what sites should be avoided when performing venipuncture quizlet

\u00a9 2023 wikiHow, Inc. All rights reserved. Sometimes you may get initial blood flow, but then it stops when you change tubes. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. 5. Drawing blood from major vessels (e.g. The median cubital vein and the cephalic vein in the wrist area should be avoided when possible. For an inpatient the nursing staff can be contacted to aid in identification prior to proceeding. When using a syringe inserted into the line, blood must be withdrawn slowly to avoid hemolysis. Inadvertently nicking a nerve causes intense pain. Avoid excessive pressure that may squeeze tissue fluid into the, mix the blood. Do not use the central portion of the heel because you might injure the underlying bone, which is close to the skin surface. Adjust the angle (the bevel may be against the vein wall). Palpate and trace the path of veins with the index finger. A requisition form must accompany each sample submitted to the laboratory. })(); The cephalic vein is a safe secondary option if the median cubital vein is not working. INR for patients on warfarin) are often knowledgeable on the veins that are most likely to work. They are also. How To Draw Blood | Phlebotomy Coach If using a syringe, make sure the needle is fitted securely on a syringe to avoid frothing. if ( zf_ifrm_data.length == 2 ) { What are the helpful hints for finding veins? The area where the blood is to be drawn from is first cleaned with a germ-killing solution. Patient identification is critical for safety. Cleanse in a circular fashion, beginning at the site and working outward. Make the cut across the heelprint lines so that a drop of blood can well up and not run down along the lines. If a patient has an IV giving them fluids in their right arm which arm should be your first choice to draw blood out of? Antiseptic. Certain other sites should also be avoided. Guidelines established by the Clinical and Laboratory Standards Institute (CLSI) dictate that a phlebotomist shall not attempt a venipuncture more than two times, and a maximum of three attempts shall be undertaken on a patient. Get instant access to our latest tools and our must-read site updates: What Certifications Are Used For Higher Pay For Phlebotomists? The median cubital creates, The dorsal venous network is the next most common vein site for phlebotomists. 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. Apply firm pressure. Giavarina D, Lippi G. Blood venous sample collection: Recommendations overview and a checklist to improve quality. A government issued photo identification card such as a driver's license can aid in resolving identification issues. 1. If an inpatient is able to respond, ask for a full name and always check the armband or bracelet for confirmation. Contains acid citrate dextrose. 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. f.style.width="100%"; Dispose of needles immediately upon removal from the patient's vein. 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. 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. A. standards What Is Venipuncture? This requisition form must contain the proper information in order to process the specimen. The blood is normally drawn from a vein on the top of the hand or from the inside of the elbow. Check the requisition form for requested tests, patient information, and any special requirements. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. Email is the #1 attack vector cybercriminals use to lure you into a malicious website. 1. Label the collection tubes at the bedside or drawing area. If blood stops flowing into the vacuum tube, the vein may have collapsed. World Health Organization. NOTE:Tubes with additives must be thoroughly mixed. 9. How to Avoid Dangerous Websites - Lifewire 5. What sites should be avoided when drawing blood? Erroneous test results may be obtained when the blood is not thoroughly mixed with the additive. Do not use alcohol for prepping the site when drawing a blood alcohol sample. d.appendChild(f); www.mlo-online.com is using a security service for protection against online attacks. Gas tubes (must warm the site before collecting the specimen), 4. The patient should make a fist without pumping the hand. (b) the power developed by the output shaft. WHO guidelines on drawing blood: best practices in phlebotomy. Predict a possible value of the thickness of the soap bubble. (c) the rate of heat transfer. Deliver specimens promptly to the laboratory. Phlebitis can also occur as a result of vein trauma during insertion, use of an inappropriate I.V. Avoid placing sample onhot surfaces such as bili-lights or monitors. 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. Previous puncture sites should be avoided. Label the specimens before leaving the patients bedside. UF Health Pathology Laboratories Nontuberculosis Mycobacteria Laboratory, This page uses Google Analytics (Google Privacy Policy), Capillary puncture may be used for obtaining specimens in infants or in adults where. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. 5. While most patients veins are compatible with a standard needle gauge, others require a. . if ( (iframe.src).indexOf('formperma') > 0 && (iframe.src).indexOf(zf_perma) > 0 ) { Unlike the cephalic and basilic veins, the median cubital vein is not near major nerves or arteries. By holding the needle either by the plastic wings or the hub, phlebotomists can achieve a shallower angle, typically 10-15 degrees. The median cubital creates less bruising and pain than other draw sites. 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. Capillary Specimens may be used immediately for point-of-care testing. Press down on the gauze once the needle is out of the arm, applying adequate pressure to avoid formation of a hematoma. 6. Venipuncture requires good skills in order to perform the procedure not only correctly, but also painlessly. How far above a venipuncture sight should you place a tourniquet? 12. Do not place too tightly or leave on more than 2 minutes (and no more than a minute to avoid increasing risk for hemoconcentration). Finger - Usually the third or fourth finger is preferred in adults and children. In this elbow pit, phlebotomists have easy access to the top three vein sites used in phlebotomy: Median cubital vein. 1. Each phlebotomist generally establishes a routine that is comfortable for her or him. You should not perform this technique unless you are certain that the needle is in the immediate vicinity of the vein. (a) the electric power required. 2. Do not use the tip of the finger or the center of the finger. Provide for their comfort as much as possible, and gain the patient's cooperation. var zf_perma = zf_ifrm_data[0]; This vein lies close to the surface of the skin and there is not a large nerve supply. Venipuncture Quiz Flashcards | Quizlet D. all of the above, Julie S Snyder, Linda Lilley, Shelly Collins, Zoology Chapter 16 & 17: Invertebrate Deutero. To enhance students careers, meet the needs of healthcare providers and improve patient care by providing high quality, cost effective phlebotomy education through industry leading curriculum, current technology and extensive hands on experience. with their hand to stabilize it for the draw. Properly fill out appropriate requisition forms, indicating the test(s) ordered. You will be redirected once the validation is complete. % of people told us that this article helped them. Discarding the first set minimizes the effects of any potential additive contamination. var evntData = event.data; Normal reference ranges are often noted according to age. Make certain that the blood completely saturates all four (4) circles and is visible from bothsides. Asking the patient about their previous blood draw experiences is beneficial, especially if they are a hard stick and know which area works best. Consider three elements with the following abbreviated electron configurations: X=[Ar]4s23d5Y=[Ar]4s23d104p1Z=[Ar]4s23d104p6\mathrm{X} = \mathrm{[Ar]4s^23d^5}~~~\mathrm{Y}=\mathrm{[Ar]4s^23d^{10}4p^1}~~~\mathrm{Z}=\mathrm{[Ar]4s^23d^{10}4p^6} What should you never do to a site you just cleansed with alcohol? This is especially important when collecting EDTA (lavender top) or heparin (green top) tubes. 3. Identification errors in pathology and laboratory medicine. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. if ( prevIframeHeight != zf_ifrm_ht_nw ) { Two forms of active identification are required. C. the seal is broken Then the medical technician or phlebotomist will wrap a flexible band on the upper part of the arm to apply some pressure to that area making the vein enlarge with blood. Background: Venipuncture is the most common invasive medical procedure performed by health care providers. jugular) or a central venous catheter is out of the scope of practice of a certified phlebotomist and should only be performed by a physician or advanced nurse. wikiHow is where trusted research and expert knowledge come together. Hemoconcentration: An increased concentration of larger molecules and formed elements in the blood may be due to several factors: Prolonged tourniquet application (no more than 1 minute). Summarize the problems that may be encountered in accessing a vein, including the procedure to follow when a specimen is not obtained. (function() { If you stick yourself with a contaminated needle: Remove your gloves and dispose of them properly. Phlebotomy is the practice of drawing blood from patients to gather data about their health. Regardless of the source of payment, request and receive an itemized and detailed explanation of the total bill for services rendered in the hospital. To prevent hemolysis (which can interfere with many tests): Mix tubes with anticoagulant additives gently 4-6 times, Avoid drawing the plunger back too forcefully, if using a needle and syringe, or too small a needle, and avoid frothing of the sample. Here phlebotomists will typically choose from three veins: the median cubital vein, the cephalic vein or the basilic vein. 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. Never draw blood through a hematoma. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. Interruptions and distractions during medical encounters and procedures should be avoided. Start with the arm closest to you and palpate the antecubital fossa. Dispose of contaminated materials in appropriate waste receptacles. Make sure the venipuncture site is dry before proceeding with draw. Try another tube. Effects of Exercise: Muscular activity has both transient and longer lasting effects. var zf_ifrm_ht_nw = ( parseInt(zf_ifrm_data[1], 10) + 15 ) + "px"; 6. Promptly send the specimens with the requisition to the laboratory. Our students gain a vast amount of experience with phlebotomy vein sites through our hands-on and engaging curriculum and externship program. Capillary punctures are not suitable for blood culture testing and most coagulation tests. Switch to the other arm if you can't find anything. Some DNS services support web filtering, too. D. Near a tattoo, Needles are used once and then: If this is not successful, remove the needle, take care of the puncture site and redraw at another site. Posture: Postural changes (supine to sitting etc.) ROUTINE CAPILLARY PUNCTURE BLOOD COLLECTION GUIDELINES. What are the green/lavender 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. f.style.transition="all 0.5s ease"; Approach the patient in a friendly, calm manner. If the patient is sitting in a phlebotomy chair, make sure they are sitting upright with their back against the chair. Serum iron levels tend to drop during the day. Compare and contrast the two major types of neuronal pathways. A commercial heel warmer may be used. 4. When multiple vials of blood are collected it can seem like a large amount. finger should be avoided. Ernst, Dennis J. (2017). In fact, many search engines provide the option to avoid dangerous sites by turning on a "safer" search. If the tech is not comfortable with any of the veins in the inside elbow area, they may choose a dorsal vein in the hand or, as a last resort, choose a vein in the foot. A. the plastic sleeve is removed outstretched or raised How can you tell if you are palpating a vein? Avoid excessive pressure that may squeeze tissue fluidinto the drop of blood. These items include: The recommended order of draw for plastic collection tubes is: First - blood culture bottle or tube (yellow or yellow-black top). If using a needle and syringe, avoid drawing the plunger back too forcefully. Kiechle FL. 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.