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Clinical Procedures > Venipuncture/Phlebotomy > Flashcards

Venipuncture/Phlebotomy Flashcards

1
Q

What are the indications for phlebotomy?

A

venous blood sampling

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2
Q

What are the contraindications for phlebotomy?

A
  1. Cellulitis
  2. Trauma
  3. Burns
  4. Radical mastectomy
  5. AV fistula
  6. Hematoma
  7. Arm with IV line
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3
Q

What are the potential complications of phlebotomy?

A
  1. Skin infection (cellulitis)
  2. Infection of the vein (phlebitis)
  3. Thrombosis
  4. Laceration of the vein
  5. Accidental arterial puncture
  6. Hemorrhage or hematoma at site of puncture
  7. Vasovagal syncope
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4
Q

What equipment is needed for phlebotomy?

A
  1. Gloves and alcohol wipes, tourniquet
  2. 21 to 25 gauge straight needles or butterfly needles
  3. Vacutainer holder
  4. Alcohol wipes
  5. Bandaid oe 2x2 gauze and papertape
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5
Q

What is the phlebotomy procedure?

A
  1. Know what specific samples you need to collect and what order of draw for different tubes/lab tests
  2. Insure no latex allergies
  3. If failed first attempt, do not repeat at the same site
  4. Ask for help if needed
  5. Wash hands
  6. Explain procedure to pt and obtain consent
  7. Gather all equipment
  8. Have pt in supine position
  9. Use standard precautions
  10. Use upper extremity and have the pt extend the arm at the elbow
  11. Place tourniquet 2-4 inches above or 3 finger widths
  12. Not necessary to have the pt make a fist
  13. Cleanse the area with alcohol wipe. DO not touch the area after you clean it-if so, must reclean
  14. Apply gentle skin traction distal to the vein
  15. insert needle into vessel at a 30 degree angle and observe for flash of blood
  16. insert vacutainer tubes into vacutainer needle holder to collect sample
  17. Release tourniquet when last tube is 3/4 of the way full, remove tube from needle, and remove needle
  18. Apply pressure to the phlebotomy site with 2x2 gauze until bleeding stops
  19. apply bandage
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6
Q

What is a blue top tube used for?

A
  1. Coagulation studies, INR + KCCT, d-dimer, fibrinogen
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7
Q

What is a red top tube used for?

A
  1. bacteriology and viral serology

2. Selenium, zinc, 17 OHP, androgens, GH, vitamin D, INsulin, C peptide, antibiotic assays, DHAS, Cryoglobin, IGF1/GFBP3

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8
Q

What is a yellow top tube used for

A

Aldosterone, B12, ferritin, S folate, down’s screen, all routine biochemistry profiles except those mentioned above

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9
Q

What is a green top tube used for?

A

Carboxyhemoglobin, methemoglobin, cytogenetics

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10
Q

What are the lavender top tubes used for?

A

FBC, platelets, sickle cell test, malaria, HbA1c, Hb electrophoresis, CBC with diff

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11
Q

What are pink top tubes used for?

A

Blood group and cross matching

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12
Q

What are grey top tubes used for?

A

Blood glucose, ethanol, lactate

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13
Q

What are the the red/black tubes used for?

A

Combat, SST (serum separator tube) BMP

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14
Q

What is the order of draw for tubes?

A
  1. Blood cultures
  2. blue
  3. red
  4. yellow
  5. green
  6. Lavender
  7. Pink
  8. grey
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15
Q

Where are the most common locations for venipuncture?

A
  1. Medial cubital
  2. Cephalic
  3. Basilic vein
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16
Q

What are the special considerations for phlebotomy?

A
  1. May need to pull back needle slightly if you do not see a flash of blood
  2. May need to redirect needle after pulling back to get into the vein
  3. If blood stops flowing, the vein may have collapsed
  4. Never draw from a scarred vein
  5. Never attempt in an artery
  6. Never draw from an arm on the side of a s/p masectomy

Clinical Procedures (15 decks)

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