Clinical Skills Medicine

Question 1

Risks of Venepuncture, Blood Cultures, ABGs and Cannulation

Answer 1

 Infection – you will observe ANTT, clean the patients skin and use PPE
 Adverse reaction- check patients allergy status and monitor patient
 Pain – you will locate the vein first, explain the needle should feel like a
scratch and you will stop if increased levels of pain are experienced
 Missing the vein- If you miss, then with the patient’s permission you can
have another attempt (maximum of 2 attempts)
 Bleeding and bruising – apply pressure post procedure followed by a
dressing if you miss the vein

Question 2

Blood culture cap colour

Answer 2

White

Question 3

Us+Es, LFTs, TFTs, CRP, tumour markers cap colour

Answer 3

Brown

Question 4

Coagulation studies cap colour

Answer 4

Green

Question 5

Troponin cap colour

Answer 5

Orange

Question 6

HBA1c cap colour

Answer 6

Purple

Question 7

FBC, PTH cap colour

Answer 7

Pink/ red

Question 8

Glucose, lactate cap colour

Answer 8

Yellow

Question 9

PMH Considerations

Answer 9

 Patient issues: e.g., Phobias, patient anxiety and the need for chaperone.
 Medications and existing conditions: anti coagulations, chemotherapy,
steroids, fragile vessels, dehydration, renal dialysis, blood infections.
 Previous Injury: trauma, previous surgical interventions (e.g mastectomy),
Grafts, C.V.A/T.I.A, topical infection, drug abuse, new tattoos.

Question 10

ECG Risks

Answer 10

 There is a small risk that the patient could have an allergy or be
sensitive to the stickers - so during the procedure if they feel
heat or itching where the stickers you will remove them and
source some hypo-allergenic stickers.
 You are going to have to press on their chest to see where you
need place the stickers this shouldn’t be painful but the patient
let should if they feel any discomfort

Question 11

IV Infusion risks

Answer 11

 Infection – You will observe ANTT, clean the patients skin and use PPE
 Phlebitis – Dilute the drug and check the cannula
 Adverse reaction- check patients allergy status and monitor patient
 Speed Shock- dilute the drug and administer over recommended time
 Extravasation/pain – flush the cannula before administration
 Fluid overload – consider renal and cardiac patients can the drug be
given in less fluid?
 Embolism – expel all air from syringes and infusion lines

Question 12

IV Med questions

Answer 12

 What is the medication?
 Why is the patient having it?
 What is the normal dose?
 Do you know the general side effects?
 Are there any precautions/contra-indications?
 How do you give it and over what time/rate?