what sites should be avoided when performing venipuncture quizlet

Failure to do this results in an unequal blood-to-additive ratio, making the specimen unsuitable for analysis. f.style.transition="all 0.5s ease"; Always thank the patient and excuse yourself courteously when finished. Phlebotomy is the practice of drawing blood from patients to gather data about their health. Am J Clin Pathol. What are the contraindications to venipuncture? B. precautions Through a combination of revolutionary treatments and extraordinary patient experiences, our care does more than heal. Try another tube. Precautions include a medical grade face mask. The creatine kinase (CK), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), and platelet count may increase. Fill the microtainer tube(s) as needed, adhering to the order of draw. Phlebotomy is not a one size fits all; each patient is different and may have their blood drawn at other sites with varying needle sizes. Unlike the cephalic and basilic veins, the median cubital vein is not near major nerves or arteries. 1. 2009;18(2):117-139. The median cubital creates, The dorsal venous network is the next most common vein site for phlebotomists. Northfield, IL: College of American, NCCLS. A clinical study is performed to determine the optimal time for application of the tourniquet during phlebotomy. Scan the skin for lines of blue indicating a prominently visible vein. Avoid drawing blood from a hematoma; select another draw site. Consult the nursing unit or your facility's resources prior to drawing from an IV or PICC line or performing venipuncture on an arm with an IV line in place. if ( zf_ifrm_data.length == 2 ) { Recognize complications associated with the phlebotomy procedure. 5. var zf_ifrm_data = evntData.split("|"); Other draw sites, particularly below the waist, are rarely used. 2. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. Transferring a sample from one collection tube to another or mixing blood from different collection tubes must be avoided. The Patient's Bill of Rights has been adopted by many hospitals as declared by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). 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. B. Yellow Concentrations of fluids and medications could affect baseline test results. CLSI document H04-A6. *NEVER BEND THE ARM*. Significant increases can be found in total protein, aspartate aminotransferase (AST), total lipids, cholesterol, iron, Affects packed cell volume and other cellular elements. NOTE:Tubes with additives must be thoroughly mixed. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. While hand veins may be utilized for blood draws and intravenous infusions, veins in the feet and legs should be avoided for adults. Adjust the angle (the bevel may be against the vein wall). Once you establish blood flow, slightly modify your hand position to stabilize the needle against the arm and prevent further movement. Proper Handling of an Uncooperative Patient in an Outpatient Setting Akron. -use correct angle of needle insertion Draw 5 ml of blood and discard before drawing the specimen tubes for testing. Avoid bruising the infants heel when obtainingblood. Collect the drops of blood into the collection device by gently massaging, Avoid excessive pressure that may squeeze tissue fluid into the drop of, When full, cap and then gently invert the collection device 5-10 times to, Hold a gauze pad over the puncture site for a short time to stop the, Dispose of the contaminated materials and lancet in the appropriate waste, Place a band-aid on the patients finger or have someone continue to hold, gauze on the finger. Compared to the standard blood donation which is about sixteen ounces, one ounce is really small. Avoid placing sample onhot surfaces such as bili-lights or monitors. Remove the first glove so that it turns inside out during removal A phlebotomy technician is preparing to dispose of contaminated sharps. Clean the site to be punctured with an alcohol sponge. Refuse treatment to the extent permitted by law. 2019;95(1):15-19. doi: 10.1016/j.diagmicrobio.2019.04.001. The recommended location for blood collection on a newborn baby or infant is the heel. Get instant access to our latest tools and our must-read site updates: What Certifications Are Used For Higher Pay For Phlebotomists? This information must be given when requesting microbiology, cytology, fluid analysis, or other testing where analysis and reporting is site specific. A. given to the patient } When 25.0 mL of 0.500 M H2S04 is added to 25.0 mL of 1.00 M KOH in a coffee-cup calorimeter at 23.50C23.50 ^ { \circ } \mathrm { C }23.50C the temperature rises to 30.17C30.17 ^ { \circ } \mathrm { C }30.17C . Allow it to air, Grasp the finger, and using a sterile lancet, press firmly against the finger. Ask the patient to lie on their back. A key element for successful venipuncture is choosing the best vein. Procedure for Capillary Puncture of the Finger: The best site for a finger puncture is just off the center of the finger pad of, the 3rd (middle) or 4th (ring) finger of the hand. What should you never do to a site you just cleansed with alcohol? In fact, many search engines provide the option to avoid dangerous sites by turning on a "safer" search. Holder/Adapter - use with the evacuated collection system. This image may not be used by other entities without the express written consent of wikiHow, Inc.
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\u00a9 2023 wikiHow, Inc. All rights reserved. Joslin JO. Subcutaneous tissue feels squishy and muscle feels hard. He previously worked in a high-volume outpatient lab and is currently employed in an acute care hospital and Level III trauma center in downtown Vancouver. catheter size for the vein, or prolonged use of the same I.V. The hydrostatic pressure causes some water and filterable elements to leave the extracellular space. 3. It may be, necessary, on occasion, to perform a capillary puncture on the toe of a patient, who is severely burned. If another site is not available, collect the specimen distal to the hematoma. Hyperextend the patient's arm. 11. Promptly send the specimens with the requisition to the laboratory. Wipe away the first drop of blood with sterile 22 gauze. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. Apply the tourniquet approximately 4-5 finger-widths above the planned venepuncture site. Place blood collection equipment away from patients, especially children and psychiatric patients. Apply an adhesive bandage. Patients in these populations are often nervous and may flail their limbs. Anxiety that results in hyperventilation may cause acid-base imbalances, and increased lactate. www.mlo-online.com is using a security service for protection against online attacks. Automated systems may include labels with bar codes. Reasonable informed participation in decisions involving the patient's health care. Verify the patient's condition. Have the patient position their arm on the armrest. HealthStar Press, Inc. 2001, updated 1/08. Effective communication - both verbal and nonverbal - is essential. Free Flashcards about Phlebotomy Chapter 9 - StudyStack Complications occurring from diagnostic venipuncture - PubMed If multiple blood samples are to be taken, the phlebotomist must be careful to follow the proper order of draw. (a) the electric power required. Sites to avoid: Extensive scarring from burns or surgery The upper extremity on the side that a mastectomy was performed. 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. What Is Venipuncture? Procedures, Risks & Fears - Phlebotomy Coach Do not obtain specimens from an arm having a cannula, fistula, or vascular graft. Several essential steps are required for every successful collection procedure: Patient comfort. jugular) or a central venous catheter is out of the scope of practice of a certified phlebotomist and should only be performed by a physician or advanced nurse. Be methodical in your search for a vein. Never attempt venipuncture in an artery. Which of the following actions should the technician take? What are the complications that can occur when performing a venipuncture? D. 70% isopropyl alcohol. containers. Warning: Make sure you are confident that the structure you're palpitating is indeed a vein. Check for timing instructions for drawing the appropriate samples. Dorsal hand veins are often utilized for intravenous infusions but are viable options for blood draw sites. doi: 10.1002/14651858.CD005179.pub3. Lippi G, Blanckaert N, Bonini P, Green S, Kitchen S, Palicka V, Vassault AJ, Mattiuzzi C, Plebani M. Causes, consequences, detection, and prevention of identification errors in laboratory diagnostics. If an inpatient is able to respond, ask for a full name and always check the armband or bracelet for confirmation. Is the seating comfortable and has the patient been seated for at least 5 minutes to avoid being rushed or confused? Povidone-iodine wipes/swabs - Used if blood culture is to be drawn. -obvious skin infection (including newly tattooed areas). (See, The chlorhexidine is a concern for the premature babies in NICU as it can, be absorbed through the skin. In this elbow pit, phlebotomists have easy access to the top three vein sites used in phlebotomy: The median cubital vein, also known as the antecubital vein, is the most common vein for phlebotomy. Primary effect is hemoconcentration of non-filterable elements (i.e. var d = document.getElementById("zf_div_SBGg-3DTNCwt65i9A6n_zU3SneyGD89SSqM_7F_nCas"); What equipment is needed for a venipuncture? 2011-2023 Phlebotomy Coach. Tip: If you realize you've collected in the wrong order of draw, remove the tube, insert the correct one, fill it halfway before discarding it, then insert a new tube and fill it completely. Contains acid citrate dextrose. This vein lies close to the surface of the skin and there is not a large nerve supply. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. Smaller collection tubes for sample sizes of 2 mL or less may be appropriate in situations where a smaller amount blood should be drawn, as in pediatric patients, or to minimize hemolysis during collection, or to avoid insufficient sample volume in the collection tube. 3. The thumb has a pulse and is likely to bleed excessively. 10. Allow another large drop of blood to form. Check for any allergies to antiseptics, adhesives, or latex by observing for armbands and/or by asking the patient. In the case of an accidental stick, immediately wash the area with an antibacterial soap,express blood from the wound, and contact your supervisor. 9. Use a smaller tube with less vacuum. The sides and the tip of the. PERFORMING A CAPILLARY PUNCTURE - Akron Children's Hospital Avoid puncturing a finger that is cold or cyanotic, swollen, scarred, or covered with a rash. INR for patients on warfarin) are often knowledgeable on the veins that are most likely to work. These may include listening to music or a story, watching a video, playing with a toy, having a parent provide distraction with talk or touch, using flash cards, and squeezing a rubber ball. What is the best position to perform venipuncture in? How far above a venipuncture sight should you place a tourniquet? The most commonly used site for a venipuncture is at the bend of the elbow, also called the antecubital fossa 1. A. Edema Dry the cleaned area with a dry cotton sponge. Other Factors: Age, gender, and pregnancy have an influence on laboratory testing. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. While the median cubital, cephalic, and basilic veins are the most popular draw sites for blood draws, phlebotomists may resort to other draw sites if their ability to draw is restricted. Label all specimens per accepted guidelines. How to Avoid Dangerous Websites - Lifewire Avoid excessive pressure that may squeeze tissue fluid into the, mix the blood. Wipe away the first drop of blood with sterile 22 gauze. What caution should you observe when using a Vacutainer? window.addEventListener('message', function (){ Adhesive bandages / tape - protects the venipuncture site after collection. outstretched or raised Apply the tourniquet below the IV site. While venipuncture is considered to be reasonably safe, the present study investigated the incidence of serious complications occurring in an outpatient setting. 2017;148(4):330-335. Using the smallest acceptable needle size can help reduce the risk of bleeding or hematoma .