Venepuncture, Blood Cultures & Cannulation Flashcards
What is meant by ‘venepuncture’?
the process of taking a venous blood sample to aid diagnosis and treatment
What is meant by ‘cannulation’?
the process of inserting a small plastic tube into a vein
this can be used to deliver fluids or medication
What is meant by ‘blood cultures’?
the process of taking a venous blood sample that will be sent to microbiology to look for the presence of infection causing organisms
What is meant by ‘asepsis’?
the absence of bacteria, viruses and other microorganisms
What is ANTT?
aseptic no touch technique
the standardised technique for achieving asepsis during invasive procedures
What % of healthcare associated infections are avoidable?
What is their cost to the NHS each year?
30% are preventable
They cost the NHS £2.3 billion each year
Around how many patients are harmed by sepsis each year?
250,000
What is the first stage in risk assessing clinical procedures?
Determining the need for standard or surgical ANTT
When would standard ANTT be the technique of choice?
When procedures are uncomplicated, short (<20 minutes) or involve small and minimal numbers of key components
Surgical ANTT is needed in all other situations
What are the appropriate infection control precautions that help to ensure asepsis?
- handwashing
- wearing gloves
- cleaning the site
What is involved in identifying key components of equipment?
These are the parts that have contact with the patient
If they are contaminated, they present a higher risk of infection
What is the most effective way to protect key components of equipment?
- leave any protective caps on until they are required
2. once they are exposed, do not touch them
What are the 7 words that describe a good vein?
- soft
- straight
- bouncy
- refillable
- spongy
- supported
- visible
When taking blood samples, where are the most appropriate vessels found?
vessels in the antecubital fossa
they are large and palpable
When using a cannula, which areas are avoided?
Joints are avoided as they are likely to become occulded in these areas
Where do cannulas tend to be placed?
More peripherally
Usually in the upper limb
The lower limb is an option if the upper limb is contra-indicated
What piece of apparatus is used to help visualise vessels?
Tourniquets
What are the 3 key properties of a tourniquet?
- latex free
- single patients use
- quick, one-handed release
What happens if the tourniquet is left on for longer than 1 minute?
Pressure causes potassium to leak out of tissue into blood
This gives inaccurate results
What types of veins should be avoided?
sclerosed, fibrosed, thrombosed, hard veins
tortuous, mobile, thin, fragile veins
Veins in which areas should be avoided?
inflamed, painful, bruised areas
adjacent to areas of infection
What types of compromised/injured limbs should be avoided?
- mastectomy
- casts
- decreased circulation
- paralysis
- AV fistula
What are the 6 complications of venous puncture?
- bruising
- infection - phlebitis/septicaemia
- missing the vein
- thromboembolism
- hitting an artery, tendon or nerve
- haematoma
What are the indications for venepuncture?
Whenever a blood test is required
What are the indications for blood culture?
- when bloodstream infection is suspected
2. pyrexia of unknown origin
What areas should not be used for blood culture?
do not use existing cannula or sites immediately above peripheral cannula
What are the indications for cannulation?
- delivery of IV fluids
- delivery of IV medication
- blood transfusion
What are the 3 stages involved in choosing and fitting the right size cannula?
- always choose smallest cannula for required function
- use non-ported safety device where possible
- attach needle free safe site connection
When should a purple cannula be used?
In neonates
When should a yellow cannula be used?
Paediatrics, oncology, elderly
When should a blue cannula be used?
Paediatrics, oncology
When should a pink cannula be used?
Crystalloids - general use
When should a green cannula be used?
For blood products, medicines and fluids
When should a grey or orange cannula be used?
For rapid transfusion of blood or fluids
What should be done to the culture bottles before taking the blood sample?
Clean the lids of the culture bottles and allow them to dry
Which culture bottle should be filled first and why?
Aerobic bottle - blue lid
There will air in the butterfly tubing which cannot be introduced into the anaerobic bottle
What happens to the sharps waste after performing a procedure?
ALL sharp objects go into a sharps bin
What happens to waste soiled with body fluids?
It goes into a clinical waste bin
This is an orange bag
What happens to paper and packaging waste?
It goes in a domestic waste bag
This is a black bag
When should samples be labelled?
At the bedside after the sample has been taken
What should be included on the sample label?
- name
- hospital number
- date of birth
What are the 4 stages in dealing with a needlestick injury?
- bleed it - squeeze to encourage bleeding
- wash it with soap and warm running water
- cover it with waterproof dressing
- report it immediately
