Procedural Error Risks| Procedural Error Risks Flashcards
Most common complication
Hematoma Formation
swelling or mass of blood that can be caused by blood leaking from a blood vessel during or following venipuncture
Hematoma Formation
What to do in case of hematoma?
first 24 hrs: apply ice (20 to 30 mins) After 24 hrs: apply warm compress
Causes of hematoma (8)
● Excessive or blind probing
● Inadvertent arterial puncture
● Fragile vein ( too small for the needle size)
● Needle penetrates through the vein
● Needle is partially inserted
● Needle is removed while the tourniquet is still on
● Pressure is not adequately applied after venipuncture
adverse condition brought by the effects of treatment/procedure
iatrogenic
After 24 hrs:
apply warm compress
first 24 hrs:
apply ice for 20-30 mins
Blood loss due to blood draw
iatrogenic anemia
iatrogenic:
adverse condition brought by the effects of treatment/procedure
Life is threatened if more than 10% of a patient’s blood volume is removed at one time
IATROGENIC ANEMIA
IATROGENIC ANEMIA
Life is threatened if more than _______ is removed at one time
10% of a patient’s blood volume
apply direct forceful pressure to the site for at least 5 minutes and until bleeding
stops
INADVERTENT ARTERIAL PUNCTURE
INADVERTENT ARTERIAL PUNCTURE
● Deep or blind probing, in the area of the basilic vein (close proximity to the
brachial artery)
● Can result in compression injury to a nearby nerve
● Signs of inadvertent arterial puncture:
○ rapidly forming hematoma
○ blood filling the tube very quickly
● Terminate the venipuncture immediately
● apply direct forceful pressure to the site for at least 5 minutes and until bleeding stops
Terminate the venipuncture immediately
INADVERTENT ARTERIAL PUNCTURE
Procedural Error Risks
Hematoma Formation
Iatrogenic Anemia
INADVERTENT ARTERIAL PUNCTURE
INFECTION
NERVE INJURY
REFLUX OF ADDITIVE
VEIN DAMAGE
INADVERTENT ARTERIAL PUNCTURE
Deep or blind probing, in the area of the basilic vein (close proximity to the
________)
brachial artery
Can result in compression injury to a nearby nerve
INADVERTENT ARTERIAL PUNCTURE
Signs of inadvertent arterial puncture:
○ rapidly forming hematoma
○ blood filling the tube very quickly
INFECTION
How to minimized by proper aseptic technique:
INFECTION
How to minimized by proper aseptic technique:
○ Do not open adhesive tape or bandages ahead of time or temporarily tape
them to your lab coat cuffs or other contaminated objects.
○ Do not preload needles onto tube holders
○ Do not touch the site after sterilization
○ Minimize the time between removing the needle cap and performing the
venipuncture
○ Remind the patient to keep the bandage on for at least 15 minutes after
specimen collection
○ Improper vein selection
NERVE INJURY
SIGNS of nerve injury
■Extreme pain
■Burning / electric shock sensation
■Numbness of arm
■Radiating pain
Remove the needle immediately and look for an alternative site
NERVE INJURY
(flow back)
Reflux
___ into the patient’s vein from the collection tube during the
venipuncture procedure
Reflux (flow back)
REFLUX OF ADDITIVE
Reflux (flow back) into the patient’s vein from the collection tube during the venipuncture procedure
- Patient’s arm must be kept in a downward position
● Numerous venipunctures in the same area over an extended period of
time
● Blind probing and improper technique when redirecting the needle
VEIN DAMAGE
REFLUX OF ADDITIVE
Patient’s arm must be kept in a ___ position
downward
VEIN DAMAGE
____ AND ____ when redirecting the needle
Blind probing and improper technique
Numerous venipunctures in the same area over an extended period of
time
VEIN DAMAGE
