the challenges of phlebotomy and customer service Flashcards
Can happen if the vein is located more deeply
Needle Not Inserted Far Enough
how to correct Needle Not Inserted Far Enough
you need to slowly advance the needle forward
This is why it’s important to palpate the vein before puncturing – to know the size, depth and direction of the vein
Needle Not Inserted Far Enough
Needle not completely under the skin
Bevel Partially out of the Skin
Can happen if the veins are superficial and your angle is steep
Bevel Partially out of the Skin
The tube vacuum can be lost when the bevel is partially out of the skin
Bevel Partially out of the Skin
short hissing sound or slight spurt of blood then the flow goes to a complete stop
Indication that the vacuum is lost
how to correct Bevel Partially out of the Skin
discard the tube, advance the needle, then engage a NEW tube
Needle not inserted deeply enough – half under the vein, half out
Bevel Partially into the Vein
The bevel may be under the skin but only partly through the upper vein wall, resulting to the blood filling the tube very slowly
Bevel Partially into the Vein
The blood will leak, and if not corrected quickly, it may cause hematoma
Bevel Partially into the Vein
how to correct Bevel Partially into the Vein
insert the needle
An angle that is too shallow may be in contact with the upper wall
Bevel Against a Vein Wall
An angle that is too steep (bevel down) may be in contact with the lower wall
Bevel Against a Vein Wall
how to correct Bevel Against a Vein Wall
remove the tube to preserve vacuum, tilt (rotate) it slightly so that the bevel will face upward, then re-engage the tube
Needle slip to the side of the vein slightly under it
Needle Beside the Vein
Usually happens if the vein is not anchored well – vein may roll or move slightly
Needle Beside the Vein
how to correct Needle Beside the Vein
withdraw the needle slightly until the bevel is just under the skin, then redirect (do not search or probe for the vein or move the needle in a lateral sideways direction to find it)
Causes of Unsuccessful Venipuncture: Improper Technique
a.) Bevel on lower wall of vein
b.) Needle rotated 45 degrees
c.) Needle inserted too far
d.) Needle partially inserted
causes blood to leak into tissue
Needle partially inserted
does not allow blood to flow
Bevel on lower wall of vein
To prevent this, apply direct pressure; Before putting adhesive, make sure that the bleeding has stopped
Excessive bleeding
Ask the patient to breathe slowly and deeply, then apply the cold wash cloth on the forehead
Nausea and vomiting
When you insert the needle, normally, it is painful; If it is very painful, you need to stop
pain
very rare Complication of Venipuncture
seizures/convulsion
tiny red spots; usually caused by platelet abnormalities and defect in the capillary wall
petechiae
loss of consciousness due to insufficiency of blood supply to the brain; second common complication in phlebotomy; apply cold compress on the patient’s forehead
Fainting / vasovagal syncope
most common complication
hematoma
Blood leaked to the blood vessel following a venipuncture
hematoma
Long-term complications in veinipuncture
a.) Iatrogenic anemia
b.) Infection
c.) Vein damage
d.) nerve injury
adverse condition brought by the effects of treatment or procedure; iron deficiency anemia
latrogenic
Usually happens when the needle used is not sterile
infection
SIGNS of nerve injury
a.) Extreme pain
b.) Burning / electric shock sensation
c.) Numbness of arm
d.) Radiating pain
is normally recommended for pediatric patients since their veins are small and not well-developed
Capillary collection
superficial veins and not deep, hard-to-find veins
1-2 years old
Other potential venipuncture sites include?
a.) medial wrist
b.) the dorsum of the foot
c.) the scalp
d.) the medial ankle
removing more than 10% of an infant’s blood volume at one time can lead to?
shock and cardiac arrest
volume of blood to be collected in babies are dependent on?
their weight
method of restrain in newborn or young infant
wrapped in a blanket
method of restrain in toddlers
sit upright in parent’s lap
method of restrain in older children
sit by themselves but a parent or another phlebotomist should help steady the child’s arm
geriatric
old age
Must be treated with compassion, kindness, and treated with respect
geriatric
site selection in geriatric
antecubital
A Patient Who Is Resistant has what right
right to refuse
A Patient Who Is too aggressive should be?
sedated
A Patient w/o consent
can lead to charges of assault and battery
A Patient Who refuse blood collection
Do not collect blood, the inform the doctor
Veins are often difficult to feel through layers of tissue
obese patients
usually the most prominent vein to feel in obese patients
median cubital
blood collection on Patients with Damaged or Collapsing Veins
syringe method
a persistent irrational fear of pins and needles
Belonephobia
“belone” means
needle
“phobos”
fear
heightened sensitivity to pain and can experience a shock type reaction during or immediately following venipuncture
Belonephobia
how long should an ice pack be used during Belonephobia
10 - 15 mins
most legal actions against healthcare workers
civil actions
The most common civil actions in healthcare are based on
tort law
came from the Latin word tortum, meaning twisted, crooked, or wrong
tort
An act or threat causing another to be in fear of immediate battery
assault
An intentional harmful or offensive touching of, or use of force on, another person without consent or legal justification
battery
usually both a tort and a criminal offense
battery
are both examples of physical violence
assault and battery
The violation of ones right to be left alone.
invasion of privacy
failure to keep privileged medical information private
Breach of confidentiality
failure to exercise due care
Negligence
A type of negligence committed by a professional
malpractice
Latin for “the thing speaks for itself”
Res ipsa loquitur
Latin for “let the master respond”
Respondeat superior
When a breach of duty is so obvious that it does not need further explanation, it is said that the situation speaks for itself
Res ipsa loquitur
An employer is liable (legally responsible) for the actions of an employee, even though the employee is the one at fault
Respondeat superior
Compensates the insured in the event of malpractice liability
Malpractice insurance
are not typically targets of lawsuits because of respondeat superior
Malpractice insurance
communication skill that the patient will understand
verbal
communication skill that uses body language
non-verbal
communication skill that limits your talking and focuses on customer
listening
Reasons of patients in choosing a phlebotomy area (draw site)
a.) Insurance company
b.) Physician’s order
c.) Convenient location
d.) Image of draw site
Reasons of patients in choosing a phlebotomy area (draw site)
a.) Insurance company
b.) Physician’s order
c.) Convenient location
d.) Image of draw site
