what sites should be avoided when performing venipuncture quizlet

\u00a9 2023 wikiHow, Inc. All rights reserved. Although the skill set and procedures may apply to both instances, this content is primarily aimed towards venous blood collection using evacuated tube systems (e.g. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. 8. This preliminary action allows you to safely adjust the needle's position. The maximum number of times an individual should attempt a venipuncture on a patient is two, True or False? PERFORMING A CAPILLARY PUNCTURE - Akron Children's Hospital This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. Anxiety that results in hyperventilation may cause acid-base imbalances, and increased lactate. If blood is not obtained, change the position of the needle carefully by moving it forward or backward. The puncture should be made perpendicular to the ridges of the fingerprint so that the drop of blood does not run down the ridges. A. the tubes are filled and properly labeled Dorsal hand veins are often utilized for intravenous infusions but are viable options for blood draw sites. Most commonly, venipuncture will be performed on the Antecubital Fossa, or the inside of the elbow. Clin Chem Lab Med. This enables the bloodto form as a drop on the fingertip. After cleansing, allow the venipuncture site to air dry. 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. 7. 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. The area where the blood is to be drawn from is first cleaned with a germ-killing solution. Never draw blood through a hematoma. Stop the procedure if a hematoma occurs. What are the gold top containers used for? What is an Approved Phlebotomy School in California. Verify the patient's condition. Sign up for wikiHow's weekly email newsletter. If this is not successful, remove the needle, take care of the puncture site and redraw at another site. Observe all applicable isolationprocedures. EDTA and sodium citrate tubes should still be filled to the marked fill line to ensure a correct blood-to-additive ratio. World Health Organization. 7. Allow filter paper to air dry for two (2) hours at room temperature. var d = document.getElementById("zf_div_SBGg-3DTNCwt65i9A6n_zU3SneyGD89SSqM_7F_nCas"); All of the following are common types of equipment used for venipuncture EXCEPT: Some images used in this set are licensed under the Creative Commons through Flickr.com.Click to see the original works with their full license. Cleanse the heel with alcohol prep, then dry with a sterile 22 as alcohol can influence testresults. Follow the same procedure as for performing a finger, Order of Draw for a Capillary Puncture: Proper collection of tubes when. As a phlebotomist, it is critical to know which vein sites offer stable flows for blood draws. Which of the following is the most likely mechanism for alteration in protein values in this situation? All other items used for the procedure must be disposed of according to properbiohazardous waste disposal policy. Using a sterile lancet, make a skin puncture just off the center of the finger pad. Do not use a previous puncture site. A. in the region of a hematoma Phlebitis is inflammation of a vein. This vein lies close to the surface of the skin and there is not a large nerve supply. Venipuncture can also happen when patients have intravenous (IV) lines started. PROBLEMS OTHER THAN AN INCOMPLETE COLLECTION: A hematoma forms under the skin adjacent to the puncture site - release the tourniquet immediately and withdraw the needle. When would you use a butterfly/infustion set? Remove your gloves and wash your hands. A. Syringe Do not use the central portion of the heel because you might injure the underlying bone, which is close to the skin surface. When finished, elevate the heel, place a piece of clean, dry cotton on the puncture site, and hold it in place until the bleeding has stopped. var zf_perma = zf_ifrm_data[0]; Place a pillow under the patient's arm if additional support is needed. Check for any allergies to antiseptics, adhesives, or latex by observing for armbands and/or by asking the patient. The first drop contains excess tissue fluid and must be wiped away. PDF Venipuncture - Central Zone - Alberta Health Services Specimen Collection Procedure - PERFORMING A VENIPUNCTURE | Akron After the needle selection, phlebotomists begin to look and feel for a viable vein. 11. Phlebotomy Essentials 5th Edition Chapter 9. 5. 1. 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. 13. If you stick yourself with a contaminated needle: Remove your gloves and dispose of them properly. Identify the patient. How far above a venipuncture sight should you place a tourniquet? Coagulation tests (protime and prothrombin time), Tube is designed to contain no contaminating metals, Trace element testing (zinc, copper, lead, mercury) and toxicology, Antiglycolytic agent preserves glucose up to 5 days, HLA tissue typing, paternity testing, DNA studies, Inactivates thrombin and thromboplastin; contains virtually no lead. 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. Capillary Specimens may be used immediately for point-of-care testing. 3. 4. Never draw above an IV site. What are the helpful hints for finding veins? Be sure to dispose of the lancet in the appropriate sharps container. Hematoma - A venipuncture should not be performed on a hematoma, regardless of how small it may be. Specimens from infants under the age of 6 months are typically collected by heelstick. D. Butterfly, Before leaving the patient's bedside, you must make sure that: The thumb has a pulse and is likely to bleed excessively. If the blood flow is diminished, repeat the capillary PUNCTURE to complete the collection. Second - coagulation tube (light blue top). This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. The fifth finger tends to have less soft tissue overlying the bone. Scan the skin for lines of blue indicating a prominently visible vein. Impact of Use of Smaller Volume, Smaller Vacuum Blood Collection Tubes on Hemolysis in Emergency Department Blood Samples. Previous puncture sites should be avoided. -hemorrhage/hematoma. Capillary Specimens may be collected on filter paper and sent to lab for testing for. Use of hair nets and face masks to decrease blood culture contamination rates. https://www.ncbi.nlm.nih.gov/books/NBK138650/pdf/Bookshelf_NBK138650.pdf (Accessed June 13, 2022). Date, time and initials of the phlebotomist must be on the label of EACH tube. Common Venipuncture Sites | Healthfully -tourniquet 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. These items include: D. all of the above, Common causes of hematomas that form during a venipuncture include: 5. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. 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. Effects of Exercise: Muscular activity has both transient and longer lasting effects. A tin can containing air is sealed. A. 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. PDF Selecting The Venipuncture Site - Yola Reasonable informed participation in decisions involving the patient's health care. Source of specimen. containers. Avoid bruising the infant's heel when obtaining blood. 7. Calculate H\Delta \mathrm { H }H of this reaction. Clin Lab Med. performing a capillary puncture is as follows: 1. Place blood collection equipment away from patients, especially children and psychiatric patients. Watch for formation of a hematoma. 4. Erroneous test results may be obtained when the blood is not thoroughly mixed with the additive. the 3 rd (middle) or 4 th (ring) finger of the hand. NHA Exam Questions Flashcards | Chegg.com Of course, the phlebotomist may understand this, however, the patient may not. Hematoma - may cause erroneous test results. Follow institution's guidelines regarding treatment and follow-up. PhlebotomyU offers Certified Phlebotomy Technician (CPT I) courses for aspiring phlebotomists. Apply blood to the printed side of the filter paper. However, drawing blood from the hand is affiliated with higher levels of pain and less control. (Partial penetration may allow blood to leak into the soft tissue surrounding the vein by way of the needle bevel). Transferring a sample from one collection tube to another or mixing blood from different collection tubes must be avoided. When using a syringe and needle, avoid drawing the plunger back too forcibly. Place labeled specimens in zip lock bag and deliver to the laboratory as soon as possible. The antecubital fossa is a collection of veins located within the arms inner area, opposite of the elbow, where the arm folds in. Diurnal variations associated with some blood components are: Adhesive bandages / tape - protects the venipuncture site after collection. Each time a vein is accessed with a needle, scar tissue forms as part of the body's healing process. 2009;18(2):117-139. Blood should NEVER be poured from one tube to another since the tubes can have different additives or coatings (see illustrations at end). Place labeled specimens in zip lock bag and deliver to the laboratory as soon as possible. However, blood samples that are normally taken are actually very small. obvious areas of skin infections https://www.osha.gov/laws-regs/standardinterpretations/2007-10-26 and https://www.osha.gov/OshDoc/data_BloodborneFacts/bbfact03.pdf (Accessed June 13, 2022). Because of contacts with sick patients and their specimens, it is important to follow safety and infection control procedures.