\u00a9 2023 wikiHow, Inc. All rights reserved. Cochrane Database Syst Rev. f.style.height="352px"; This vein can be found along the upper arm to the thumb, but it is commonly drawn from the forearm or antecubital fossa area. https://www.osha.gov/laws-regs/standardinterpretations/2007-10-26 and https://www.osha.gov/OshDoc/data_BloodborneFacts/bbfact03.pdf (Accessed June 13, 2022). Press down on the gauze once the needle is out of the arm, applying adequate pressure to avoid formation of a hematoma. -obvious skin infection (including newly tattooed areas) -extensive scarring -don't use same side as mastectomy -avoid previous hematoma -avoid arm w/ fistula/cannula -edamtous extremity What is the most common site for blood sampling? Specimen Collection Procedure - PERFORMING A VENIPUNCTURE | Akron 7. 3. Perform the venipuncture, collecting the sample(s) in the appropriate container(s). Tip: Patients who need regular bloodwork (e.g. 5. Identify the patient. Dorsal hand veins are often utilized for intravenous infusions but are viable options for blood draw sites. 13 Websites to Avoid If You Value Your Time | PCMag The blood is normally drawn from a vein on the top of the hand or from the inside of the elbow. Foot veins are a last resort because of the higher probability of complications. Obtain from the practitioner complete and current information about diagnosis, treatment, and any known prognosis, in terms the patient can reasonably be expected to understand. 4. 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. The index finger can be calloused or sensitive and the little finger does not have enough tissue to prevent hitting the bone with the lancet. Re-anchor the vein. Avoid areas of hematoma. -use correct angle of needle insertion Do not use the tip of the finger or the center of the finger. -do not rapidly insert the needle. WHO guidelines on drawing blood: best practices in phlebotomy. Complications of venipuncture | How to avoid | Aimvein However, do not use too high a temperature warmer, because baby's skin is thin and susceptible to thermal injury. However, if there is no alternative and an arm with an IV line in place must be used for venipuncture, try to choose a site away from and below the location of the IV. Cannula/fistula/heparin lock - hospitals have special policies regarding these devices. The median cubital vein and the cephalic vein in the wrist area should be avoided when possible. 10. therapy is usually associated with acidic or alkaline solutions or solutions that have a high osmolarity. Other Factors: Age, gender, and pregnancy have an influence on laboratory testing. Make the cut across the heelprint lines so that a drop of blood can well up and not run down along the lines. Blood is commonly obtained from the median cubital vein on the anterior forearm. }, false); There are three phlebotomy vein sites located in the arm most utilized by medical professionals and three additional draw sites that are last resorts. Some individuals are afraid of needles, while others are frightened at the sight of blood. What is an Approved Phlebotomy School in California. apply pressure for at least 10 minutes. 1. Performing a Venipuncture on an Arm Containing an Intravenous Line - LabCE Venipuncture (sometimes referred to as venapuncture, venepuncture or even venu puncture) is the collection of blood from a vein which is usually done for laboratory testing. It is an employer's responsibility to provide, clean, repair, replace, and/or dispose of personal protective equipment/clothing. Safely discard potentially infectious materials. B. Yellow Various sizes are available. Our students gain a vast amount of experience with phlebotomy vein sites through our hands-on and engaging curriculum and externship program. Ernst, Dennis J. This article was co-authored by Matt Garcia. X=[Ar]4s23d5Y=[Ar]4s23d104p1Z=[Ar]4s23d104p6. A requisition form must accompany each sample submitted to the laboratory. How should you have the patient position their arm after the venipuncture is complete? 4. What are the gray top containers used for? Patients in these populations are often nervous and may flail their limbs. 9. Take enough time to assess the vein before beginning the venipuncture procedure. A scooping motion to collect blood and strong repetitive pressure (milking) MUST be avoided, as both procedures may result in hemolysis or tissue-fluid contamination fo the specimen. An example of a simple requisition form with the essential elements is shown below: A properly labeled sample is essential so that the results of the test match the patient. If possible, speak with the patient during the process. C. the seal is broken In some instances, the legs or feet are required for use, but a physician or doctor should be completing the draw, not a phlebotomist. Previous puncture sites should be avoided. A. in the region of a hematoma The use of a tourniquet during a venipuncture procedure makes: A. 3. Phlebotomy Essentials 5th Edition Chapter 9. 2019;95(1):15-19. doi: 10.1016/j.diagmicrobio.2019.04.001. www.mlo-online.com is using a security service for protection against online attacks. C. laws A. Syringe Never draw from a thrombosed or scarred vein. Scan the skin for lines of blue indicating a prominently visible vein. Do not use the central portion of the heel because you might injure the underlying bone, which is close to the skin surface. Cephalic vein. Common Venipuncture Sites | Healthfully wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. Stress: May cause transient elevation in white blood cells (WBC's) and elevated adrenal hormone values (cortisol and catecholamines). ; worn to protect the patient and the phlebotomist. Wipe away the first drop of blood, which tends to contain excess tissue fluid. www.mlo-online.com is using a security service for protection against online attacks. Phlebitis is inflammation of a vein. Capillary punctures are not suitable for blood culture testing and most coagulation tests. 8. Unlike the cephalic and basilic veins, the median cubital vein is not near major nerves or arteries. Allow to air dry. Always thank the patient and excuse yourself courteously when finished. A commercial heel warmer may be used. 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. As a phlebotomist, it is critical to know which vein sites offer stable flows for blood draws. Venipuncture Quiz Flashcards | Quizlet Never draw blood through a hematoma. This article has been viewed 43,712 times. Automated systems may include labels with bar codes. McCall, R. E., & Tankersley, C. M. (2016). If just a routine coagulation assay is the only test ordered, then a single light blue top tube may be drawn. Change your approach when dealing with uncooperative patients, such as pediatrics and those with neurodevelopmental or psychiatric disorders. B. the needle is inserted into the patient's arm Wipe away the first drop of blood with a piece of clean, dry cotton. Lightly touch the microtainer capillary collectiondevice (or filter paper) to the LARGE drop of blood. f.style.border="none"; Sharps Disposal Container. A warm compress or heel warmer should be used to warm, fingers and heels that are cold, or if a capillary blood gas is being drawn, to. This image may not be used by other entities without the express written consent of wikiHow, Inc.
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