\u00a9 2023 wikiHow, Inc. All rights reserved. What Is Venipuncture? To determine the best vein, use both sight and touch. A. Edema Asking the patient about their previous blood draw experiences is beneficial, especially if they are a hard stick and know which area works best. -use a smaller gauge needle 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. B. the needle is only partially in the vein This information must match therequisition. These may include listening to music or a story, watching a video, playing with a toy, having a parent provide distraction with talk or touch, using flash cards, and squeezing a rubber ball. Collection tubes can vary in size for volume of blood drawn, appropriate to the tests ordered with sample size required, and vary in the kind of additive for anticoagulation, separation of plasma, or preservation of analyte. Try another tube. Switch to the other arm if you can't find anything. } It brings the entire family By signing up you are agreeing to receive emails according to our privacy policy. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. Follow the procedure as outlined above for greeting and identifying the patient. Wipe away the first drop of blood with a sterile 22 gauze. A. Extensive scarring or healed burn areas should be avoided Specimens should not be obtained from the arm on the same side as a mastectomy. The venipuncture procedure is complex, requiring both knowledge and skill to perform. 23-gauge needles (e.g. Identify the patient. 1. Always wear a clean lab coat or gown. X=[Ar]4s23d5Y=[Ar]4s23d104p1Z=[Ar]4s23d104p6. var zf_ifrm_data = evntData.split("|"); When there is an IV line present, blood can be drawn from this line. Palpate and trace the path of veins with the index finger. PDF Venipuncture - Central Zone - Alberta Health Services In general, blood should not be drawn from an arm with a fistula or cannula without consulting the attending physician. The median cubital vein is used the most for its accessibility. The patient should either sit in a chair, lie down or sit up in bed. (2017). Hematoma - A venipuncture should not be performed on a hematoma, regardless of how small it may be. Perform the venipuncture, collecting the sample(s) in the appropriate container(s). The rubber stoppers are color coded according to the additive that the tube contains. 2004;24(4):979-96, vii. A thin soap bubble of index of refraction 1.33 is viewed with light of wavelength 550.0 nm and appears very bright. Previous puncture sites should be avoided. Identify the additive, additive function, volume, and specimen considerations to be followed for each of the various color coded tubes. 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. 2. www.mlo-online.com is using a security service for protection against online attacks. increase the circulation of blood to the area. Ask the patient to lie on their back. Diagn Microbiol Infect Dis. Proper patient identification procedures. What can happen if you vigorously shake the tubes? 9. Sites that should be avoided include areas with extensive scarring, healed burns, inflamed sites, edematous sites, previous puncture sites, earlobes and thumbs. Drawing blood for laboratory analysis is most often a routine and uneventful procedure. 2006;52(5-6):217-30. Prepare the patient's arm using an alcohol prep. Peripheral Intravenous Catheter Insertion - Video - JoVE You will be redirected once the validation is complete. Dorsal hand veins are often utilized for intravenous infusions but are viable options for blood draw sites. However, blood samples that are normally taken are actually very small. 4. Provide for their comfort as much as possible, and gain the patient's cooperation. Gauze sponges - for application on the site from which the needle is withdrawn. Preanalytical phase of the testing process begins for the laboratory when a: Test is ordered by a patient's physician. A tin can containing air is sealed. 2011-2023 Phlebotomy Coach. While most patients veins are compatible with a standard needle gauge, others require a butterfly needle. 6. Such terms as "needs to," "must," "require" and "should" are used to explain how medical professionals should perform capillary blood collection procedures. C. at a mastectomy site Regardless of the source of payment, request and receive an itemized and detailed explanation of the total bill for services rendered in the hospital. He holds a Diploma in Medical Laboratory Assistance and is certified under the British Columbia Society of Laboratory Science. Please enable JavaScript on your browser and try again. When finished, clean the site and apply pressure with a clean gauze to stop the bleeding. Phlebotomy Essentials 5th Edition Chapter 9. What is an Approved Phlebotomy School in California. Penetrate the skin at a 30 to 45 angle at first (even less with a butterfly), then once you get a flash, reduce the angle by bringing the needle assembly down closer to the arm and advance the needle a tiny bit further into the vein. Serum red top or amber tube with red top. 5. Precautions include a medical grade face mask. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. D. Blue, Which of the following conditions should prevent a site from being selected for venipuncture? 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. 5 Common Capillary Puncture Blood Collection Sites - Neoteryx Any attempt to repeat a puncture at the same site increases the risk of complications. 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. Blood Collection Process: Venipuncture - University of Florida What are the best veins for venipuncture? 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. Allsurfaces are cleaned daily with bleach. Place labeled specimens in zip lock bag and deliver to the laboratory as soon as possible. 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. Proper Handling of an Uncooperative Patient in an Outpatient Setting Akron. Avoid the side of the finger where there is less soft tissue, where vessels and nerves are located, and where the bone is closer to the surface. 7. How To Draw Blood | A Step-by-Step Guide - Nurse.org Antiseptic. Through a combination of revolutionary treatments and extraordinary patient experiences, our care does more than heal. 7. It doesn't matter . Question. McCall, R. E., & Tankersley, C. M. (2016). There are three phlebotomy vein sites located in the arm most utilized by medical professionals and three additional draw sites that are last resorts. This article was co-authored by Matt Garcia. After the third attempt, further medical directions must be sought with the attending physician before proceeding. Cleanse in a circular fashion, beginning at the site and working outward. Certain areas are to be avoided when choosing a site: Extensive scars from burns and surgery - it is difficult to puncture the scar tissue and obtain a specimen. Tip: When using a butterfly and sodium citrate is the first to be collected in the order of draw, a discard tube must always be filled first to purge the air from the tubing. Once you establish blood flow, slightly modify your hand position to stabilize the needle against the arm and prevent further movement.