what sites should be avoided when performing venipuncture quizlet

\u00a9 2023 wikiHow, Inc. All rights reserved. Hematoma - may cause erroneous test results. Venipuncture can also happen when patients have intravenous (IV) lines started. How should you have the patient position their arm after the venipuncture is complete? The 2nd (index) finger tends to have thicker, callused skin. This enables the bloodto form as a drop on the fingertip. This is especially important when collecting EDTA (lavender top) or heparin (green top) tubes. When would you use a butterfly/infustion set? What is the best position to perform venipuncture in? Recommended order of collection for microtainer specimens: 7. C. laws Phlebitis can also occur as a result of vein trauma during insertion, use of an inappropriate I.V. So You're Going to Collect a Blood Specimen: An Introduction to Phlebotomy, 13th Edition (2010), College of American Pathologists, Northfield, IL. Allow it to air, Grasp the finger, and using a sterile lancet, press firmly against the finger. Hold the baby's foot firmly to avoid sudden movement. PST (light green top). avoid sites of extensive scarring (burns, surgery, injuries) Cannula/fistula/heparin lock - hospitals have special policies regarding these devices. -keep extremity below heart level for a few minutes. Re-secure the tourniquet to increase venous filling. proteins). While most patients veins are compatible with a standard needle gauge, others require a butterfly needle. Serum iron levels tend to drop during the day. They are also. A government issued photo identification card such as a driver's license can aid in resolving identification issues. 1. drawing from hand or foot Patients in these populations are often nervous and may flail their limbs. www.mlo-online.com is using a security service for protection against online attacks. It is observed that if the tourniquet is left on longer than 2 minutes, changes in the value of a total protein test occur. obvious areas of skin infections Which of the following actions should the technician take? 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. Consult the nursing unit or your facility's resources prior to drawing from an IV or PICC line or performing venipuncture on an arm with an IV line in place. Puncture only the uppermost wall of the vein, Remove the tourniquet before removing the needle, Make sure the needle fully penetrates the upper most wall of the vein. Start with the arm closest to you and palpate the antecubital fossa. 1. All other items used for the procedure must be disposed of according to properbiohazardous waste disposal policy. The Patient's Bill of Rights has been adopted by many hospitals as declared by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. It doesn't matter . When the last tube to be drawn is filling, remove the tourniquet. Websites that masquerade as the ones you trust. Do not obtain specimens from an arm having a cannula, fistula, or vascular graft. Lines - Drawing from an intravenous line may avoid a difficult venipuncture, but introduces problems. C. Lancet Each phlebotomist generally establishes a routine that is comfortable for her or him. C. at a mastectomy site (Assume that the total volume is the sum of the individual volumes and that the density and specific heat capacity of the solution are the same as for pure water.). By signing up you are agreeing to receive emails according to our privacy policy. In some cases, a phlebotomist may have to switch sites if they find the blood is not properly flowing from the vein. Two forms of active identification are required. C. all disposable equipment has been discarded properly C. Iodine Warning: Do not make lateral (side-to-side) movements with the needle. Summarize the problems that may be encountered in accessing a vein, including the procedure to follow when a specimen is not obtained. What sites should be avoided when drawing blood? *NEVER BEND THE ARM*. Holder/Adapter - use with the evacuated collection system. Last draw - additive tubes in this order: SST (red-gray or gold top). Adjust the angle (the bevel may be against the vein wall). Proper patient identification MANDATORY. Change gloves after each patient or when contaminated. var zf_ifrm_data = evntData.split("|"); B. the needle is inserted into the patient's arm 6. A needle is then gently inserted into the vein. A clinical study is performed to determine the optimal time for application of the tourniquet during phlebotomy. What are the red top containers used for? The maximum number of times an individual should attempt a venipuncture on a patient is two, True or False? Apply an adhesive bandage. Valenstein PN, Sirota RL. 5. 2019;95(1):15-19. doi: 10.1016/j.diagmicrobio.2019.04.001. Nursing Personnel. 23-gauge needles (e.g. Warm the heel from which blood is to be obtained. A warm compress or heel warmer should be used to warm, fingers and heels that are cold, or if a capillary blood gas is being drawn, to. Occupational Safety and Health Administration, United States Department of Labor. Allow the blood to soak through and completely fill the pre-printed circle on the filter paper. Position the infant with the head slightly elevated. with their hand to stabilize it for the draw. Using a sterile lancet, puncture the most medial or lateral portion of the plantar surface of theheel, medial to a line drawn posteriorly from the mid great toe to the heel. The performance of routine vascular access procedures by skilled phlebotomists requires, at a minimum, the use of gloves to prevent contact with blood. How to Troubleshoot a Difficult Venipuncture. 1. Background: Venipuncture is the most common invasive medical procedure performed by health care providers. Use a smaller tube with less vacuum. site. What caution should you observe when using a Vacutainer? f.style.border="none"; Cleanse in a circular fashion, beginning at the site and working outward. Keep in mind that elderly patients often have fragile veins. Giavarina D, Lippi G. Blood venous sample collection: Recommendations overview and a checklist to improve quality. Other draw sites, particularly below the waist, are rarely used. Children, particularly under the age of 10, may experience pain and anxiety during the phlebotomy procedure. Apply the tourniquet approximately 4-5 finger-widths above the planned venepuncture site. This vein can be found along the upper arm to the thumb, but it is commonly drawn from the forearm or antecubital fossa area. Using the smallest acceptable needle size can help reduce the risk of bleeding or hematoma . are known to vary lab results of some analytes. Be methodical in your search for a vein. Povidone-iodine wipes/swabs - Used if blood culture is to be drawn. In fact, many search engines provide the option to avoid dangerous sites by turning on a "safer" search. The recommended order of draw for plastic collection tubes is: First - blood culture bottle or tube (yellow or yellow-black top). (b) the power developed by the output shaft. 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. Various sizes are available. By holding the needle either by the plastic wings or the hub, phlebotomists can achieve a shallower angle, typically 10-15 degrees. A tin can containing air is sealed. This article was co-authored by Matt Garcia. This preliminary action allows you to safely adjust the needle's position. Too tight of a tourniquet may cause the vein to collapse upon needle insertion. if ( zf_ifrm_data.length == 2 ) { Have an assistant stabilize the arm by firmly locking the elbow joint. 3. 6. 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. Lancets are disposed of in an appropriate sharps container as one unit. Performing a venipuncture on a child under one year of age . What are the best veins for venipuncture? Safely discard potentially infectious materials. Let's take a look at the types of websites you and your staff need to be wary of and how to avoid them. B. Betadine Stop the procedure and remove the needle if: Thanks to all authors for creating a page that has been read 43,712 times. While venipuncture is considered to be reasonably safe, the present study investigated the incidence of serious complications occurring in an outpatient setting. A. Edema If a vein feels hard, it may be scarred or sclerosed. A commercial heel warmer may be used. ROUTINE CAPILLARY PUNCTURE BLOOD COLLECTION GUIDELINES. 9. NOTE:Tubes with additives must be thoroughly mixed. Dalal BI, Brigden ML. What is an Approved Phlebotomy School in California. When finished, clean the site and apply pressure with a clean gauze to stop the bleeding. Wikipedia. (a) the electric power required. 7. If multiple blood samples are to be taken, the phlebotomist must be careful to follow the proper order of draw. If using a syringe, make sure the needle is fitted securely on a syringe to avoid frothing. f.style.width="100%"; What are the complications that can occur when performing a venipuncture? Wear gloves and a lab coat or gown when handling blood/body fluids. Patient care following completion of venipuncture. Proper labeling procedures and completion of laboratory requisitions. 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