specimen collection (venipuncture) Flashcards
deoxygenated blood with a dark red color
Venous blood
oxygenated with bright red color
Arterial blood
PUNCTURE SITES
- Antecubital fossa region
- Veins on the wrist and dorsal aspect of hands
- Vein on the ankle
Basilic, cephalic, median cubital
Antecubital fossa region
- not ideal for diabetic patients or patients with poor circulation
Veins on the wrist and dorsal aspect of hands
Best site for venipuncture, largest,
best anchored, and less moveable
Median cubital vein
Most commonly used vein if the patient is obese
Cephalic vein
- Considered as the least for venipuncture within the antecubital fossa region because it is near the brachial artery and nerves
- Puncturing the nerve could result to a certain condition to the patient
Basilic vein
Not recommended with diabetic patients
Veins on the wrist and dorsal aspect of hands
Least choice just in case the veins in the
arms, wrist, and dorsal aspect of the hand
is not suitable/available
Vein on the ankle
Sites (in Newborns)
a. Scalp
b. Popliteal
c. Jugular
d. Dorsal of the hand
a. IV lines in both arms
b. Areas with Hematoma
c. Burned or scarred areas
d. Thrombosed veins
e. Edematous arms
f. Partial/Radial mastectomy
g. With AV shunt or fistula
h. Cast (s) on arm (s)
SITES TO BE AVOIDED
Can cause lymphangitis and lymphostasis wherein there is blockage of the normal lymph node drainage
Partial/Radial mastectomy
removal of the breast
o If right breast is removed, perform puncture on the left arm and vice versa
o If both breasts are removed, perform the puncture on the opposite side of the arm in which the first procedure was performed
o If mastectomy is still within 6 months after procedure, perform the puncture on the hand or ankle
Mastectomy
AV- arteriovenous; common in kidney patients; product of anastomosis of the vein and the arteryvein and artery will be connected so the blood will flow from there serving as a vascular access site for
hemodialysis patients
With AV shunt or fistula
The major veins for venipuncture are in the ____
antecubital fossa
- At the center of antecubital fossa
- First choice for venipuncture
MCV H-PATTERN
- Lateral
- Second-choice in H-pattern
- Often hard to palpate
- Obese patients
Cephalic Vein H-PATTERN
- Medial of antecubital fossa
- Not well anchored, rolls easily
- Accidentally puncture the brachial artery and the median cutaneous nerve branch
Basilic vein H-PATTERN
o Located at the very center
o First choice in M - pattern
o Safe to puncture
Median Vein
- M-pattern
Venipuncture can be performed by means of 3 different methods
- syringe method
- butterfly infusion method
- Vacutainer/ETS method
Protect as to the one performing the venipuncture
Gloves
disposable; discard after each use
- Winged infusion set
- Multi- sample needle
- Hypodermic needle with different
colors according to hub size
needles
- Gloves
- Needles
- Hub/Tube holder/ needle adapter
- Evacuated tubes
- Antiseptic
- Syringes
- Bandages/tapes
- Gauze sponges/cotton
- Tourniquet
- Sharp container
- Requisition form
Equipment Necessary to Perform a Venipuncture
- has different stopper colors
depending on the additive inside
Evacuated tubes
Alcohol wipes/ Alcohol Pad/ Wet Cotton/
Povidone Iodine (usually in blood culture)
Antiseptic
different capacity rangers from 1mL to 60 mL; in blood collection, 10 mL is already a lot
Syringes
usually surgical tape (the white one;
micropore)
Bandages/Tape
venipuncture cannot be performed
without a request form; to know how much blood is to be withdrawn and for what purpose
Requisition form
- Single sample needle
o Used in one patient only then discard - Sterile and disposable
- “The larger the gauge number, the smaller
the needle bore and length.”
Needles
gauge commonly used for venipuncture.
20-21 gauge
gauge used for blood collection (more of
the 21)
21-22
gauge for children
23 gauge
gauge used for butterfly infusion set
21-23, 25 gauge
in collecting 30-50 mL of blood
18 gauge
yellow gauge
20
green gauge
21
black gauge
22
blue gauge
23
orange gauge
25
brown gauge
26
Needle length
* Standard but
still depends on
the gauge
1 or 1.5 inch
butterfly needle length
½ to ¾ inches
Parts of the Syringe:
- Graduated barrel
- Plunger
- Transfer device
contains the measurement of the volume
of the blood depending on its capacity (1mL- 60mL; in chemistry, 10mL will suffice)
Graduated barrel
attached to the nozzle of the syringe
and it has a needle with a rubber cover. The rubber cover will retract once you insert the evacuated tube.
Evacuated tube has vacuum inside so even though the plunger is not pushed, the blood will freely flow inside the
tube.
o Safer compared to uncapping method.
o However, NOT PRACTICAL. You have to use different transfer device from one patient to another
Transfer device
o Short needle with a thin tube with attached plastic wings
* The thin tube present with the set has
different lengths.
o Used for infants and children and patients with fragile veins
o Could be connected to syringe or evacuated tubes
* Through the use of leur adapter
Winged Infusion Sets
