Week 2 Lab: Specimen Collection (Venipuncture) Flashcards
It is the collection of blood from veins.
Venipuncture
It is most often performed for the purpose of laboratory testing.
Venipuncture
Venipuncture is done with a needle, and typically performed by a?
phlebotomist
Purposes of venipuncture?
- laboratory testing
- remove extra red blood cells from the blood
- treat various blood disorders
What type of blood is preferred for most hematological examination?
Venous blood
Why is venous blood preferred for most hematological examination?
- It is easier and more convenient and adequate volume of blood suitable for a variety of test.
- Offers the fastest method of collecting sample from a large number of patients.
- Allow the test to be repeated.
- It also allows the performance of additional test that may be requested.
- It reduces the possibility of error resulting from the dilution with tissues juices or constriction of skin vessels.
Three General Methods of Venous Blood Collection?
- Syringe Method
- ETS (Evacuated Tube System) method
- Butterfly infusion Method
Materials for venipuncture?
- Sterile syringe
- Tourniquet
- Alcohol swab
- Tube holder
- Gauze pad
- Evacuated tubes
- Micropore tape
Procedure for venipuncture?
- Identify the patient by having the patient verbally state his/her full name and confirm with the patient’s identification number (ID band or any valid ID).
- Verify any diet restrictions.
- Prepare all materials so that they are within your reach at the time of blood extraction.
- Position the patient.
- Apply the tourniquet 3 to 4 inches above the selected puncture site for no longer than 1 minute.
- Ask the patient to make a fist. This makes the vein more easily palpable.
- Select a suitable vein for puncture.
- Cleanse the area with 70% alcohol using concentric circles, working from the inside to outside.
- Allow the area to dry.
- Inspect the needle. Check if the needle is not clogged by moving the plunger of the syringe up and down forcing air through the needle.
- Grasp the patient’s arm 1 to 2 inches below the puncture site. This anchors the vein and prevents it from rolling.
- Align the needle in the same direction as the vein. The needle should be in the bevel up position. (Needle opening facing upward)
- Using one deliberate, smooth motion, insert the needle in the same direction as the vein at approximately 15°-30° angle with the skin.
- Withdraw the desired volume of the blood for the examination to be performed when the needle enters the vein. Pull the plunger gently during aspiration.
- Remove the tourniquet and ask the patient to open his fist.
- Apply dry cotton lightly over the punctured site and withdraw the needle.
- Remove the needle from the syringe and fill the tubes
- Label the tubes properly. (Patient’s full name, age, gender, date and time of collection and collector’s initials.)
- Dispose the puncture equipment and other biohazardous wastes.
How far should the tourniquet be from the puncture site?
3-4 inches or 7.5-10 cm
How long should you leave the tourniquet on the arm?
no more than 1 minute
Area of the arm preferred for venipuncture?
Antecubital fossa
Vein of choice for venipuncture?
Median cubital vein
2nd vein of choice for venipuncture?
Cephalic vein
3rd vein of choice for venipuncture?
Basilic vein
Used to cleanse the puncture site for venipuncture.
70% alcohol
How should you cleanse the puncture site for venipuncture?
concentric circles, working from the inside to outside
How do you check if the needle is not clogged?
move the plunger of the syringe up and down forcing air through the needle
How do you anchor and prevent the vein from rolling?
grasp the patient’s arm 1 to 2 inches below the puncture site
Needle should be in a _______ position.
bevel up
Angle for venipuncture?
15°-30°
Information to be written on the label of tubes?
- patient’s full name
- age
- gender
- date and time of collection
- collector’s initials
Needle gauge routinely used?
19, 20 , and 21 G
Common gauge routinely used?
20 G
Rodak: needle gauge routinely used?
21 G
Length of needle?
1-1.5 inch
Color of hub: 18 g?
pink
Color of hub: 21 g?
green
Color of hub: 22 g?
black
Color of hub: 23 g?
blue, light blue
Which governing body recommends that tourniquet should not exceed 1 minute application?
Clinical & Laboratory Standards Institute (CLSI), formerly National Committee for Clinical Laboratory Standards (NCCLS)
Types of Complications of Venipuncture?
- Local Immediate Complications
- Local Delayed Complications
- General Delayed Complication
Examples of Local Immediate Complications?
- Hemoconcentration
- Failure of the blood to enter the syringe
Examples of Local Delayed Complications?
- Hematoma
- Thrombosis of the vein
- Thrombophlebitis
Examples of General Delayed Complications?
- HIV
- Hepatitis
Order of draw for venipuncture?
- Blood culture tube (yellow stopper)
- Coagulation tube (light blue stopper)
- Serum tube with or without activator (red, gold, red-gray marbled, orange, or yellow-gray stopper)
- Heparin tube (green or light green stopper)
- EDTA tube (lavender or pink stopper)
- Sodium fluoride with or without EDTA or oxalate (gray stopper)
