what sites should be avoided when performing venipuncture quizlet

If blood is not obtained, change the position of the needle carefully by moving it forward or backward. Wipe away the first drop of blood with a sterile 22 gauze. BD Vacutainer), rather than IV catheter insertions. Lancets are disposed of in an appropriate sharps container as one unit. with their hand to stabilize it for the draw. -keep extremity below heart level for a few minutes. Interruptions and distractions during medical encounters and procedures should be avoided. This makes every subsequent poke harder and harder because scar tissue is more fibrous and tougher to puncture. Hard and dense structures may be nerves or tendons. Look at the dorsum of the hand as a last resort. Any attempt to repeat a puncture at the same site increases the risk of complications. Begin by selecting the proper, approved lancet, such as: BD Microtainer Quikheel Lancet, 2.5 mm for full-term babies (green), BD Microtainer Quickheel Preemie Lancet, 1.75 mm for neonatal, Unistick2 Neonatal 18G, 1.2mm Lancet for neonatal babies less than, Prepare the heel by cleaning it with a Chlorhexadine wipe. Use a smaller tube with less vacuum. Avoid prolonged tourniquet application or fist clenching. What are the best veins for venipuncture? In general, blood should not be drawn from an arm with a fistula or cannula without consulting the attending physician. Using a sterile lancet, puncture the fingertip in the fleshy part of the finger, slightly to the sideof the center and across (perpendicular to) the grooves of the fingertip. Subcutaneous tissue feels squishy and muscle feels hard. Cleanse the fingertip of the 3rd (middle) or 4th (ring) finger with an alcohol prep. The recommended location for blood collection on a newborn baby or infant is the heel. Copyright 2023 - PhlebotomyU | Website Design & SEO by, Phlebotomy: 5 Tips on Finding Difficult Veins. Which of the following is the most likely mechanism for alteration in protein values in this situation? By signing up you are agreeing to receive emails according to our privacy policy. Change your approach when dealing with uncooperative patients, such as pediatrics and those with neurodevelopmental or psychiatric disorders. Within the antecubital fossa, this vein poses the least amount of risk. This requisition form must contain the proper information in order to process the specimen. Loosen the tourniquet. 1. Apply firm pressure. Phlebitis can also occur as a result of vein trauma during insertion, use of an inappropriate I.V. What are the gray top containers used for? 2019;95(1):15-19. doi: 10.1016/j.diagmicrobio.2019.04.001. Clean up any blood spills with a disinfectant such as freshly made 10% bleach. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. Order of draw for multiple tube phlebotomy. Needles are available for evacuated systems and for use with a syringe, single draw or butterfly system. Place labeled specimens in zip lock bag and deliver to the laboratory as soon as possible. d.appendChild(f); doi: 10.1002/14651858.CD005179.pub3. (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.). (See picture.) Allow to air dry. Procedures and Devices for the Collection of Diagnostic Capillary Blood. It is an employer's responsibility to provide, clean, repair, replace, and/or dispose of personal protective equipment/clothing. Other draw sites, particularly below the waist, are rarely used. Thrombosed veins lack resilience, feel cord-like, and roll easily. Each phlebotomist generally establishes a routine that is comfortable for her or him. Choosing an appropriate site for venipuncture is crucial for a successful . How To Draw Blood | A Step-by-Step Guide - Nurse.org Hematoma formation is a problem in older patients. Inadvertently nicking a nerve causes intense pain. A. ROUTINE CAPILLARY PUNCTURE BLOOD COLLECTION GUIDELINES. 7. Cleanse in a circular fashion, beginning at the site and working outward. Summarize the problems that may be encountered in accessing a vein, including the procedure to follow when a specimen is not obtained. 6. This vein can be found along the upper arm to the thumb, but it is commonly drawn from the forearm or antecubital fossa area. B. the needle is only partially in the vein Best practices in capillary blood collection - Medical Laboratory Observer 7. What caution should you observe when using a Vacutainer? f.style.border="none"; Lightly touch the microtainer capillary collectiondevice (or filter paper) to the LARGE drop of blood. Effective communication - both verbal and nonverbal - is essential. Do not use alcohol for prepping the site when drawing a blood alcohol sample. Look for visual clues which may help assess the patient's condition. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. Safely dispose of potentially infectious materials. What angle should you insert the needle at? Wayne, PA: Clinical and Laboratory Standards Institute; 2008. 13. Hyperextend the patient's arm. 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. The service requires full JavaScript support in order to view this website. Mix and label all appropriate tubes at the patient bedside. DOC Blood Collection by Venipuncture - Michigan 5. Gloves are to be worn during all blood collection procedures, and changed betweenpatient collections. How to Troubleshoot a Difficult Venipuncture: 14 Steps - wikiHow Nursing Personnel. Adjust the height and swivel the chair to ensure your body is in line with the vein. Clinical and Laboratory Standards Institute. 9. After the third attempt, further medical directions must be sought with the attending physician before proceeding. Venipuncture requires good skills in order to perform the procedure not only correctly, but also painlessly. PDF Selecting The Venipuncture Site - Yola Dispose of contaminated materials in appropriate waste receptacles. 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. An outpatient must provide identification other than the verbal statement of a name. The antecubital fossa is a collection of veins located within the arm's inner area, opposite of the elbow, where the arm folds in. Do not bend, break, recap, or resheath needles to avoid accidental needle puncture or splashing of contents. 4. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. Fill the capillary tube(s) or micro collection device(s) as needed. After the needle selection, phlebotomists begin to look and feel for a viable vein. Povidone-iodine wipes/swabs - Used if blood culture is to be drawn. As a phlebotomist, it is critical to know which vein sites offer stable flows for blood draws. Avoid puncturing a finger that is cold or cyanotic, swollen, scarred, or covered with a rash. 1. Patients in these populations are often nervous and may flail their limbs. 2017;50(10-11):568-573. var f = document.createElement("iframe"); In other words, there is no need for another venipuncture procedure. 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. Venipuncture Flashcards | Quizlet Finally, when the necessary blood is collected, the needle will be removed and properly disposed of in a Sharps container and the puncture site will be covered to stop the bleeding. The phlebotomist's role requires a professional, courteous, and understanding manner in all contacts with the patient. var prevIframeHeight = iframe.style.height; The blood is normally drawn from a vein on the top of the hand or from the inside of the elbow. Watch for formation of a hematoma. Heparin light or dark green top tube, 5. 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. Contains a gel separator and clot activator. Please enable cookies on your browser and try again. Track marks are not only found on IV drug users, but also on chronically ill patients requiring repeated vascular access and blood draws and may be a sign of an anticipated difficult draw. Change gloves after each patient or when contaminated. A needle is then gently inserted into the vein. Additionally, a hematoma may compress the nerve and lead to long-term damage. var evntData = event.data; Significant increases can be found in total protein, aspartate aminotransferase (AST), total lipids, cholesterol, iron, Affects packed cell volume and other cellular elements. finger should be avoided. are known to vary lab results of some analytes. Otherwise, satisfactory samples may be drawn below the IV by following these procedures: Turn off the IV for at least 2 minutes before venipuncture. A. just prior to needle insertion Re-secure the tourniquet to increase venous filling. The best locations for fingersticks are the 3rd (middle) and 4th (ring) fingers of the non-dominant hand. The equipment used during the venipuncture test can vary, but the following are most commonly used for routine venipuncture: Phlebotomists may choose to draw blood from several different sites of the body. Fill the microtainer tube(s) as needed, adhering to the order of draw. Tourniquet - Wipe off with alcohol and replace frequently. This complication of peripheral I.V. When multiple vials of blood are collected it can seem like a large amount. The basic patient rights endorsed by the JCAHO follow in condensed form are given below. For most clinical examinations the blood is obtained: The vacuum (evacuated) tube system (vacutainer) requires the following components: The healthcare worker needs essential items for either venipuncture or microcollection. Asking the patient about their previous blood draw experiences is beneficial, especially if they are a hard stick and know which area works best. Expect reasonable safety congruent with the hospital practices and environment.