ACT 3 - Venipuncture Flashcards
Two patterns of veins in the antecubital fossa
H and M pattern
Order of the preferred vein for venipuncture in H pattern
Median cubital, cephalic vein, basilic vein
Order of preferred vein for venipuncture in M pattern
Median vein, median cephalic vein, median basilic vein
Sites deferred for venipuncture
- Tattooed, burns, scars
- Edematous arm
- Arm adjacent to mastectomy
- Burns
Means “in front of the elbow”
Antecubital
Why is locating the proper site for venipuncture important?
To avoid erroneous lab results and affect the overall outcome
Typically larger, closer to the surface, better anchored, and more stationary than the others
Median antecubital vein
Easiest and least painful site to puncture
Median antecubital vein
Site to collect blood when the Median antecubital vein fails
Cephalic vein
Movable and not embedded in the muscle
Cephalic vein
Often well-anchored but harder to palpate that the median cubital vein. Often vein that is found in obese patients
Cephalic vein
Most painful site for extraction
Basilic vein
Last resort vein for venipuncture
Basilic vein
Easy to palpate, not as well anchored, rolls more easily
Basilic vein
Materials for locating the proper site for venipuncture
Gloves, mask, tourniquet
A constricting device applied to a patient’s arm prior to venipuncture with the aim of inflating the veins by restricting venous blood for a period of time
Tourniquet
The position of the tourniquet above antecubital area
3-4 fingers above
Where does the loop of the tourniquet point?
Antecubital area
Where does the tail of the tourniquet point?
Above
A properly applied tourniquet is what?
Tight enough to restrict venous flow out of the area but not so tight as to restrict arterial flow into the area
Restriction of venous flow helps what?
- inflate veins, making it larger and easier to find,
- Stretches the vein walls so they are thinner and easier to pierce with a needle
How many minutes will it take to change the blood components of the restriction of blood flow by a tourniquet?
1 minute
2 types of positions for patients
- Seated patient
- Supine patient
Position of a Seated patient
- Patient’s arm supported
- Arms not bent at the elbow
Position of a Supine patient
- Arm extended
- Not bent at elbow
Types of tourniquet
- Strap tourniquet
- Single use latex free tourniquet
- rubber tubing
type of tourniquet that is less painful
rubber tubing
type of tourniquet that is a flat strip of stretchable material such as latex nitrile or vinyl
strap tourniquet
steps of the pre-analytical procedure
- identify the patient properly
- orient the patient on the procedure to be performed
- wash hands thoroughly
- prepare all the materials needed
- reassure the patient
- position the patient
steps of applying the tourniquet
- sanitize hands, wear appropriate PPE
- position the arm for venipuncture (proper position and support)
- as the patient to make a fist
- apply tourniquet
- palpate the vein using your index fingertip
- pull the skin and anchor the vein using the thumb
- select suitable vein for extraction
- release tourniquet and prepare puncture site
T/F you should caress the vein while palpating the patient’s arm
False
T/F Bruising signifies a traumatic extraction
False
T/F The priority vein is the medial antecubital vein
True
T/F Making a fist helps locate the veins
True
T/F both the phlebotomist ant patient should be comfortable while doing the procedure
True
painful to the patient and could cause tissue and vascular damage at and around the phlebotomy site
fishing
usually located in old and skinny patients with loose and thin skin
rolling veins
