Phlebotomy Flashcards
phelobotomy
practice of drawing blood
required informed consent.
shaft length
3/4 inch - 1/5 inches
gauge
23-16 g
larger gauge = smaller needle
most common gauge = 21 g
types of needles
Multisample (double ended)
syringe
winged infusion “butterflies”
Order of draw:
Tube top color
additive
tests
order of draw: 1
Color: yellow
additive: SPS - inhibits complement and phagocytosis
test: Blood culture
order of draw: 2
Blue
additive: Sodium citrate
test: Coagulation tests
Order of draw: 3
red
additive: clot activators (serum)
test: chemistry, serology, blood bank
order of draw: 4
SST (gold/gray)
additive: clot activators and gel seperator (serum)
test: chemistru
order of draw: 5
green
additive: heparin
test: Stat chemistry, ammonia, blood gases
order of draw:
purple
additive: EDTA
Test CBC, ESR
order of draw: 7
gray
addiitve; antiglycolytic agent
test: lactic acid, glucose, fasting blood sugar. blood alcohol
1.
greet and identify patient
check two patient identifiers (name and DOB)
2.
position and prepare patient
Fasting? Abstaining from medications?
NEVER draw blood from a standing patient ot sitting on a high stool
support the chosen arm under the elbow
3.
perform hand hygiene + gloves
wash/sanitize dry hands properly
put on gloves
4.
assembly equipment
required items:
- antiseptic pad
- torniquet
- needle
- adapter/syringe
- tubes
- gauze
- bandage/coban
- disposal system
5.
apply tourniquet
3-4 inches above the puncture site
form an X
should NOT% be left on for over 1 min
Occludes venous flow NOT arterial flow
6.
select the site
site should not be scarred, bruised or IV arm
7.
palpate the vein
- locate by palpitation, feel
push up and down with non dominant index finger
- feel small bounce back
- should not feel pulse or rigidity (artery or bone tendon)
8 .
clean the site
9.
examine needle
- blunted
- barbed
- obstruction
- bent shaft
10.
perform venipuncture
anchor vein 1-2 inches below puncture site
insert needle
-15-30 degrees above skin
11.
fill first tube/remove touniquet
push in tube with non dominant hand
TORNIQUET must be removed before removing the needle
12.
advance and change tubes
mix 8-10 times
13.
prepare for needle removal
make sure last tube is removed from adapter and TORNIQUET
14.
withdraw the needle
14.
withdraw the needle
apply gauze to puncture site w pressure(non-dominant hand)
hold for 3-5 min.
prevents hematoma
15.
dispose of the used needle properly
16
label the tube
2 patient ID (name, DOB)
best veins for venipunctureare
located in antecubital fossa
1st choice of vein
Medial Cubital Vein
- middle of arms surface / large and well anchored
2nd choice of vein
cephalic vein
- same side of arm as the THUMB / not well anchored
Best for obese pateints
3rd choice of vein
Basilic vein
- same side of arm as pinky finger
- even less anchored/ near briachial artery
antiseptic
any agent used to clean LIVING tissue
70% isoprpyl alcohol
allow site to dry
- “bacteriostatic action”
- bacteriostatic - inhibits growth or reproduction of bacteria without killing
___ must be removed before the needle
tourniquet
if you have a problem with safety mechanism..
dispose of needle without safety
