\u00a9 2023 wikiHow, Inc. All rights reserved. Patients in these populations are often nervous and may flail their limbs. Sign up for wikiHow's weekly email newsletter. 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. Effective communication - both verbal and nonverbal - is essential. Describe and perform the venipuncture process including: Appropriate clothing and protective equipment. What are the helpful hints for finding veins? Identification errors in pathology and laboratory medicine. 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. prevent falls, should the patient lose consciousness. Capillary Specimens may be used immediately for point-of-care testing. The needle may have pulled out of the vein when switching tubes. Determine the final temperature of the R-134a and the final specific internal energy. Select the appropriate microtainers for the specimens to be collected. C. sterile gauze pads 3. It is large and near the skins surface, making it easier for phlebotomists to see before anchoring the vein. 2009;47(2):143-53. Avoid UE on same side of mastectomy (lymphedema) C. laws A clinical study is performed to determine the optimal time for application of the tourniquet during phlebotomy. It may be, necessary, on occasion, to perform a capillary puncture on the toe of a patient, who is severely burned. Please enable JavaScript on your browser and try again. Gloves are to be discarded in the appropriate container immediately after the bloodcollection procedure. Other Factors: Age, gender, and pregnancy have an influence on laboratory testing. Clinical and Laboratory Standards Institute. What is the most common complication of venipuncture? Clin Chem Lab Med. 5. Last draw - additive tubes in this order: SST (red-gray or gold top). Guidelines established by the Clinical and Laboratory Standards Institute (CLSI) dictate that a phlebotomist shall not attempt a venipuncture more than two times, and a maximum of three attempts shall be undertaken on a patient. })(); The cephalic vein is a safe secondary option if the median cubital vein is not working. if ( prevIframeHeight != zf_ifrm_ht_nw ) { Never draw over scars or a new tattoo sites. Remove your gloves and wash your hands. Promptly send the specimens with the requisition to the laboratory. However, drawing blood from the hand is affiliated with higher levels of pain and less control. Source of specimen. Summarize the problems that may be encountered in accessing a vein, including the procedure to follow when a specimen is not obtained. This vein lies close to the surface of the skin and there is not a large nerve supply. A face mask reduces risk for blood culture specimen contamination. Arteries pulsate, are very elastic, and have a thick wall. The first drop contains excess tissue fluid and must be wiped away. 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: Most commonly, venipuncture will be performed on the Antecubital Fossa, or the inside of the elbow. Apply only ONE drop of blood per circle. Psychological interventions for needle-related procedural pain and distress in children and adolescents. Some DNS services support web filtering, too. You should not perform this technique unless you are certain that the needle is in the immediate vicinity of the vein. D. Blue, Which of the following conditions should prevent a site from being selected for venipuncture? Occupational Safety and Health Administration, United States Department of Labor. Allsurfaces are cleaned daily with bleach. When there is an IV line present, blood can be drawn from this line. The rubber stoppers are color coded according to the additive that the tube contains. Cephalic vein. Also found in the antecubital fossa, the basilic vein serves as a last resort for blood draws. This process is automatic. outstretched or raised McCall, R. E., & Tankersley, C. M. (2016). There may be no vacuum in the tube being used. Wipe away the first drop of blood, which tends to contain excess tissue fluid. Include your email address to get a message when this question is answered. While most patients veins are compatible with a standard needle gauge, others require a butterfly needle. -tourniquet PST (light green top). Certain larger molecules are not filterable into the tissue, therefore they are more concentrated in the blood. the chlorhexidine residue before tying a piece of gauze around the foot. What are some of the reasons to draw blood? 10. Several veins in the antecubital fossa provide excellent access. Deliver specimens promptly to the laboratory. The hydrostatic pressure causes some water and filterable elements to leave the extracellular space. He holds a Diploma in Medical Laboratory Assistance and is certified under the British Columbia Society of Laboratory Science. Identify the additive, additive function, volume, and specimen considerations to be followed for each of the various color coded tubes. (2017). Valenstein PN, Sirota RL. Arteries pulsate, are most elastic, and have a thick wall. or move it backward (it may have penetrated too far). These items include: The median cubital creates, The dorsal venous network is the next most common vein site for phlebotomists. 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. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. Remove the first glove so that it turns inside out during removal A phlebotomy technician is preparing to dispose of contaminated sharps. Blood should NEVER be poured from one tube to another since the tubes can have different additives or coatings (see illustrations at end). The thumb has a pulse and is likely to bleed excessively. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. Label the specimens before leaving the patients bedside. This enables the bloodto form as a drop on the fingertip. Cleanse in a circular fashion, beginning at the site and working outward. The upper extremity on the side of a previous mastectomy - test results may be affected because of lymphedema. 2009;18(2):117-139. You may also remove the tube, wait a few seconds for blood flow to resume, and then engage a short drawtube. Avoid bruising the infant's heel when obtaining blood. A typical single vial contains about five milliliters, which is about one teaspoon. 3. If just a routine coagulation assay is the only test ordered, then a single light blue top tube may be drawn. Let's take a look at the types of websites you and your staff need to be wary of and how to avoid them. This guide follows the steps as outlined in the World Health Organizations Guidelines on Drawing Blood: Best Practices in Phlebotomy. When multiple vials of blood are collected it can seem like a large amount. Always wear a clean lab coat or gown. -antiseptic swabs 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. Of course, the phlebotomist may understand this, however, the patient may not. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. Avoid trauma and excessive probing. 1. } Warning: Make sure you are confident that the structure you're palpitating is indeed a vein. While this may be effective in some difficult draws, the risk of a needlestick injury is higher if the patient has a withdrawal reflex and the needle recoils back into your finger. The first attempt is the antecubital fossa area, starting with the median cubital vein, then the cephalic vein, and the basilic vein. True or False? If it is then heated, what can you say about: b) how often the molecules hit the walls of the can. if( evntData && evntData.constructor == String ){ A requisition form must accompany each sample submitted to the laboratory. This image may not be used by other entities without the express written consent of wikiHow, Inc.
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