Venipuncture

Question 1

How do you initiate the procedure?

Answer 1

1. introduce self by full name and post
2. identify patient - name, hospital number, DOB -against lab requests forms and patient wrist band and notes
3. have you had blood taken before? which location is best for you? how are you around needles?
4. explain procedure - involves me inserting a needle into one of your veins so I can take some of your blood and we see whats going on
5. inform about potential complications - after there might be some pain, a little bleeding, some swelling and there is a small risk of infection
6. obtain consent - is this all okay?
7. any known allergies to surgical tape, dressing etc?

Question 2

How do you prep yourself and set up the task?

Answer 2

1. clean hands - alcohol or water
2. put on gloves and apron
3. collect required equipment

Question 3

What is the required equipment?

Answer 3

1. Patient’s blood request forms and patient’s notes.
2. Butterfly device.
3. Vacutainer barrel.
4. Appropriate blood sample tubes/blood culture bottles for collection of
   samples.
5. Non-sterile gloves.
6. Disposable plastic apron.
7. A clean receptacle to put the equipment in.
8. A sharps disposal bin.
9. Clinell wipe.
10. Tourniquet.
11. Gauze.
12. Cotton wool and tape

Question 4

How do you prepare the patient?

Answer 4

1. position patients arm, supported with a pillow and identify suitable vein
2. check site for: broken skin, fistulas, infection, hard/cord-like veins
3. ask if patient has had breast surgery/axillary lymph node removal or radiotherapy on the side of venipuncture

Question 5

How do you insert a butterfly device?

Answer 5

1. remove cap from culture bottle and disinfect opening with alcohol wipe
2. apply tourniquet 5-10cms above site. Use finger as guide to avoid over tightening. Repalpate vein
3. clean site per local policy
4. open butterfly device and connect luer lock to vacutainer adapter
5. remove safety sheath from butterfly needle
6. ensure patient is ready, explain they might feel a slight scratch
7. stretch skin below site, insert needle bevel upwards, in line with vein at an angle of 30-45 degrees, advance until flashback of blood appears in device
8. secure butterfly with tape across wings

Question 6

How do you obtain blood cultures from a butterfly device?

Answer 6

1. attach adapter cap to blood culture bottle and allow required amount of blood to collect
2. obtain aerobic and anaerobic samples in respective bottles
3. aerobic before anaerobic

Question 7

How do you obtain additional samples using a butterfly device?

Answer 7

1. urea and electrolytes - yellow cap
2. clotting - blue cap (needs to be filled)
3. full blood count - purple cap (done last to prevent EDTA contamination)
4. invert tubes to mix sample

Question 8

How do you finish the procedures?

Answer 8

1. release tourniquet before removing needle
2. remove needle and discard immediately in sharps bin
3. check site for prolonged bleeding or haematoma
4. apply suitable dressing and ask patient to apply pressure (make sure to check surgical tape allergies?)
5. document procedure in patient notes
6. label all samples clearly and correctly by hand
7. complete lab request forms including signing and dating
8. request patient inform staff if any pain/discomfort/swelling felt around site
9. remove gloves and apron
10. thank paitent