what sites should be avoided when performing venipuncture quizlet

A. Needles - The gauge number indicates the bore size: the larger the gauge number, the smaller the needle bore. Any attempt to repeat a puncture at the same site increases the risk of complications. Fill the capillary tube(s) or micro collection device(s) as needed. obvious areas of skin infections The first drop contains excess tissue fluid and must be wiped away. When finished, clean the site and apply pressure with a clean gauze to stop the bleeding. Stop the procedure if a hematoma occurs. try{ Apply firm pressure. www.mlo-online.com is using a security service for protection against online attacks. -do not rapidly insert the needle. NOTE:Tubes with additives must be thoroughly mixed. 1. Similarly, it's quite easy to get lost in a "Wikipedia wormhole." Indeed, Wikipedia's depth is infinite, as you link from subject to subject, never able to stop. A needle is then gently inserted into the vein. Remove your gloves and wash your hands. Common Venipuncture Sites | Healthfully Through a combination of revolutionary treatments and extraordinary patient experiences, our care does more than heal. } Avoid excessive pressure that may squeeze tissue fluidinto the drop of blood. 3. True or False? Identify the additive, additive function, volume, and specimen considerations to be followed for each of the various color coded tubes. 2. How many time should you invert them? This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. Apply firm pressure for more than 5 minutes. 5. The phlebotomist's role requires a professional, courteous, and understanding manner in all contacts with the patient. Procedure for Capillary Puncture of the Finger: The best site for a finger puncture is just off the center of the finger pad of, the 3rd (middle) or 4th (ring) finger of the hand. Other Factors: Age, gender, and pregnancy have an influence on laboratory testing. Other draw sites, particularly below the waist, are rarely used. What is an Approved Phlebotomy School in California. Avoid trauma and excessive probing. What are the gray top containers used for? 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. CLSI document H04-A6. The sides and the tip of the. catheter size for the vein, or prolonged use of the same I.V. Over 52 percent of all web traffic is from mobile devices . Look at the dorsum of the hand as a last resort. It is not uncommon for adults and children to feel some fear when having blood drawn, which is why any discussion of venipuncture should at least bring this topic to focus. By signing up you are agreeing to receive emails according to our privacy policy. Significant increases can be found in total protein, aspartate aminotransferase (AST), total lipids, cholesterol, iron, Affects packed cell volume and other cellular elements. Of course, the phlebotomist may understand this, however, the patient may not. Capillary Specimens may be collected on filter paper and sent to lab for testing for. Using a sterile blood lancet, puncture the side of the heel in the appropriate regions shown above in green. Question. Intravenous therapy (IV) / blood transfusions - fluid may dilute the specimen, so collect from the opposite arm if possible. EDTA and sodium citrate tubes should still be filled to the marked fill line to ensure a correct blood-to-additive ratio. A. the tubes are filled and properly labeled Consult a specialist at the patient's own request and expense. Wash hands in warm, running water with an appropriate hand washing product, or if notvisibly contaminated, with a commercial foaming hand wash product before and aftereach patient collection. Forward completed/dry collections to the laboratory as soon as possible. Stabilize the needle as you're inserting your tubes. For example, serum cortisol levels are highest in early morning but are decreased in the afternoon. Obtain from the practitioner complete and current information about diagnosis, treatment, and any known prognosis, in terms the patient can reasonably be expected to understand. Cap, rotate and invert the collection device to mix the blood collected. Patient care following completion of venipuncture. Thrombosed veins lack resilience, feel cord-like, and roll easily. Dispose of contaminated materials in appropriate waste receptacles. D. after needle removal, When drawing blood you should always follow universal ______ Approach the patient in a friendly, calm manner. Normal reference ranges are often noted according to age. Blood is commonly obtained from the median cubital vein on the anterior forearm. 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. This vein lies close to the surface of the skin and there is not a large nerve supply. (c) How would you prepare tetracaine from benzene? Please enable JavaScript on your browser and try again. Proper Handling of an Uncooperative Patient in an Outpatient Setting Akron. What should you never do to a site you just cleansed with alcohol? Avoid previous hematoma (draw distal of hematoma) Have the patient drink fluids if dehydrated. Check the requisition form for requested tests, patient information, and any special requirements. Contaminated surfaces must be cleaned with freshly prepared 10% bleach solution. Gloves are to be worn during all blood collection procedures, and changed betweenpatient collections. Previous puncture sites should be avoided. Each time a vein is accessed with a needle, scar tissue forms as part of the body's healing process. Label the collection tubes at the bedside or drawing area. Blood Collection Process: Venipuncture - University of Florida Veins on the underside of the wrist should be avoided. Recognize complications associated with the phlebotomy procedure. Label collection tubes after identification of the patient. D. Near a tattoo, Needles are used once and then: Clean the site to be punctured with an alcohol sponge. Use a butterfly to compensate for patient movement. -cotton sponges The antecubital fossa is a collection of veins located within the arm's inner area, opposite of the elbow, where the arm folds in. Venipuncture can also happen when patients have intravenous (IV) lines started. If the puncture is parallel to the lines of the fingerprint, theblood will not form as a drop but will run down the finger making collection difficult. Lightly touch the microtainer capillary collectiondevice (or filter paper) to the LARGE drop of blood. avoid sites of extensive scarring (burns, surgery, injuries) What are the light blue top containers used for? chemistries, serology, immunnology, blood bank. Wipe away the first drop of blood with sterile 22 gauze. 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. When do you release the tourniquet during venipuncture? Label the specimens before leaving the patients bedside. Recommended order of collection for microtainer specimens: 7. Such terms as "needs to," "must," "require" and "should" are used to explain how medical professionals should perform capillary blood collection procedures. D. all of the above, Common causes of hematomas that form during a venipuncture include: Arteries pulsate, are very elastic, and have a thick wall. These items include: Place blood collection equipment away from patients, especially children and psychiatric patients. 2. The service requires full JavaScript support in order to view this website. Blood should NEVER be poured from one tube to another since the tubes can have different additives or coatings (see illustrations at end). Tip: If you realize you've collected in the wrong order of draw, remove the tube, insert the correct one, fill it halfway before discarding it, then insert a new tube and fill it completely. Hematoma formation is a problem in older patients. After the needle selection, phlebotomists begin to look and feel for a viable vein. To determine the best vein, use both sight and touch. Take enough time to assess the vein before beginning the venipuncture procedure. Specimens; Approved StandardSixth Edition. X=[Ar]4s23d5Y=[Ar]4s23d104p1Z=[Ar]4s23d104p6. A scooping motion to collect blood and strong repetitive pressure (milking) MUST be avoided, as both procedures may result in hemolysis or tissue-fluid contamination fo the specimen. Label the specimens before leaving the patients bedside. Wayne, PA: Clinical and Laboratory Standards Institute; 2008. The patient who is at ease will be less focused on the procedure. Dorsal hand veins are often utilized for intravenous infusions but are viable options for blood draw sites. Proper labeling procedures and completion of laboratory requisitions. Contains a gel separator and clot activator. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. An electric motor draws a current of 10 amp with a voltage of 110V110 \mathrm{~V}110V. The output shaft develops a torque of 10.2Nm10.2 \mathrm{~N} \cdot \mathrm{m}10.2Nm and a rotational speed of 1000 RPM. Stop the procedure and remove the needle if: Thanks to all authors for creating a page that has been read 43,712 times. Adjust the angle (the bevel may be against the vein wall). Be informed of the hospital rules and regulations regarding patient conduct. Collect the drops of blood into the collection device by gently massaging, Avoid excessive pressure that may squeeze tissue fluid into the drop of, When full, cap and then gently invert the collection device 5-10 times to, Hold a gauze pad over the puncture site for a short time to stop the, Dispose of the contaminated materials and lancet in the appropriate waste, Place a band-aid on the patients finger or have someone continue to hold, gauze on the finger. (2017). Select a vein other than the one with the IV. The blood is bright red (arterial) rather than venous. Top Vein Sites Used in Phlebotomy | PhlebotomyU | CPT1 Course Hold equipment firmly and place fingers against patient's arm, using the flange for leverage when withdrawing and inserting tubes. } There are three phlebotomy vein sites located in the arm most utilized by medical professionals and three additional draw sites that are last resorts. Perform the venipuncture. A requisition form must accompany each sample submitted to the laboratory. Procedure for Capillary Puncture of the Heel: A heel puncture is performed on the lateral or medial plantar surface of the, foot. Two forms of active identification are required. Determine the final temperature of the R-134a and the final specific internal energy. When multiple vials of blood are collected it can seem like a large amount. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. Hold the baby's foot firmly to avoid sudden movement. 13 Websites to Avoid If You Value Your Time | PCMag C. placed in the sharps container Cleanse in a circular fashion, beginning at the site and working outward. Drawing the patient in a reclined position. Inadvertently nicking a nerve causes intense pain. if( evntData && evntData.constructor == String ){ Carry out hand hygiene before and after each patient procedure, before putting on and after removing gloves. -infection at site Do not use the tip of the finger or the center of the finger. An artery has been punctured (characterized by bright red, pulsating blood), A nerve has been nicked (patient may complain of an electrical sensation up and down the limb), A hematoma starts to form (a bubble under the skin starts to rapidly appear at the site), The patient loses consciousness or starts seizing.