Peripheral & CVAD Blood Draw

Question 1

Equipment for blood draw

Answer 1

Gloves
Tourniquet
Chlorhexidine
Needle holder
Needles
Blood tubes
Syringes
Cotton balls
Bandaid / Coban
Patient labels
Computer requisitions

Question 2

14 gauge needle

Answer 2

Color:olive
.071 inch (1.83mm)

Question 3

15 gauge needle

Answer 3

Color:amber
.065 inch (1.65 mm)

Question 4

16 gauge

Answer 4

Color:grey
.064 in (1.63 mm)

Question 5

18 gauge

Answer 5

Green
.050 in (1.27 mm)

Question 6

20 gauge

Answer 6

Pink
.036 in
(.91 mm )

Question 7

21 gauge

Answer 7

Purple
.33 in (.83 mm)

Question 8

22 gauge

Answer 8

Blue
.027 in (.70 mm)

Question 9

23 gauge

Answer 9

Orange
.025 in ( .63 mm)

Question 10

25 gauge

Answer 10

Red
.020 in (.53 mm)

Question 11

27 gauge

Answer 11

White .016 in (.42mm)

Question 12

The larger needles to use to prevent hemolysis

Answer 12

21 gauge ( purple)
22gauge (blue)
23 gauge (orange)

Question 13

Tips for success

Answer 13

Tourniquets need to be tight
Phlebotomy is an art- practice!
About feel not sight
Hot packs can help. Vein
Position patient
Anchor the vein before accessing

Question 14

Options for venipuncture

Answer 14

Cephalic
Accessory cephalon
Basilic
Median cubical
Cephalic
Dorsal venous network

Question 15

Proper initial insertion of angles

Answer 15

20 degree

Question 16

Things to consider about IV

Answer 16

Only collect blood from an arm with a continuous infusion if there are no other options
Stop infusion prior to collection for 2-3 minutes
Infusions with heparin need to be stopped for 10 minutes prior to blood collection

Question 17

The venipuncture procedure

Answer 17

Review lab/req labels
AIDET
Hand hygene and gloves
Fasting and or diet restrictions
Assemble supplies
Position patient
Apply tourniquet
Cleanse site and allow to dry
Assess sites and select supplies
Inform patient
Insert needle
Collect blood specimens
Order of draw
Release tourniquet apply gauze, remove needle pressure
Sharps and label
Evaluate site and bandage
Thank you

Question 18

Order of draw

Answer 18

Stop (sterile)
Light (light blue)
Red (red)
Stay (sst)
Put (pst)
Green (green)
Light ( lavender)
Go (gray)

Question 19

RED

Answer 19

No additive

Question 20

Yellow

Answer 20

Sps-sodium polyanethol sulfate

Question 21

Red marble top or gold

Answer 21

Clot activator and gel for serum separation

Question 22

Yellow marble top or orange

Answer 22

Thrombin

Question 23

Light blue

Answer 23

Sodium citrate

Question 24

Light green

Answer 24

Lithium heparin and gel for plasma separation

Question 25

Green

Answer 25

Sodium heparin or lithium heparin

Question 26

Pink

Answer 26

EDTA

Question 27

Lavender

Answer 27

EDTA Ethlenediamine tetraacetic acid

Question 28

Tan

Answer 28

Sodium Heperin -Glass tubes Edta - (plastic)

Question 29

Gray

Answer 29

Potassium oxalate/sodium fluoride or sodium fluoride

Question 30

Royal blue

Answer 30

Sodium heparin EDT-none

Question 31

CVAD blood draw considerations

Answer 31

Stop any infusions beforehand Aspirate to verify blood return Flush with 9 mL Waste 3-5 mL and discard Collect sample Flush with 19 mL

Question 32

Preventing hemolysis

Answer 32

Problem free venipuncture Use a larger bore needle to draw -21 22 or 23 gauge Use larger needles for transferring blood into test tubes -18 g blunt fill works well Tilt blood tubes so that the blood washes down the side of the tube Aspirate slowly when collection from veins or catheter

Question 33

Blood cultures

Answer 33

Priority to minimize risk of contamination Blood cultures when ordered should be collected first 5-10 mL of blood should be collected for each sample Never attach blood culture bottles directly onto vacuholers because beads in the culture bottle can be introduce into the patients vein

Question 34

Trouble shooting

Answer 34

Change the position of the needle Tourniquet too tight- could obstruct blood flow Change tubes- vacuum could be a problem Re anchor the vermin some veins roll Have patient make a fist to help engorge muscles Prewarlm area of venipuncture to increase blood flow Rehydrate patient