what sites should be avoided when performing venipuncture quizlet
This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. C. the needle has penetrated all the way through the vein Various sizes are available. The phlebotomist's role requires a professional, courteous, and understanding manner in all contacts with the patient. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. Copyright 2023 - PhlebotomyU | Website Design & SEO by, Phlebotomy: 5 Tips on Finding Difficult Veins. What angle should you insert the needle at? For the CLSI Updated Phlebotomy Procedures please click here. What is the procedure to draw blood from an arm with an IV in it? When using a syringe and needle, avoid drawing the plunger back too forcibly. Wikipedia. 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. 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. For operation at steady state, determine for the motor, each in kW\mathrm{kW}kW McCall, R. E., & Tankersley, C. M. (2016). All other items used for the procedure must be disposed of according to properbiohazardous waste disposal policy. Allow it to air, Grasp the finger, and using a sterile lancet, press firmly against the finger. If multiple blood samples are to be taken, the phlebotomist must be careful to follow the proper order of draw. Contaminated surfaces must be cleaned with freshly prepared 10% bleach solution. 1. Capillary specimens are collected in microtainers with colored caps that are used to. 9. var zf_perma = zf_ifrm_data[0]; This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. 7. Prepare the equipment, the patient and the puncture site. Top Vein Sites Used in Phlebotomy | PhlebotomyU | CPT1 Course Avoid bruising the infants heel when obtainingblood. Wait 2 minutes before reapplying the tourniquet. 5. Some individuals are afraid of needles, while others are frightened at the sight of blood. Patient care following completion of venipuncture. www.mlo-online.com is using a security service for protection against online attacks. Recognize complications associated with the phlebotomy procedure. Blood is collected into an attached vial or tube that is airtight and the flexible band is then removed from the arm. 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. remove needle Expect reasonable safety congruent with the hospital practices and environment. What are the red top containers used for? Lines - Drawing from an intravenous line may avoid a difficult venipuncture, but introduces problems. 4. This enables the bloodto form as a drop on the fingertip. The most common complications are bleeding at the puncture site or hematoma formation. Alcohol not dry in the required amount of time B. Veins less prominent and less filling C. Veins more prominent and easier to puncture D. Blood stop flowing to arteries but not veins A The most common site (s) for the venipuncture procedure is/are the following: 12. Intravenous therapy (IV) / blood transfusions - fluid may dilute the specimen, so collect from the opposite arm if possible. All rights reserved. if ( prevIframeHeight != zf_ifrm_ht_nw ) { What are the helpful hints for finding veins? Patient identification is critical for safety. var d = document.getElementById("zf_div_SBGg-3DTNCwt65i9A6n_zU3SneyGD89SSqM_7F_nCas"); 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. var evntData = event.data; Sanders AM, Agger WA, Gray AM, Fischer CM, Kamprud EA. Since newborns do not often bleed immediately, use gentle pressure to produce a rounded drop of blood. In some cases, a phlebotomist may have to switch sites if they find the blood is not properly flowing from the vein. Ask the patient orcaregiver to state the patients name and date of birth. https://www.ncbi.nlm.nih.gov/books/NBK138650/pdf/Bookshelf_NBK138650.pdf (Accessed June 13, 2022). The 2nd (index) finger tends to have thicker, callused skin. The blood is bright red (arterial) rather than venous. It is not as close to the skin surface as the median cubital and cephalic veins, which poses a greater risk of damage to the median nerve and brachial artery. -use a smaller gauge needle Adhesive bandages / tape - protects the venipuncture site after collection. Apply the tourniquet 3-4 inches above the selected puncture site. Hemolysis may occur, with pseudohyperkalemia. Any microtainerscontaining additives should be tapped to dislodge additives from the walls and top. Identify the additive, additive function, volume, and specimen considerations to be followed for each of the various color coded tubes. It may be obstructing blood flow. 2009;47(2):143-53. Avoid excessive pressure that may squeeze tissue fluidinto the drop of blood. 4. The first attempt is the antecubital fossa area, starting with the median cubital vein, then the cephalic vein, and the basilic vein. (See picture.) B. Hematoma The fluid may dilute the specimen, so collect from the opposite arm. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. Collect drops of blood into the . How To Draw Blood | A Step-by-Step Guide - Nurse.org World Health Organization. Loosen the tourniquet. Answer. The patient should either sit in a chair, lie down or sit up in bed. What are the gray top containers used for? If you are using a butterfly, try to retie the tourniquet around the patient's arm to increase pressure and re-establish blood flow. This is especially important when collecting EDTA (lavender top) or heparin (green top) tubes. 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. Extensive scarring or healed burn areas should be avoided Specimens should not be obtained from the arm on the same side as a mastectomy. ; worn to protect the patient and the phlebotomist. Position the patient so that the hand is easily accessible. Do not use the tip of the finger or the center of the finger. 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. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. Any attempt to repeat a puncture at the same site increases the risk of complications. The median cubital vein is used the most for its accessibility. antecubital fossa What are the best veins for venipuncture? After assembling the appropriate equipment, follow the next steps to perform a proper venipuncture. C. Scarring Have the patient position their arm on the armrest. When would you use a butterfly/infustion set? Warning: Some phlebotomists use a method of anchoring called the "C-hold", in which the index finger pulls upwards superiorly while the thumb pulls downwards inferiorly. containers. Therefore, an arm containing an IV should not be used to draw blood specimens if it can be avoided. In some instances, the legs or feet are required for use, but a physician or doctor should be completing the draw, not a phlebotomist. This article was co-authored by Matt Garcia. (Uman et al, 2013). The hydrostatic pressure causes some water and filterable elements to leave the extracellular space. 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. (a) How would you prepare tetracaine from the corresponding aniline derivative, ArNH2_22? Allow the blood to soak through and completely fill the pre-printed circle on the filter paper. Concentrations of fluids and medications could affect baseline test results. Tubes with different additives are used for collecting blood specimens for specific types. Needles are available for evacuated systems and for use with a syringe, single draw or butterfly system. -cotton sponges 6. How can you decrease the risk of hematoma formation? {"smallUrl":"https:\/\/www.wikihow.com\/images\/thumb\/6\/68\/Troubleshoot-a-Difficult-Venipuncture-Step-1.jpg\/v4-460px-Troubleshoot-a-Difficult-Venipuncture-Step-1.jpg","bigUrl":"\/images\/thumb\/6\/68\/Troubleshoot-a-Difficult-Venipuncture-Step-1.jpg\/aid11732774-v4-728px-Troubleshoot-a-Difficult-Venipuncture-Step-1.jpg","smallWidth":460,"smallHeight":345,"bigWidth":728,"bigHeight":546,"licensing":"

\u00a9 2023 wikiHow, Inc. All rights reserved. if ( (iframe.src).indexOf('formperma') > 0 && (iframe.src).indexOf(zf_perma) > 0 ) { An example of a simple requisition form with the essential elements is shown below: A properly labeled sample is essential so that the results of the test match the patient. Capillary Specimens may be used immediately for point-of-care testing. f.style.width="100%"; You will be redirected once the validation is complete. } Hematoma formation is a problem in older patients. f.src = 'https://forms.zohopublic.com/healthservicesacademy/form/RequestCourseInformationCPTIAccelerated/formperma/SBGg-3DTNCwt65i9A6n_zU3SneyGD89SSqM_7F_nCas?zf_rszfm=1'; List six areas to be avoided when performing venipuncture and the reasons for the restrictions. This complication of peripheral I.V. Place labeled specimens in zip lock bag and deliver to the laboratory as soon as possible. How To Draw Blood | Phlebotomy Coach 70% isopropyl alcohol 3. While hand veins may be utilized for blood draws and intravenous infusions, veins in the feet and legs should be avoided for adults. The infograph below provides a detailed description of the venipuncture steps as found in our how to draw blood resource. D. all of the above, Julie S Snyder, Linda Lilley, Shelly Collins, Zoology Chapter 16 & 17: Invertebrate Deutero. Staying safe online: Avoid these types of websites - USWired % of people told us that this article helped them. Do not use a previous puncture site. Remove the needle from the patient's arm using a swift backward motion. At least two patient identifiers, such as name and date of birth, are needed. 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. When using a syringe avoid drawing the plunger back too forcefully. Blindly maneuvering the needle within the skin is painful to the patient and you run the risk of hitting a nerve, tendon, or artery. 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. 8. In this elbow pit, phlebotomists have easy access to the top three vein sites used in phlebotomy: Median cubital vein. var f = document.createElement("iframe"); Asking the patient about their previous blood draw experiences is beneficial, especially if they are a hard stick and know which area works best. This image may not be used by other entities without the express written consent of wikiHow, Inc.
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