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

\u00a9 2023 wikiHow, Inc. All rights reserved. Follow the same procedure as for performing a finger, Order of Draw for a Capillary Puncture: Proper collection of tubes when. Proper patient identification MANDATORY. B. the needle is only partially in the vein If using a syringe, make sure the needle is fitted securely on a syringe to avoid frothing. Adjust the angle (the bevel may be against the vein wall). He holds a Diploma in Medical Laboratory Assistance and is certified under the British Columbia Society of Laboratory Science. Never draw over scars or a new tattoo sites. Significant increases can be found in total protein, aspartate aminotransferase (AST), total lipids, cholesterol, iron, Affects packed cell volume and other cellular elements. Avoid excessive pressure that may squeeze tissue fluid into the drop of blood. (a) the electric power required. How many time should you invert them? window.addEventListener('message', function (){ Cannula/fistula/heparin lock - hospitals have special policies regarding these devices. Blood clots, and the serum is separated by centrifugation, Chemistries, Immunology and Serology, Blood Bank (Crossmatch), Serum separator tube (SST) contains a gel at the bottom to separate blood from serum on centrifugation, Plasma Separating Tube (PST) with Lithium heparin, Anticoagulates with lithium heparin; Plasma is separated with PST gel at the bottom of the tube, Hematology (CBC) and Blood Bank (Crossmatch); requires. 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. Through a combination of revolutionary treatments and extraordinary patient experiences, our care does more than heal. Venipuncture sites should be carefully assessed for contraindications, such as pain, wounds, decreased circulation, a previous cerebral vascular accident (CVA), dialysis fistulas, or a mastectomy on the same side. 5. Hard and dense structures may be nerves or tendons. Too tight of a tourniquet may cause the vein to collapse upon needle insertion. Cleanse the heel with alcohol prep, then dry with a sterile 22 as alcohol can influence testresults. B. collection device A lab coat or gown must be worn during blood collection procedures. Greet the patient and identify yourself and indicate the procedure that will take place. Use a smaller tube with less vacuum. A tin can containing air is sealed. Individually packaged 70% isopropyl alcohol wipes. 2011-2023 Phlebotomy Coach. Press down on the gauze once the needle is out of the arm, applying adequate pressure to avoid formation of a hematoma. What is the most common site for blood sampling? This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. How can you tell if you are palpating a vein? Areas of fingers and heels that are cold, swollen, scarred or covered with a rash, should be avoided. (function() { While hand veins may be utilized for blood draws and intravenous infusions, veins in the feet and legs should be avoided for adults. Occupational Safety and Health Administration, United States Department of Labor. Do not add blood to a circle already filled orpartially filled with blood. Punctures to the posterior curvature of the heel cab cause damage to the bones. Second - coagulation tube (light blue top). 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. If the blood flow is diminished, repeat the capillary PUNCTURE to complete the collection. If none of these veins work, then the phlebotomists use the hand veins. Erroneous test results may be obtained when the blood is not thoroughly mixed with the additive. Finger - Usually the third or fourth finger is preferred in adults and children. A. excessive probing with the needle Ask the patient to lie on their back. This is more common in humeral and femoral punctures than radial punctures. For the CLSI Updated Phlebotomy Procedures please click here. When working with patients who have undergone a mastectomy, draw from the arm on the opposite side of the mastectomy to avoid edematous tissue. When using a syringe and needle, avoid drawing the plunger back too forcibly. Procedures and Devices for the Collection of Diagnostic Capillary Blood. Basilic vein. Stop the procedure if a hematoma occurs. Firmly grasp the flanges of the tube holder to avoid advancing the needle further into the vein as you change tubes. Have the patient hold a small gauze pad over the puncture site for a couple of minutes to stop the bleeding. This complication of peripheral I.V. When the last tube to be drawn is filling, remove the tourniquet. Remove the first glove so that it turns inside out during removal A phlebotomy technician is preparing to dispose of contaminated sharps. Wipe away the first drop of blood with a piece of clean, dry cotton. Step 3: Venipuncture. Include your email address to get a message when this question is answered. 1. Some examples of these include notices from banks, online retailers such as Amazon or eBay, and even . Always thank the patient and excuse yourself courteously when finished. The antecubital fossa is a collection of veins located within the arm's inner area, opposite of the elbow, where the arm folds in. Safely discard potentially infectious materials. Refuse treatment to the extent permitted by law. 8. Make certain that the blood completely saturates all four (4) circles and is visible from bothsides. Anxiety that results in hyperventilation may cause acid-base imbalances, and increased lactate. Avoid prolonged tourniquet application or fist clenching. Drawing blood from major vessels (e.g. -use a smaller gauge needle 2009;47(2):143-53. Confidentiality of all communications and other records pertaining to the patient's care. Additionally, blood samples should not be taken on an arm with a fistula used for dialysis treatments. Why? Sanders AM, Agger WA, Gray AM, Fischer CM, Kamprud EA. Specimen Collection Procedure - PERFORMING A VENIPUNCTURE | Akron Enzymes, proteins, lipids, iron, and calcium are significantly increased with changes in position. diet, exercise, stress, basal state). Areas in which two veins join should be avoided where possible, as valves are often present. However, blood samples that are normally taken are actually very small. Select a vein other than the one with the IV. Cap, rotate and invert the microtainer to mix the blood collected. As always, properly fill out appropriate requisition forms, indicating the test(s) ordered. A. Effective methods use distraction. Performing a venipuncture on a child under one year of age . C. After all specimens have been collected -antiseptic swabs Determine the final temperature of the R-134a and the final specific internal energy. var d = document.getElementById("zf_div_SBGg-3DTNCwt65i9A6n_zU3SneyGD89SSqM_7F_nCas"); Although the larger and fuller median cubital and cephalic veins of the arm are used most frequently, the basilic vein on the dorsum of the arm or dorsal hand veins are also acceptable for venipuncture. 9. 2. While the median cubital, cephalic, and basilic veins are the most popular draw sites for blood draws, phlebotomists may resort to other draw sites if their ability to draw is restricted. The upper extremity on the side of a previous mastectomy - test results may be affected because of lymphedema. Matt Garcia is an experienced phlebotomist in Vancouver, Canada. Discarding the first set minimizes the effects of any potential additive contamination. Avoid bruising the infants heel when obtainingblood. 8. {"smallUrl":"https:\/\/www.wikihow.com\/images\/thumb\/6\/68\/Troubleshoot-a-Difficult-Venipuncture-Step-1.jpg\/v4-460px-Troubleshoot-a-Difficult-Venipuncture-Step-1.jpg","bigUrl":"\/images\/thumb\/6\/68\/Troubleshoot-a-Difficult-Venipuncture-Step-1.jpg\/aid11732774-v4-728px-Troubleshoot-a-Difficult-Venipuncture-Step-1.jpg","smallWidth":460,"smallHeight":345,"bigWidth":728,"bigHeight":546,"licensing":"