BB LAB VENIPUNCTURE Flashcards
Is the most integral part in any laboratory procedures
Specimen collection
Is a closed system with sterile evacuated tubes, blood flows directly into the tube and no messy specimen transfer is needed
Venipuncture using the vacutainer system
Is usually used for beginners and for veins which are not very prominent
Venipuncture using the syringe
Materials for vacutainer system
- Vacutainer adaptor
- Gloves
- Vacutainer needles and tube
- Tourniquet
- Cotton swab
Materials for venipuncture using syringe
- Syringe
- Gloves
- Tourniquet
- Cotton swab
This is the most important step in the venipuncture procedure
Identify the patient
Apply tourniquet _______ inches above the elbow
3-4 inches
The patient’s arm should be in a _________ position so that blood will go directly to the bottom of the tube
Slightly downward position
If veins are still not palpable, you may apply warm, moist cloth about _____•c
40 degree celsius
Veins of the arm which are the site of the majority of venipunctures are:
Cephalic
Median cubital
Basilica
Preferred vein for venipuncture
Median cubital vein
Why is Median cubital vein is the preferred vein for venipuncture?
Because it is the largest and best anchored vein
Cleanse the site with ______
70% alcohol
Grasp the patient’s arm _____ inches below the puncture site
1-2 inches
The needle should be in the ______ position
Bevel up position
Degree angle with the arm before puncturing the site
15 degree angle
If the site is still bleeding, what will the phlebotomist should do?
Apply direct pressure on the site until bleeding ceased
Dispose the needle directly in a ________ or _______
Puncture resistant container or incinerate
Do recap the needle of the syringe. T or F.
False. Do not recap the needle of the syringe to avoid finger prick
Cause: needle may not be placed at the center of the stopper causing blockage
What is the solution for this?
Remove and reposition the tube correctly
Cause: needle bevel may be flushed against the wall of the vein causing blockage
What is the solution for this?
Rotate the needle 1/4 turn clockwise
Solution: release pressure slowly
What is the cause?
Tourniquet applied too tightly or too long stopping blood flow
Cause: tube may have been prematurely punctured
Tube may have been previously opened
What is the solution for this?
Replace the tube
Solution: pull back slightly on the needle holder
What is the cause?
The needle has transfixed the vein
Cause: the needle is not completely in the vein or has not reached the vein
What is the solution for this?
Advance the needle forward until you feel the “give” as the needle penetrates the vein
Solution: reintroduce tube for collection until vacuum is completely exhausted
What is the cause?
Premature removal of tube
Cause: long lines of tubing contain air
What is the solution?
Use “dummy tube” first to ensure accurate test results
Cause: vein may have collapsed
What is the solution?
Remove the tube holder for a few seconds to allow the vein to fill again.
Replace tube to continue collection.
Solution: repeat venipuncture at different site when hematoma occurs
What is the cause?
Needle may have been repositioned or out of the vein during venipuncture
Occurrence of hematoma - causes
- needle not completely in the vein
-needle transfixed the vein
-excessive probing resulting in enlargement at the site of entry
-tourniquet placed too near the venipuncture site
Occurrence of hematoma - solutions
- release tourniquet and remove the needle
-apply firm pressure over swollen area (elevate affected arm)
-reassure patient that the bruise will resolve
-repeat venipuncture at a different site
Possible causes leading to hemolyzed specimen
- excessive probing
- vigorous mixing of tubes
- under filling of tubes
- transferring from syringe and needle to evacuated tube
- alcohol contamination
- prolonged tourniquet application (> 2mins)
