what sites should be avoided when performing venipuncture quizlet

wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. A face mask reduces risk for blood culture specimen contamination. Finger - Usually the third or fourth finger is preferred in adults and children. Any attempt to repeat a puncture at the same site increases the risk of complications. Get instant access to our latest tools and our must-read site updates: What Certifications Are Used For Higher Pay For Phlebotomists? 12. 5 Common Capillary Puncture Blood Collection Sites - Neoteryx 7. Contaminated surfaces must be cleaned with freshly prepared 10% bleach solution. Mix and label all appropriate tubes at the patient bedside. Use pillows or foam wedges to elevate the arm and help with extension. Press down on the gauze once the needle is out of the arm, applying adequate pressure to avoid formation of a hematoma. The first step to choosing the right vein is to select the appropriate needle gauge. Wayne, PA: Clinical and Laboratory Standards Institute; 2008. Make sure the venipuncture site is dry. As part of presenting a professional appearance, an institutional dress code may include wearing of a laboratory coat or smock. It is not uncommon for adults and children to feel some fear when having blood drawn, which is why any discussion of venipuncture should at least bring this topic to focus. Capillary specimens are collected in microtainers with colored caps that are used to. Always thank the patient and excuse yourself courteously when finished. Erroneous test results may be obtained when the blood is not thoroughly mixed with the additive. The fluid may dilute the specimen, so collect from the opposite arm. The phlebotomist's role requires a professional, courteous, and understanding manner in all contacts with the patient. The creatine kinase (CK), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), and platelet count may increase. 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. } Hemoconcentration: An increased concentration of larger molecules and formed elements in the blood may be due to several factors: Prolonged tourniquet application (no more than 1 minute). What are the gold top containers used for? Do not attempt a capillary puncture more than twice. Venipuncture can also happen when patients have intravenous (IV) lines started. 2. Gauze sponges - for application on the site from which the needle is withdrawn. BD Eclipse green-capped) is used for most routine and uncomplicated venipunctures. 1. 9. Include your email address to get a message when this question is answered. Lightly touch the microtainer capillary collectiondevice (or filter paper) to the LARGE drop of blood. 2009;47(2):143-53. Clin Chem Lab Med. Preanalytical phase of the testing process begins for the laboratory when a: Test is ordered by a patient's physician. If a patient has an IV giving them fluids in their right arm which arm should be your first choice to draw blood out of? proteins). (c) the rate of heat transfer. This information must match therequisition. D. all of the above, Common causes of hematomas that form during a venipuncture include: Hemolysis may occur, with pseudohyperkalemia. Using the smallest acceptable needle size can help reduce the risk of bleeding or hematoma . var iframe = document.getElementById("zf_div_SBGg-3DTNCwt65i9A6n_zU3SneyGD89SSqM_7F_nCas").getElementsByTagName("iframe")[0]; The blood is bright red (arterial) rather than venous. Sanders AM, Agger WA, Gray AM, Fischer CM, Kamprud EA. While most patients veins are compatible with a standard needle gauge, others require a. . 5. This is a general guide for troubleshooting a venipuncture scenario in which blood flow is not initially established upon needle insertion. -use a smaller gauge needle D. all of the above, Julie S Snyder, Linda Lilley, Shelly Collins, Zoology Chapter 16 & 17: Invertebrate Deutero. Complications occurring from diagnostic venipuncture - PubMed Butterflies are incredibly valuable tools for tackling difficult draws, owing to their precision, shorter shaft length, and maneuverability. Any microtainerscontaining additives should be tapped to dislodge additives from the walls and top. If it is then heated, what can you say about: b) how often the molecules hit the walls of the can. 7. Apply firm pressure. var d = document.getElementById("zf_div_SBGg-3DTNCwt65i9A6n_zU3SneyGD89SSqM_7F_nCas"); C. the needle has penetrated all the way through the vein A variety of techniques can be employed to reduce pain and anxiety. Be careful not to withdraw the needle completely or else you risk losing the tube's vacuum and starting a hematoma when the bevel exits the skin. -keep extremity below heart level for a few minutes. 10. PROBLEMS OTHER THAN AN INCOMPLETE COLLECTION: A hematoma forms under the skin adjacent to the puncture site - release the tourniquet immediately and withdraw the needle. The blood is normally drawn from a vein on the top of the hand or from the inside of the elbow. Drawing blood from major vessels (e.g. When finished, clean the site and apply pressure with clean gauze to stop the bleeding. 4. By using our site, you agree to our. Venepuncture Procedure - OSCE | How to Take Blood | Geeky Medics There are three phlebotomy vein sites located in the arm most utilized by medical professionals and three additional draw sites that are last resorts. Unlike the cephalic and basilic veins, the median cubital vein is not near major nerves or arteries. To prevent hemolysis when performing a venipuncture, the phlebotomist should: 1. The basic patient rights endorsed by the JCAHO follow in condensed form are given below. var zf_ifrm_ht_nw = ( parseInt(zf_ifrm_data[1], 10) + 15 ) + "px"; A commercial heel warmer may be used. Proper patient identification MANDATORY. Serum iron levels tend to drop during the day. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. In fact, many search engines provide the option to avoid dangerous sites by turning on a "safer" search. Choosing an appropriate site for venipuncture is crucial for a successful . Regardless of the source of payment, request and receive an itemized and detailed explanation of the total bill for services rendered in the hospital. Each time a vein is accessed with a needle, scar tissue forms as part of the body's healing process. 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. Many drugs will have "peak" and "trough" levels that vary according to dosage levels and intervals. ROUTINE CAPILLARY PUNCTURE BLOOD COLLECTION GUIDELINES. When wearing gloves, change them between each patient and wash your hands frequently. Venipuncture requires good skills in order to perform the procedure not only correctly, but also painlessly. Wipe away the first drop of blood with a sterile 22 gauze. Step 3: Venipuncture. 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. Capillary Specimens may be used immediately for point-of-care testing. Swiftly insert the needle through the skin and into the lumen of the vein. Because of contacts with sick patients and their specimens, it is important to follow safety and infection control procedures. A. just prior to needle insertion wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. Edematous extremities - tissue fluid accumulation alters test results. 12. All of the following are common types of equipment used for venipuncture EXCEPT: However, drawing blood from the hand is affiliated with higher levels of pain and less control. Prepare the patient's arm using an alcohol prep. Elderly patients often have fragile skin and veins that roll quite easily, When a vein rolls, the needle tends to push the vein aside rather than penetrating through. When would you use a butterfly/infustion set? Allow filter paper to air dry for two (2) hours at room temperature. What should you never do to a site you just cleansed with alcohol? PhlebotomyU offers Certified Phlebotomy Technician (CPT I) courses for aspiring phlebotomists. Track marks are not only found on IV drug users, but also on chronically ill patients requiring repeated vascular access and blood draws and may be a sign of an anticipated difficult draw. If another site is not available, collect the specimen distal to the hematoma. Precautions include a medical grade face mask. This image may not be used by other entities without the express written consent of wikiHow, Inc.
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