Venepuncture

Question 1

For venepuncture, what qualities are you looking for in a vein?

Answer 1

Feels bouncy
Feels soft
Refills when pressed
Is well supported by surrounding tissue

Question 2

If you find a good vein (for venepuncture) which is not well supported by surrounding tissue (as often happens in elderly patients) how can you combat this?

Answer 2

By holding the vein in place

Question 3

How high above the intended puncture site should a tourniquet be placed in venipuncture?

Answer 3

7-8cm

Question 4

How tight should a tourniquet be tied for venepuncture?

Answer 4

So that you can fit two fingers between cuff and skin

Question 5

A latex glove can be used as a tourniquet. T/F?

Answer 5

False - this should never be done

Question 6

Why might venepuncutre be used?

Answer 6

To obtain a blood sample for diagnostic purposes

To monitor levels of blood components

Question 7

Palpation should be relied upon more than visual inspection for finding of vein to use in venepuncture. T/F?

Answer 7

True

Question 8

What equipment is needed for venepuncture?

Answer 8

PPE
Tray
Sharps bin
Disposable tourniquet
Sterile alcohol swab
Sharp safe butterfly needle and vacuette holder
blood sample collecting bottles
sterile gauze
tape

Question 9

How can you prevent bruising following venepuncture?

Answer 9

Apply pressure over puncture site

Question 10

The order in which sample bottles are used in the process of venepuncture is important. Why is this?

Answer 10

Some sample bottles have additives which could contaminated subsequent samples if used in the wrong order

Question 11

The vacutainer system is not used in paediatrics as there is too great a pressure in the collection bottle which causes the vein to collapse. What is used instead?

Answer 11

10mL syringe to transfer sample to collection bottle (like what we did in collecting Cather urine sample)

Question 12

Describe the process of venepuncture.

Answer 12

Introduce yourself, explain procedure and gain consent from patient
wash hands
don PPE
collect equipment (take extra plasters etc.)
Assess and palpate vein to choose site
apply tourniquet
cleanse skin with alcohol wipes for 15 seconds in spiral motion from inside out
connect sharp safe needle to vacutainer system
anchor vein with non-dominant hand and advance the needle with dominant hand at a 30 degree angle
once flashback is visualised use non-dominant hand to connect appropriate blood container to the vacutainer holder
once all blood bottles accurately fills, leased tourniquet and loosely cover puncture site with gauze whilst still holding the needle in place
remove the needle and use the quhckshield safety device
Immediately put needle in sharps bind
Apply pressure to puncture site until haemostasis achieved
apply plaster
label blood bottles and send to lab
remove PPE and wash hands

Question 13

What should you do in the event of a needlestick injury?

Answer 13

Make the site bleed under warm running water
report to nurse in charge who would undertake a risk assessment
contact occupational health within 1 hour for advice
Datix the incident