Methods of Blood Collection (P) Flashcards
What are the sites of collection of sx for skin puncture for adults?
Tip of the 3rd finger
Tip of the 4th finger
Earlobe
What are the sites of collection of sx for skin puncture for newborn?
Heel
Big toe
What is the sx collected via skin puncture?
Capillary blood
How is skin puncture for adults done?
1) Cleanse the site with a cotton ball soaked in 70% isopropyl alcohol. Allow the site to air dry or pat-dry with sterile cotton
2) Puncture the preferred site with a sterile disposable lancet. The puncture is ideally 2-3 mm in depth
3) Wipe off the first drop of blood and collect the subsequent drops
How is skin puncture for newborns done?
1) Hold the baby’s foot firmly between the thumb and the index finger of your non-working hand
2) Cleanse the site with a cotton ball soaked in 70% isopropyl alcohol. Allow the site to air dry or pat-dry with sterile cotton.
3) Puncture the anterior rim of the posterior aspect of the heel or big toe with a sterile disposable lancet. The puncture is ideally 2-3 mm in depth
4) Wipe off the first drop of blood and collect the subsequent drops
What are the sites of collection of sx for venipuncture of adults?
Antecubital fossa: median cubital vein, cephalic vein, and basilic vein
Veins at the back of hands
What are the sites of collection of sx for venipuncture of newborns?
External jugular vein
What is the sx collected via venipuncture?
Venous blood
How is venipuncture for adults done?
1) Apply the tourniquet 3-4 inches above the puncture site in a half-knot manner to congest the vein. Ask the patient to open and close the hand several times.
2) Cleanse the site with a cotton ball soaked in 70% isopropyl alcohol. Allow the site to dry. Puncture the vein with a sterile 20-21 gauge needle attached to a syringe at a 15 deg angle and a depth of about 0.5-1 cm.
3) As soon as backflow is seen, loosen the tourniquet and pull the plunger to aspirate the blood. When blood has filled the tube to its proper volume, stop pulling the plunger.
4) After obtaining the required quantity of blood, place sterile gauze or cotton over the puncture site then withdraw the needle. Apply pressure to stop bleeding. Never flex the arm
How is ETS for adults done?
1) Attach the two-way needle to the adaptor. Prepare the evacuated tubes.
2) Apply the tourniquet 3-4 inches above the puncture site in a half-knot manner to congest the vein. Ask the patient to open and close the hand several times.
3) Cleanse the site with 70% isopropyl alcohol. Allow the site to dry.
3) Puncture the vein with a two-way needle attached to a adaptor. Push the tube into the adaptor until the other side of the needle penetrates the evacuated tube, making sure that the needle remains in position in the vein. Loosen the tourniquet. When blood has filled the tube to its proper volume, remove the tube.
4) After obtaining the required quantity of blood, place sterile gauze or cotton over the puncture site then withdraw the needle. Apply pressure to stop bleeding. Never flex the arm
How is venipuncture via the use of two syringe method done?
1) Apply the tourniquet 3-4 inches above the puncture site in a half-knot manner to congest the vein. Ask the patient to open and close the hand several times.
2) Cleanse the site with a cotton ball soaked in 70% isopropyl alcohol. Allow the site to dry. Puncture the vein with a sterile 20-21 gauge needle attached to a syringe at a 15 deg angle and a depth of about 0.5-1 cm.
3) Loosen the tourniquet and pull the plunger to aspirate the blood. When blood has filled the tube to its proper volume, stop pulling the plunger.
4) Place sterile gauze or cotton below the hub of the needle to prevent spillage of blood. Remove syringe after aspirating 3 mL of blood, taking care not to dislodge the needle from the vein. Attach a second syringe and aspirate the required amount of blood.
5) After obtaining the required quantity of blood, place sterile gauze or cotton over the puncture site then withdraw the needle. Apply pressure to stop bleeding. Never flex the arm
How is external jugular venipuncture on newborns done?
1) Wrap the infant in a sheet so that his/her arms are immovable along the side of the body.
2) Position the infant on the dorsal side on the examining table so that his/her head hangs over the edge of the table as an assistant steadies the infant’s body.
3) Support the infant’s head and turn it to one side. This is done by another assistant.
4) When an infant cries, the external jugular vein becomes prominent. The external jugular vein runs from an angle of the mandible to the submandibular area.
5) Sterilize the area and follow the procedure in obtaining venous blood
6) Cleanse the site with a cotton ball soaked in 70% isopropyl alcohol. Allow the site to dry. Puncture the vein with a sterile 20-21 gauge needle attached to a syringe at a 15 deg angle and a depth of about 0.5-1 cm.
7) Pull the plunger to aspirate the blood. When blood has filled the tube to its proper volume, stop pulling the plunger. When blood has filled the tube to its proper volume, stop pulling the plunger.
8) After obtaining the required quantity of blood, place sterile gauze or cotton over the puncture site then withdraw the needle. Apply pressure to stop bleeding
How to prevent hemolysis when skin puncture is done?
1) Use a sharp lancet
2) Avoid squeezing the area near the site
How to prevent hemolysis when venipuncture is done?
1) Use a sharp, smooth needle.
2) Penetrate the uppermost wall of the vein fully.
3) Check and make sure the tourniquet is not too tight when aspirating blood.
4) Aspirate the blood gently.
5) Mix the tube by gentle inversion if the tubes contain additives.
6) If serum is needed, do not rim and centrifuge the blood until the clot has formed
