Venepuncture:

Question 1

Venepuncture:

Answer 1

• most common method of obtaining blood specimens
• insertion of a hollow-bore needle into the lumen of a large vein to obtain a specimen using either a needle and syringe of a vacutainer device that allows the drawing of multiply samples

Question 2

Scope of practice as an EN:

Answer 2

• the 3 methods of obtaining blood specimens are - skin puncture, venepuncture and arterial puncture
• arterial blood gasses can only be collected by trained RNs, physicians or laboratory technicians

Question 3

Blood specimen collection overview:

Answer 3

*Complete pre-procedure protocol:
- hand hygiene, identify patient, explain and provide education, seek consent
* Check for any special conditions that need to be met before specimen collection:
- fasting blood glucose, drug peak, trough levels
* Assess the patient for possible risks associated with venepuncture. review medication history:
- increase risk of bleeding and hematoma formation due to anticoagulant therapy, low platelet count, bleeding disorders
* Assess patient for contraindicated sites for venepuncture

Question 4

Venepuncture procedure overview:

Answer 4

• Apply tourniquet so it can be released easily
• tourniquet blocks venous return to heart from extremity, causing veins to dilate for easier visibility
• Position tourniquet 5-10 cm above venepuncture site selected:
• antecubital fossa site is most often used. place over gown sleeve to protect skin
• Ensure tourniquet is not too tight, pressure will impede arterial flow:
• palpate distal pulse (e.g. brachial) below tourniquet. if not palpable, remove, wait 60 seconds and reapply more loosely
• Do NOT keep tourniquet on patient longer than 1 minute
• Quickly inspect extremity for best venepuncture sites

Question 5

Complications:

Answer 5

• Hematoma forms at venepuncture site:
• apply pressure using gauze dressing
• continue to monitor patient for pain and discomfort
• Bleeding at site continues:
• apply pressure to site; patient may also apply
• monitor patient
• notify RN/Doctor
• Signs and symptoms of infection at venepuncture site occur:
• notify RN/Doctor