\u00a9 2023 wikiHow, Inc. All rights reserved. Preanalytical phase of the testing process begins for the laboratory when a: Test is ordered by a patient's physician. If just a routine coagulation assay is the only test ordered, then a single light blue top tube may be drawn. 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. Expect reasonable safety congruent with the hospital practices and environment. } Apply only ONE drop of blood per circle. var zf_ifrm_data = evntData.split("|"); A. standards Remove your gloves and wash your hands. Cleanse in a circular fashion, beginning at the site and working outward. 13. Edematous extremities - tissue fluid accumulation alters test results. Select the proper approved lancet: The BD Microtainer Contact-Activated. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. prevent falls, should the patient lose consciousness. (See, The chlorhexidine is a concern for the premature babies in NICU as it can, be absorbed through the skin. Label all appropriate tubes at the patient bedside. -do not rapidly insert the needle. hemorrhage or hematoma at site of puncture, remove tourniquet Dispose of contaminated materials in appropriate waste receptacles. It may be, necessary, on occasion, to perform a capillary puncture on the toe of a patient, who is severely burned. var iframe = document.getElementById("zf_div_SBGg-3DTNCwt65i9A6n_zU3SneyGD89SSqM_7F_nCas").getElementsByTagName("iframe")[0]; They are also. 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. Dalal BI, Brigden ML. The antecubital fossa is a collection of veins located within the arm's inner area, opposite of the elbow, where the arm folds in. Sanders AM, Agger WA, Gray AM, Fischer CM, Kamprud EA. A face mask reduces risk for blood culture specimen contamination. BD Eclipse green-capped) is used for most routine and uncomplicated venipunctures. Any attempt to repeat a puncture at the same site increases the risk of complications. 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. Each phlebotomist generally establishes a routine that is comfortable for her or him. Avoid bruising the infant's heel when obtaining blood. Avoid a probing, traumatic venipuncture. This complication of peripheral I.V. Avoid bruising the infants heel when obtainingblood. 2009 Feb;131(2):195-204. Pediatric Pointers. Center for Phlebotomy Education, Inc. Ernst, Dennis J. and Catherine Ernst. Identification errors in pathology and laboratory medicine. Ernst, Dennis J. List six areas to be avoided when performing venipuncture and the reasons for the restrictions. Mix and label all appropriate tubes at the patient bedside. Properly fill out appropriate requisition forms, indicating the test(s) ordered. Avoid UE on same side of mastectomy (lymphedema) Step 3: Venipuncture. 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. Precautions include a medical grade face mask. D. it is wiped with alcohol, Venipuncture at sites with each of the following could effect the results EXCEPT: Syringes - may be used in place of the evacuated collection tube for special circumstances. Collect drops of blood into the collectiondevice by gently massaging the finger. What Is Venipuncture? Dispose of needles immediately upon removal from the patient's vein. The blood is normally drawn from a vein on the top of the hand or from the inside of the elbow. C. sterile gauze pads Arm with fistula or cannula placement Veins sometimes roll away from the point of the needle and puncture site. All rights reserved. As always, properly fill out appropriate requisition forms, indicating the test(s) ordered. D. after needle removal, When drawing blood you should always follow universal ______ 7. Place blood collection equipment away from patients, especially children and psychiatric patients. Sharps Disposal Container. 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. PDF Selecting The Venipuncture Site - Yola As part of presenting a professional appearance, an institutional dress code may include wearing of a laboratory coat or smock. Allow to air dry. Within the antecubital fossa, this vein poses the least amount of risk. f.style.border="none"; 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. Gloves - can be made of latex, rubber, vinyl, etc. Change gloves after each patient or when contaminated. This vein can be found along the upper arm to the thumb, but it is commonly drawn from the forearm or antecubital fossa area. Once you establish blood flow, slightly modify your hand position to stabilize the needle against the arm and prevent further movement. Select the appropriate microtainers for the specimens to be collected. -laceration of vein The best locations for fingersticks are the 3rd (middle) and 4th (ring) fingers of the non-dominant hand. NOTE:Tubes with additives must be thoroughly mixed. Apply the tourniquet approximately 4-5 finger-widths above the planned venepuncture site. 2009;18(2):117-139. The performance of routine vascular access procedures by skilled phlebotomists requires, at a minimum, the use of gloves to prevent contact with blood. Areas of fingers and heels that are cold, swollen, scarred or covered with a rash, should be avoided. Nursing Personnel. What are the best veins for venipuncture? Dorsal hand veins are often utilized for intravenous infusions but are viable options for blood draw sites. D. Blue, Which of the following conditions should prevent a site from being selected for venipuncture? Firmly grasp the flanges of the tube holder to avoid advancing the needle further into the vein as you change tubes. Wipe away the first drop of blood, which tends to contain excess tissue fluid. Notify your supervisor or patientsphysician if unsuccessful. This image may not be used by other entities without the express written consent of wikiHow, Inc.
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