what sites should be avoided when performing venipuncture quizletwhat sites should be avoided when performing venipuncture quizlet

\u00a9 2023 wikiHow, Inc. All rights reserved. Include your email address to get a message when this question is answered. 4. Cap, rotate and invert the microtainer to mix the blood collected. C. all disposable equipment has been discarded properly Email is the #1 attack vector cybercriminals use to lure you into a malicious website. www.mlo-online.com is using a security service for protection against online attacks. Do not use the central portion of the heel because you might injure the underlying bone, which is close to the skin surface. Matt Garcia is an experienced phlebotomist in Vancouver, Canada. Not making it mobile friendly. You should always contact your doctor or other qualified healthcare professional before starting, changing, or stopping any kind of health treatment. -keep extremity below heart level for a few minutes. A variety of techniques can be employed to reduce pain and anxiety. There are some slight risks associated with venipuncture which may include excessive bleeding, feeling light-headed, fainting, nerve damage, hematoma (accumulation of blood under the skin), and infection. Do not use a previous puncture site. if ( prevIframeHeight != zf_ifrm_ht_nw ) { A. -hemorrhage/hematoma. (a) How would you prepare tetracaine from the corresponding aniline derivative, ArNH2_22? Additionally, a hematoma may compress the nerve and lead to long-term damage. When storing a blood specimen what temp should it be at 2-8 degrees c If a patient starts to seize during a draw what should you do Stop the draw When should you use a capillary instead of venipuncture A patients veins are inaccessible What can cause a hemolysis in a specimen Shaking a tube vigorously For example, Google offers SafeSearch that can block explicit search results like porn, and it works for all image and video searches, as well as news and general search content. Foot veins are a last resort because of the higher probability of complications. Penetrate the skin at a 30 to 45 angle at first (even less with a butterfly), then once you get a flash, reduce the angle by bringing the needle assembly down closer to the arm and advance the needle a tiny bit further into the vein. You should not perform this technique unless you are certain that the needle is in the immediate vicinity of the vein. A. If there is a concern regarding contamination by tissue fluids or thromboplastins, then one may draw a non-additive tube first, and then the light blue top tube. 3. If this is not successful, remove the needle, take care of the puncture site, and redraw. Proper patient identification procedures. An OSHA acceptable, puncture proof container markedBiohazardous. Let's take a quick, high-level look at the venipuncture procedure. Patient care following completion of venipuncture. Certain areas are to be avoided when choosing a site: Extensive scars from burns and surgery - it is difficult to puncture the scar tissue and obtain a specimen. What are the gold top containers used for? if ( zf_ifrm_data.length == 2 ) { When do you release the tourniquet during venipuncture? C. Scarring Avoid a probing, traumatic venipuncture. WHO guidelines on drawing blood: best practices in phlebotomy. Areas of fingers and heels that are cold, swollen, scarred or covered with a rash, should be avoided. Blood is collected into an attached vial or tube that is airtight and the flexible band is then removed from the arm. The service requires full cookie support in order to view this website. Palpate and trace the path of veins with the index finger. Needles - The gauge number indicates the bore size: the larger the gauge number, the smaller the needle bore. Examples of labeled collection tubes are shown below: THE FOLLOWING ARE NEEDED FOR ROUTINE VENIPUNCTURE: Evacuated Collection Tubes - The tubes are designed to fill with a predetermined volume of blood by vacuum. 11. Also consider adjusting the angle of the needle. Let's take a look at the types of websites you and your staff need to be wary of and how to avoid them. All other items used for the procedure must be disposed of according to properbiohazardous waste disposal policy. Avoid excessive pressure that may squeeze tissue fluid into the, mix the blood. Select the appropriate microtainers for the specimens to be collected. Identify the additive, additive function, volume, and specimen considerations to be followed for each of the various color coded tubes. Stress: May cause transient elevation in white blood cells (WBC's) and elevated adrenal hormone values (cortisol and catecholamines). Capillary puncture should not be used. If this is not successful, remove the needle, take care of the puncture site and redraw at another site. Adapted from Phlebotomy for Nurses and. The first step to choosing the right vein is to select the appropriate needle gauge. This makes every subsequent poke harder and harder because scar tissue is more fibrous and tougher to puncture. www.mlo-online.com is using a security service for protection against online attacks. When there is an IV line present, blood can be drawn from this line. Gas tubes (must warm the site before collecting the specimen), 4. 1. Do not obtain specimens from an arm having a cannula, fistula, or vascular graft. Hold a gauze pad over the puncture site for a couple of, minutes to stop the bleeding, and then tie gauze around the foot. When working with patients who have undergone a mastectomy, draw from the arm on the opposite side of the mastectomy to avoid edematous tissue. The diagram below indicates in green the proper area to use for heel punctures for blood collection: Prewarming the infant's heel (42 C for 3 to 5 minutes) is important to obtain capillary blood gas samples and warming also greatly increases the flow of blood for collection of other specimens. What caution should you observe when using a Vacutainer? D. Blue, Which of the following conditions should prevent a site from being selected for venipuncture? Position the patient so that the hand is easily accessible. What are the helpful hints for finding veins? Sites to avoid: Extensive scarring from burns or surgery The upper extremity on the side that a mastectomy was performed. Label all specimens per accepted guidelines. Syringes - may be used in place of the evacuated collection tube for special circumstances. Squeeze puncture site to promote bleeding. An assortment of needles and syringes of different sizes Tourniquet Alcohol and alcohol swabs Gauze or cotton balls Laboratory forms and blood-specimen labels Transportation bags and sharps container Step 2: Prepping The Patient Once you have the necessary supplies, it's time to ready the patient. While we are ranked among the best children's hospitals in the country, it's our compassionate approach to treatment that makes us truly exceptional. Cannula/fistula/heparin lock - hospitals have special policies regarding these devices. (See Use of Band-Aids in the Post Phlebotomy. f.style.height="352px"; containers. When finished, clean the site and apply pressure with a clean gauze to stop the bleeding. Within the antecubital fossa, this vein poses the least amount of risk. (function() { Pediatric Pointers. Center for Phlebotomy Education, Inc. Ernst, Dennis J. and Catherine Ernst. Hematoma - may cause erroneous test results. Do not add blood to a circle already filled orpartially filled with blood. Primary effect is hemoconcentration of non-filterable elements (i.e. A requisition form must accompany each sample submitted to the laboratory. It is an employer's responsibility to provide, clean, repair, replace, and/or dispose of personal protective equipment/clothing. Punctures to the posterior curvature of the heel cab cause damage to the bones. When would you use a butterfly/infustion set? 7. 9. How should you have the patient position their arm after the venipuncture is complete? 3. The needle may have pulled out of the vein when switching tubes. To enhance students careers, meet the needs of healthcare providers and improve patient care by providing high quality, cost effective phlebotomy education through industry leading curriculum, current technology and extensive hands on experience. Then the medical technician or phlebotomist will wrap a flexible band on the upper part of the arm to apply some pressure to that area making the vein enlarge with blood. Although the skill set and procedures may apply to both instances, this content is primarily aimed towards venous blood collection using evacuated tube systems (e.g. Avoid trauma and excessive probing. Lightly touch the microtainer capillary collectiondevice (or filter paper) to the LARGE drop of blood. Select the proper approved lancet: The BD Microtainer Contact-Activated. If superficial veins are not readily apparent, you can force blood into the vein by massaging the arm from wrist to elbow, tap the site with index and second finger, apply a warm, damp washcloth to the site for 5 minutes, or lower the extremity over the bedside to allow the veins to fill. Enzymes, proteins, lipids, iron, and calcium are significantly increased with changes in position. 6. Allow filter paper to air dry for two (2) hours at room temperature. Source of specimen. Filter paper should touch only the blood and not the heel or finger. Allow it to air, Grasp the foot, and using a sterile lancet, press firmly against the heel to, Collect the drops of blood into the collection device by gently squeezing, the foot. D. discarded in the trash, True or False? If the puncture is parallel to the lines of the fingerprint, theblood will not form as a drop but will run down the finger making collection difficult. Thrombosed veins lack resilience, feel cord-like, and roll easily. 8. 2. followed pre-lab instructions. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. Diagn Microbiol Infect Dis. Practice hygiene for the patient's protection. For a detailed breakdown of each step of the venipuncture test scroll down. Avoid prolonged tourniquet application or fist clenching. Holder/Adapter - use with the evacuated collection system. Never attempt venipuncture in an artery. Wipe away the first drop of blood with a piece of clean, dry cotton. 7. Phlebitis is inflammation of a vein. It is observed that if the tourniquet is left on longer than 2 minutes, changes in the value of a total protein test occur. 10. Move it forward (it may not be in the lumen). B. sterilized and reused Applyan adhesive bandage. Avoid placing sample onhot surfaces such as bili-lights or monitors. Procedures and Devices for the Collection of Diagnostic Capillary Blood. Phlebotomy is the practice of drawing blood from patients to gather data about their health. What are some of the reasons to draw blood? The recommended location for blood collection on a newborn baby or infant is the heel. Dispose of contaminated materials/supplies in designated containers. Apply an adhesive bandage. Erroneous test results may be obtained when the blood is not thoroughly mixed with the additive. 9. ; worn to protect the patient and the phlebotomist. Avoid excessive pressure that may squeeze tissue fluid into the drop of blood. Clean the site to be punctured with an alcohol sponge. Contains lithium heparin anticoagulant and a gel separator. (Uman et al, 2013). var f = document.createElement("iframe"); Alcohol not dry in the required amount of time B. Veins less prominent and less filling C. Veins more prominent and easier to puncture D. Blood stop flowing to arteries but not veins A The most common site (s) for the venipuncture procedure is/are the following: C. Iodine It brings the entire family For an inpatient the nursing staff can be contacted to aid in identification prior to proceeding. (c) How would you prepare tetracaine from benzene? A. Edema If the tech is not comfortable with any of the veins in the inside elbow area, they may choose a dorsal vein in the hand or, as a last resort, choose a vein in the foot. Ask the patient orcaregiver to state the patients name and date of birth. Compare and contrast the two major types of neuronal pathways. Never draw from a thrombosed or scarred vein. Do not place too tightly or leave on more than 2 minutes (and no more than a minute to avoid increasing risk for hemoconcentration). Potential source of test error, particularly from hemolysis, Most lines are flushed with a solution of heparin to reduce the risk of thrombosis, Discard a sample at least three times the volume of the line before a specimen is obtained for analysis. (See picture.) B. just after needle insertion, but prior to vacutainer activation diet, exercise, stress, basal state). HealthStar Press, Inc. 2001, updated 1/08. However, drawing blood from the hand is affiliated with higher levels of pain and less control. Identify the patient using two different identifiers, asking open ended questions such as, "What is your name?" Our students gain a vast amount of experience with phlebotomy vein sites through our hands-on and engaging curriculum and externship program. What is the procedure to draw blood from an arm with an IV in it? How to Troubleshoot a Difficult Venipuncture. Why? Collection tubes can vary in size for volume of blood drawn, appropriate to the tests ordered with sample size required, and vary in the kind of additive for anticoagulation, separation of plasma, or preservation of analyte. The blood is bright red (arterial) rather than venous. When multiple vials of blood are collected it can seem like a large amount. BD Eclipse green-capped) is used for most routine and uncomplicated venipunctures. Hold equipment firmly and place fingers against patient's arm, using the flange for leverage when withdrawing and inserting tubes. It is not as close to the skin surface as the median cubital and cephalic veins, which poses a greater risk of damage to the median nerve and brachial artery. The antecubital fossa is a collection of veins located within the arms inner area, opposite of the elbow, where the arm folds in. Lippi G, Salvagno GL, Montagnana M, Franchini M, Guidi GC. Remove the first glove so that it turns inside out during removal A phlebotomy technician is preparing to dispose of contaminated sharps. Stop the procedure if a hematoma occurs. When finished, elevate the heel, place a piece of clean, dry cotton on the puncture site, and hold it in place until the bleeding has stopped. Sign up for wikiHow's weekly email newsletter. NOTE: The use of post-exposure prophylaxis following blood exposure to HIV has shown effectiveness (about 79%) in preventing seroconversion. What is an Approved Phlebotomy School in California. C. Lancet var zf_ifrm_data = evntData.split("|"); Feel for the median cubital first, the cephalic vein second, and the basilic vein third. B. the needle is only partially in the vein When finished, clean the site and apply pressure with clean gauze to stop the bleeding. Safely dispose of potentially infectious materials. 5. Most reference ranges are based on normal laboratory test values for: Healthy people in a basal state. Assess the patient's physical disposition (i.e. Capillary Specimens may be used immediately for point-of-care testing. The first step to choosing the right vein is to select the appropriate needle gauge. The use of a tourniquet during a venipuncture procedure makes: A. World Health Organization. -cotton sponges This preliminary action allows you to safely adjust the needle's position. 5. Copyright 2023 - PhlebotomyU | Website Design & SEO by, Phlebotomy: 5 Tips on Finding Difficult Veins. The patient who is at ease will be less focused on the procedure. very small or difficult vein, Ch 46 Phlebotomy & Ch 47 Hematology (MULTIPLE, Chapter 47: Phlebotomy and Blood Collection, Positive and negative feedback & examples, Meds Vanessa doesn't need because she sleeps, Medical Terminology: Learning Through Practice, April Lynch, Jerome Kotecki, Karen Vail-Smith, Laura Bonazzoli. Green BD Eclipse black-capped) have a smaller diameter and may be more suitable for smaller veins. Arteries pulsate, are most elastic, and have a thick wall. -thrombosis var prevIframeHeight = iframe.style.height; Using a sterile lancet, make a skin puncture just off the center of the finger pad. therapy is usually associated with acidic or alkaline solutions or solutions that have a high osmolarity. https://www.ncbi.nlm.nih.gov/books/NBK138650/pdf/Bookshelf_NBK138650.pdf (Accessed June 13, 2022). prevent falls, should the patient lose consciousness. Needle disposal unit - needles should NEVER be broken, bent, or recapped. Fill the microtainer tube(s) as needed, adhering to the order of draw. Tetracaine is a substance used as a spinal anesthetic. What two things should you make sure you discuss with your patients prior to venipuncture? Fill the capillary tube(s) or micro collection device(s) as needed. This is very painful, risks damage to underlying structures, and widens the needle hole to prolong bleeding time. After the third attempt, further medical directions must be sought with the attending physician before proceeding. Effective communication - both verbal and nonverbal - is essential. Warning: Some phlebotomists use a method of anchoring called the "C-hold", in which the index finger pulls upwards superiorly while the thumb pulls downwards inferiorly. A. excessive probing with the needle D. 70% isopropyl alcohol. Change your approach when dealing with uncooperative patients, such as pediatrics and those with neurodevelopmental or psychiatric disorders. This image may not be used by other entities without the express written consent of wikiHow, Inc.
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