puncture site for a short time to stop the, Dispose of the contaminated materials and lancet in the appropriate waste, Place a band-aid on the patients finger or have someone continue to hold, gauze on the finger. Question. Identify the additive, additive function, volume, and specimen considerations to be followed for each of the various color coded tubes. Wayne, PA: Clinical and Laboratory Standards Institute; 2008. When finished, clean the site and apply pressure with a clean gauze to stop the bleeding. Move it forward (it may not be in the lumen). 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. 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. 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. -hemorrhage/hematoma. Dispose of contaminated materials/supplies in designated containers. B. the needle is only partially in the vein Adhesive bandages / tape - protects the venipuncture site after collection. What is the most common site for blood sampling? Unlike the cephalic and basilic veins, the median cubital vein is not near major nerves or arteries. Cephalic vein. Dorsal hand veins are often utilized for intravenous infusions but are viable options for blood draw sites. BD Eclipse green-capped) is used for most routine and uncomplicated venipunctures. Stress: May cause transient elevation in white blood cells (WBC's) and elevated adrenal hormone values (cortisol and catecholamines). Expect that any discussion or consultation involving the patient's case will be conducted discretely and that individuals not directly involved in the case will not be present without patient permission. Procedures and Devices for the Collection of Diagnostic Capillary Blood. Apply firm pressure. The service requires full cookie support in order to view this website. Summarize the problems that may be encountered in accessing a vein, including the procedure to follow when a specimen is not obtained. As part of presenting a professional appearance, an institutional dress code may include wearing of a laboratory coat or smock. Follow the procedure as outlined above for greeting and identifying the patient. 2. Get instant access to our latest tools and our must-read site updates: What Certifications Are Used For Higher Pay For Phlebotomists? Our courses are designed to provide students with the skills and knowledge necessary to work in a variety of medical settings including: Hospitals, Clinical Laboratories, Clinics, Physicians Offices, Blood Banks and much more. Feel for the median cubital first, the cephalic vein second, and the basilic vein third. Lines - Drawing from an intravenous line may avoid a difficult venipuncture, but introduces problems. Label all specimens per accepted guidelines. Practice hygiene for the patient's protection. Forward completed/dry collections to the laboratory as soon as possible. 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. Do not add blood to a circle already filled orpartially filled with blood. 7. Additionally, a hematoma may compress the nerve and lead to long-term damage. 2013 Oct 10;(10):CD005179. Position the patient's arm in a comfortable extended position that provides adequate access to the planned venepuncture site. After the needle selection, phlebotomists begin to look and feel for a viable vein. Contains a gel separator and clot activator. HealthStar Press, Inc. 2001, updated 1/08. Thrombosed veins lack resilience, feel cord-like, and roll easily. Have the patient make a fist and flex the arm, which helps engorge muscles to fill veins. Hematoma - may cause erroneous test results.
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