\u00a9 2023 wikiHow, Inc. All rights reserved. Posture: Postural changes (supine to sitting etc.) }catch(e){} Dispose of needles immediately upon removal from the patient's vein. A lab coat or gown must be worn during blood collection procedures. 1. Not making it mobile friendly. The patient has the right to refuse participation in such activity. The first attempt is the antecubital fossa area, starting with the median cubital vein, then the cephalic vein, and the basilic vein. 9. Apply the tourniquet approximately 4-5 finger-widths above the planned venepuncture site. Press down on the gauze once the needle is out of the arm, applying adequate pressure to avoid formation of a hematoma. Am J Clin Pathol. obvious areas of skin infections The maximum number of times an individual should attempt a venipuncture on a patient is two, True or False? Some DNS services support web filtering, too. (function() { Draw 5 ml of blood and discard before drawing the specimen tubes for testing. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. What should you do with a CBC or lavender top tube before putting them down? While most patients veins are compatible with a standard needle gauge, others require a. . The median cubital vein, a superficial vein that forms a connection point between the cephalic and basilic veins of the arm is large, and therefore easier to see and feel. finger should be avoided. Apply firm pressure. The fifth finger tends to have less soft tissue overlying the bone. The antecubital fossa is a collection of veins located within the arms inner area, opposite of the elbow, where the arm folds in. This guide follows the steps as outlined in the World Health Organizations Guidelines on Drawing Blood: Best Practices in Phlebotomy. The content of this article is not intended to be a substitute for professional medical advice, examination, diagnosis, or treatment. Larger tube sizes typically provide for collection of samples from 6 to 10 mL. Hyperextend the patient's arm. BD Vacutainer), rather than IV catheter insertions. 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. Compare and contrast the two major types of neuronal pathways. Dispose of contaminated materials in appropriate waste receptacles. proteins). 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. This preliminary action allows you to safely adjust the needle's position. This enables the bloodto form as a drop on the fingertip. If the patient is sitting in a phlebotomy chair, make sure they are sitting upright with their back against the chair. Valenstein PN, Sirota RL. Filter paper should touch only the blood and not the heel or finger. D. 70% isopropyl alcohol. catheter size for the vein, or prolonged use of the same I.V. Know the identity and professional status of individuals providing service and to know which physician or other practitioner is primarily responsible for his or her care. -cotton sponges Intravenous therapy (IV) / blood transfusions - fluid may dilute the specimen, so collect from the opposite arm if possible. Label all appropriate tubes at the patient bedside. Do not use excessive pressure or heavy massaging because the blood may become diluted with tissue fluid. the 3 rd (middle) or 4 th (ring) finger of the hand. Collect drops of blood into the . 70% isopropyl alcohol 9. The most common complications are bleeding at the puncture site or hematoma formation. While we are ranked among the best children's hospitals in the country, it's our compassionate approach to treatment that makes us truly exceptional. Do not use alcohol for prepping the site when drawing a blood alcohol sample. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. 11. Blood Collection Process: Venipuncture - University of Florida Avoid areas of hematoma. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. This information must be given when requesting microbiology, cytology, fluid analysis, or other testing where analysis and reporting is site specific. D. mandates, The most common antiseptic used in venipuncture is: Applyan adhesive bandage. Sites that should be avoided include areas with extensive scarring, healed burns, inflamed sites, edematous sites, previous puncture sites, earlobes and thumbs. Order of draw for multiple tube phlebotomy. When do you release the tourniquet during venipuncture? The needle may have pulled out of the vein when switching tubes. Procedures and Devices for the Collection of Diagnostic Capillary Blood. Hard and dense structures may be nerves or tendons. The patient should make a fist without pumping the hand. BD Eclipse green-capped) is used for most routine and uncomplicated venipunctures. -obvious skin infection (including newly tattooed areas). The most commonly used site for a venipuncture is at the bend of the elbow, also called the antecubital fossa 1. (b) How would you prepare tetracaine from p-nitrobenzoic acid? He previously worked in a high-volume outpatient lab and is currently employed in an acute care hospital and Level III trauma center in downtown Vancouver. D. all of the above, Common causes of hematomas that form during a venipuncture include: Normal reference ranges are often noted according to age. 7. Carry out hand hygiene before and after each patient procedure, before putting on and after removing gloves. Located in the antecubital fossa, the median cubital vein is a well anchored, stable vein that rarely rolls during venipuncture. containers. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. Have an assistant stabilize the arm by firmly locking the elbow joint. 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. Do not attempt a capillary puncture more than twice. This makes every subsequent poke harder and harder because scar tissue is more fibrous and tougher to puncture. Specimen Collection Procedure - PERFORMING A VENIPUNCTURE | Akron Common Venipuncture Sites | Healthfully This requisition form must contain the proper information in order to process the specimen. 2. B. just after needle insertion, but prior to vacutainer activation Tip: In spite of a difficult draw, remember to invert your tubes. 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. The first drop contains excess tissue fluid and must be wiped away. The line must be flushed first. (Partial penetration may allow blood to leak into the soft tissue surrounding the vein by way of the needle bevel). 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.