Venepuncture Flashcards
Why is Aseptic Non Touch Technique (ANTT) used?
to avoid transfer of microbes to key body sites from clinicians, equipment or immediate environment
what should be written on a pt’s wristband?
Full name - surname first in block capitals
DOB
NHS number
how do endothelial cells reduce friction in vessels?
they are packed together but lie flat creating a smooth surface for blood flow -> prevents abnormal blood clots forming
semilunar folds of the tunica intima form
VALVES in veins
will valves repair themselves if damaged?
NO
What stimulates the smooth muscle of the tunica media?
Stretch - when overstretched they contract in resistance
which blood vessel layer is sensitive to irritation?
tunica media - if irritated causes spasm which makes insertion difficult
what happens when the tourniquet is left on too long?
SM in the tunica media overstretches and contracts in resistance causing blood to pool
6 characteristics of good veins for venepuncture
Soft&bouncy - indicates not damaged/sclerosed
Palpable - shldn’t pulsate
Visible
Straight
Non-mobile
Good location - not too superficial, starts in antecubital fossa, not surrounded by too many structures
Where should you avoid taking blood from?
fine veins in the back of the hand too close to the
Why is taking blood from an AV fistula contraindicated?
because it increases risk of thrombosis + damage to the fistula itself
Why should you avoid taking blood from a site near an IV?
it may dislodge the IV
3 approaches to improving venous access
keep area warm
encourage patient to be well hydrated
encourage pt to relax
What should be disposed of in a red top sharps bin?
sharps contaminated with blood only
What should be disposed of in a purple top sharps bin?
sharps contaminated with cytotoxic medications
What should be disposed of in a yellow top sharps bin?
sharps contaminated w meds
What happens if I get a needlestick injury
bleed it by squeezing
wash well w warm soapy water
apply waterproof occlusive dressing
report to nurse in charge/occupational health etc.
When should a blood sample be labelled?
immediatley after it has been taken at the pt’s bedside
What is the correct order of draw? (B B P G)
- 1- Brown bottle
- serum gel - brown monovette bottle
- use: biochemistry => urea+electrolyte lvls (Us&Es)
- 2- Blue bottle
- citrate
- use - for coagulation tests
- 3 - Purple bottle
- use - for haematology tests incl. FBCs
- 4 - Grey
- use - glucose
- 1- Brown bottle
What’s used to cleanse the skin prior to venepuncture?
2% chlorhexidine wipe
What causes bruising?
blood infiltrating into surrounding tissues
What is a haematoma?
uncontrolled bleeding into surrounding tissues causing painful swelling
What causes bruising during venepuncture?
poor technique: start-stop –> makes multiple holes in vein OR too much force push needle through both vein walls
not releasing the tourniquet before removing the needle
poor vein selection: choosing a site to close to valves, sml/thready veins, using a needle too lrg for vessel
