Module 5/6 Flashcards
How do you collect blood from a sleeping patient?
You don’t.
Gently wake them by touching the bed.
When should you interrupt the patient when they’re with their doctor or clergy?
If the sample required is STAT.
What is the most important step of sample collection?
Patient identification
How are patients identified?
Ask them to state their name.
Check their wrist band.
Cross check info with the req.
Check healthcare card or ask friend/relative/caretaker.
Can you identify a patient from an ID band not attached to them?
No
Goes for newborns too
What pre-phlebotomy criteria may have to be verified prior to collection?
Fasting
Times collections
Time of last/next medication
If not met the specimen shouldn’t be collected
What is implied consent?
The patient extending their arm.
What is informed consent?
Documents are signed either by the patient or a relative.
What can you do if a patient refuses to give a sample?
Tell them the doctor ordered the test.
Inform the supervisor and nursing staff/physicians office.
What can be done for nervous/apprehensive patients?
Distract them by speaking normally.
Use a topical anesthetic (EMLA cream, 30min prior).
How can patients be reassured?
Convert the volume to oz.
Equate one donor unit to 50 tubes.
Equate the total blood volume to 500 tubes.
Where do babies/children get their blood drawn from?
Arm or back of the hand.
What is used to collect children’s blood?
23 gauge butterfly
> 4yo can use vacutainer
What special or adapted techniques may be necessary?
Different arm positions
Help making fist
Stabilization
Alternate sites
Assistance
What are the objectives of specimen collection?
Obtain consent
Collect the best quality specimen
Perform it so the next time the patient will be less apprehensive
What are some pain reducing strategies?
Explain the procedure
Select the medial vein
Use 22-23 gauge needle
Ensure the alcohol is dry
What has happened if the patient experiences a shooting/electric like pain?
A nerve has been provoked.
What must you do it the patient insists you remove the needle?
You must stop the venipuncture.
What is hematoma?
The accumulation of blood under skin when blood escapes the vessels.
Causes pressure on surrounding tissues and nerves.
When may hematomas occur?
If the needle penetrates the vein completely.
If the bevel doesn’t enter the vein completely.
If the vein is too small for the gauge.
If the needle was removed before the tourniquet.
If insufficient direct pressure was applied afterwards.
If a tourniquet is applied above a recent venipuncture site.
What kinds of patients stop bleeding more slowly?
Those with coagulation deficiencies or on anticoagulants.
What’s the two point check?
Check for oozing
Check for mounding at the site