Venepuncture

Question 1

When routinely offered?

Answer 1

Booking (screening)
Dating (CST) 10-14 weeks
28 weeks (anemia)
Rh neg after birth

Question 2

Preparation

Answer 2

Gain consent
Prep equipment

Question 3

Patient zone

Answer 3

Wash hands
tourniquet to assess
Relax tourniquet

Question 4

Before inserting needle

Answer 4

Hands wash and gloves
Disinfect skin
Reapply tourniquet

Question 5

What angle for needle

Answer 5

15-30 degrees

Question 6

How many times invert tube

Answer 6

2-3 times

Question 7

When release tourniquet

Answer 7

While drawing last bottle

Question 8

After

Answer 8

Dispose safely
Wash hands
Label
Document

Question 9

Equipment for tray

Answer 9

Alcohol wipes
Butterfly and bell
Tourniquet
Plaster
Bottles
Gauze

Question 10

Benefits of butterfly

Answer 10

Smaller needle
Visual feedback
Good for several samples

Question 11

Which if blood cultures

Answer 11

Butterfly

Question 12

Venepuncture benefits

Answer 12

Cheaper
Best 1-2 samples

Question 13

Key parts (in contact lumen or key site)

Answer 13

Connector
Needle

Question 14

Key site

Answer 14

Entry point of cannula into skin

Question 15

Maximum time for tourniquet

Answer 15

1 min

Question 16

Why no longer than minute

Answer 16

Haemoconcentration

Question 17

When release tourniquet

Answer 17

During last bottle filled

Question 18

Why remove tourniquet before needle removal?

Answer 18

Can cause bruising

Question 19

Where should pulse be palpable

Answer 19

Below tourniquet

Question 20

Environment

Answer 20

Warm
Pillow
Hand below elbow (prevent venous return and get juicy vein)

Question 21

Ideal venepuncture location

Answer 21

Forearm
Hand
Away from flexion point
Non dominant hand

Question 22

Ideal vein

Answer 22

Visible AND palpable
Straight
Away flexion areas
Refills quickly when depressed
Soft and juicy

Question 23

Sites to avoid

Answer 23

Same arm as IV
Bruising
Recent tattoos
Wrist and lower limbs

Question 24

Which way bevel end needle face

Answer 24

Up

Question 25

Purple

Answer 25

FBC
Screen anaemia, WBC, platelet

Question 26

Pink

Answer 26

Blood group

Question 27

Blue

Answer 27

Coagulation/clotting disorder

Question 28

Yellow

Answer 28

Biochemical (liver enzymes, bile, albumin, T hormones, vitamins, proteins, urates, bilirubin)

Question 29

Grey

Answer 29

Gest Diabetes (glucose serum)
Lactate (sepsis)

Question 30

Red

Answer 30

Serology infections diseases
Antibodies
Toxicology

Question 31

Blood cultures

Answer 31

When sepsis suspected

Question 32

Nerve Damage (How)

Answer 32

Puncture nerve

Question 33

Nerve damage (prevent)

Answer 33

Angle below 30 so less deep

Question 34

Nerve damage (prevent)

Answer 34

Angle below 30 so less deep

Question 35

Pain

Answer 35

Hitting nerve/valve
Sensitive skin

Question 36

Pain (prevent)

Answer 36

Avoid veins sensitive areas
Skin cleansing agent is dry

Question 37

Bruising (how)

Answer 37

Too big needle
Puncturing through vein
Removing needle before tourniquet release

Question 38

Bruising (prevent)

Answer 38

Appropriate size needle
Don’t over advance
Release tourniquet as soon as blood flow achieved
Press on side as soon as needle removed (up to 1 min)

Question 39

Bruising (prevent)

Answer 39

Appropriate size needle
Don’t over advance
Release tourniquet as soon as blood flow achieved
Press on side as soon as needle removed (up to 1 min)

Question 40

Fainting

Answer 40

Vasovagal reflex

Question 41

Fainting (prevent)

Answer 41

Check history (lie down)
Look for signs

Question 42

Infection (how)

Answer 42

Skin barrier broken down by puncture technique

Question 43

Infection (prevent)

Answer 43

Wash hands and wear gloves
Clean puncture site
Do re-palpate once cleaned
Do not touch key parts of equipment