Module 6 Flashcards
How can venous blood be collected?
Evacuated tubes
Syringe technique
Both can be adapted with butterfly needles
Why must reqs be checked?
To determine the priority status for testing and reporting.
Where are expected TATs listed?
Guides to services
What are critical values?
Abnormal results, require special reporting.
What are alert values?
Abnormal results, require special reporting but not life threatening.
What are routine tests?
Those used for diagnosis and treatment.
What are STAT test?
Those that need to be collected and tested immediately.
Results must be reported immediately.
What is a medical emergency?
The situation is life threatening, results are required immediately.
What are urgent tests?
Similar to STAT and medical emergency but associated with transfusion medicine.
What are ASAP tests?
The situation is serious but not critical, tests can be run with the next routine batch.
What is fasting?
Requires the patient refrain from eating a certain number of hours prior to testing.
What are preop tests?
Done to determine the patient’s condition before surgery.
What are the steps of collection?
Identify yourself
Identify the patient
Check pretest protocol
Position patient
PPE
Assess vein
Collect
Which arm is blood normally drawn from?
The nondominant
What vein is chosen for venipuncture?
The largest in diameter, most turgid and well secured in tissue.
Normally median
How do you assess the veins of obese patients?
Rotate arm so cephalic is the upper most and accessible.
What can you do if the vein isn’t readily apparent?
Check tourniquet is tight enough
Have the pt. open their hand
Tap the skin
Lower the arm
Gently massage the arm
Apply a warm wash cloth
What sites should be avoided for venipuncture?
Scars
Burns
Abrasions- infection
Mastectomy- lymph disruption
Hematoma
Hardened/sclerosed
When can phlebotomy be performed on an arm with an IV line?
The IV is turned off for two min
Tourniquet is applied distal to the site
Performed on a different vein
First 5mL are discarded
Note is made on the req
What alternate sites can blood be collected from?
Hand veins- radial, more painful
Foot- great saphenous vein, not if pt. is diabetic or has a history of thrombophlebitis or leg vein clotting
Vascular access devices- require special training
Renal dialysis pt.- cannula or fistula (avoid this arm)
What VADs are there?
Central venous line- subclavian
Peripherally inserted central catheter- basilic or cephalic, not used for collection
Implanted port- beneath skin
Heparin lock- inserted into VAD to enable access
What is the vacutainer collection technique?
Assemble equipment Assemble needle, holder and tube Disinfect Reapply tourniquet Loosen needle guard and inspect Pt. close hand Anchor vein Deep breath Insert needle Push tube on Fill tubes, mix as they're filled Pt. open hand Release tourniquet Disengage vacuum Withdraw needle Activate safety device and discard Mix tubes Label tubes (always after) Make notes on req Clean up Check on pt. (two point check)
If blood doesn’t fill the tube when activated what can be checked?
Tube is seated properly
Change needle position
Check tourniquet
New tube
Rotate needle
Collapsed vein- twist tourniquet or use smaller vacuum
Pull needle back and reinsert if needle is beside the vein
Different site
Why is venipuncture the method of choice for blood specimens?
Veins are readily accessible
A large vol can be collected
Samples are free of interfering substances
Adequate for the performance of many tests from one collection
