what sites should be avoided when performing venipuncture quizlet

\u00a9 2023 wikiHow, Inc. All rights reserved. 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. A variety of techniques can be employed to reduce pain and anxiety. B. the needle is only partially in the vein Dispose of needles immediately upon removal from the patient's vein. with their hand to stabilize it for the draw. Do not attempt a capillary puncture more than twice. World Health Organization. (See Use of Band-Aids in the Post Phlebotomy. Focus on what you do best, and find someone who can help you communicate that with your target market. Consider three elements with the following abbreviated electron configurations: X=[Ar]4s23d5Y=[Ar]4s23d104p1Z=[Ar]4s23d104p6\mathrm{X} = \mathrm{[Ar]4s^23d^5}~~~\mathrm{Y}=\mathrm{[Ar]4s^23d^{10}4p^1}~~~\mathrm{Z}=\mathrm{[Ar]4s^23d^{10}4p^6} 8. 2011-2023 Phlebotomy Coach. f.style.height="352px"; You must check the timing of these variations for the desired collection point. var zf_perma = zf_ifrm_data[0]; -cotton sponges Choosing an appropriate site for venipuncture is crucial for a successful . As a countermeasure, phlebotomists anchor the vein with their hand to stabilize it for the draw. if ( prevIframeHeight != zf_ifrm_ht_nw ) { While venipuncture is considered to be reasonably safe, the present study investigated the incidence of serious complications occurring in an outpatient setting. Antiseptic. Am J Clin Pathol. var f = document.createElement("iframe"); Identify the patient. Sanders AM, Agger WA, Gray AM, Fischer CM, Kamprud EA. 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. C. all disposable equipment has been discarded properly BD Vacutainer), rather than IV catheter insertions. The performance of routine vascular access procedures by skilled phlebotomists requires, at a minimum, the use of gloves to prevent contact with blood. For the CLSI Updated Phlebotomy Procedures please click here. Feel for the median cubital first, the cephalic vein second, and the basilic vein third. (c) How would you prepare tetracaine from benzene? Guidelines established by the Clinical and Laboratory Standards Institute (CLSI) dictate that a phlebotomist shall not attempt a venipuncture more than two times, and a maximum of three attempts shall be undertaken on a patient. Needles - The gauge number indicates the bore size: the larger the gauge number, the smaller the needle bore. Deliver specimens promptly to the laboratory. When finished, clean the site and apply pressure with a clean gauze to stop the bleeding. Assess the patient's physical disposition (i.e. 12. 5. Fill the microtainer tube(s) as needed. Please enable cookies on your browser and try again. Various sizes are available. An artery has been punctured (characterized by bright red, pulsating blood), A nerve has been nicked (patient may complain of an electrical sensation up and down the limb), A hematoma starts to form (a bubble under the skin starts to rapidly appear at the site), The patient loses consciousness or starts seizing. The median cubital vein is used the most for its accessibility. Specimens; Approved StandardSixth Edition. We use cookies to make wikiHow great. Place blood collection equipment away from patients, especially children and psychiatric patients. After the third attempt, further medical directions must be sought with the attending physician before proceeding. Inadvertently nicking a nerve causes intense pain. Thrombosed veins lack resilience, feel cord-like, and roll easily. 2. D. all of the above, Common causes of hematomas that form during a venipuncture include: wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. Position the patient so that the hand is easily accessible. Over 52 percent of all web traffic is from mobile devices . 1. Using a sterile blood lancet, puncture the side of the heel in the appropriate regions shown above in green. To determine the best vein, use both sight and touch. B. just after needle insertion, but prior to vacutainer activation -test tubes This preliminary action allows you to safely adjust the needle's position. Be informed of the hospital rules and regulations regarding patient conduct. (See, The chlorhexidine is a concern for the premature babies in NICU as it can, be absorbed through the skin. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. Avoid bruising the infants heel when obtainingblood. Warm the heel from which blood is to be obtained. Nursing Personnel. wikiHow is where trusted research and expert knowledge come together. Press down on the gauze once the needle is out of the arm, applying adequate pressure to avoid formation of a hematoma. Clinical and Laboratory Standards Institute. 2. followed pre-lab instructions. A face mask reduces risk for blood culture specimen contamination. This is why a required skill for most phlebotomy jobs is to have excellent people skills with the ability to keep the patient calm during the venipuncture procedure. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. 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? Once again, please be aware that these are only guidelines for blood draws and nurses should consult with the appropriate hospital personnel regarding performing this procedure on patients. The sides and the tip of the. 4. 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. Have an assistant stabilize the arm by firmly locking the elbow joint. For an inpatient the nursing staff can be contacted to aid in identification prior to proceeding. Recommended order of collection for microtainer specimens: 7. Some examples of these include notices from banks, online retailers such as Amazon or eBay, and even . If possible, speak with the patient during the process. In general, blood should not be drawn from an arm with a fistula or cannula without consulting the attending physician. The service requires full cookie support in order to view this website. Most commonly, venipuncture will be performed on the Antecubital Fossa, or the inside of the elbow. Adhesive bandages / tape - protects the venipuncture site after collection. Verify the patient's condition. Compared to the standard blood donation which is about sixteen ounces, one ounce is really small. 1. If none of these veins work, then the phlebotomists use the hand veins. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. Lightly touch the microtainer capillary collection device (or filter paper) to the LARGE drop of blood. https://www.ncbi.nlm.nih.gov/books/NBK138650/pdf/Bookshelf_NBK138650.pdf (Accessed June 13, 2022). performing a capillary puncture is as follows: 1. However, blood samples that are normally taken are actually very small. Effective communication - both verbal and nonverbal - is essential. Grasp the patient's arm firmly using your thumb to draw the skin taut and anchor the vein. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. Stop the procedure and remove the needle if: Thanks to all authors for creating a page that has been read 43,712 times. 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. Phlebotomy Essentials 5th Edition Chapter 9. The blood is normally drawn from a vein on the top of the hand or from the inside of the elbow. When do you release the tourniquet during venipuncture? 3. 9. 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. Forward completed/dry collections to the laboratory as soon as possible. For example, serum cortisol levels are highest in early morning but are decreased in the afternoon. var d = document.getElementById("zf_div_SBGg-3DTNCwt65i9A6n_zU3SneyGD89SSqM_7F_nCas"); Drawing the patient in a reclined position. What are the contraindications to venipuncture? Switch to the other arm if you can't find anything. Position the patient's arm in a comfortable extended position that provides adequate access to the planned venepuncture site. Unlike the cephalic and basilic veins, the median cubital vein is not near major nerves or arteries. 9. A. given to the patient Clin Lab Med. The area where the blood is to be drawn from is first cleaned with a germ-killing solution. This complication of peripheral I.V. A government issued photo identification card such as a driver's license can aid in resolving identification issues. 3. Tip: BD Vacutainer tubes use a translucent stopper to identify short draw variants. Larger tube sizes typically provide for collection of samples from 6 to 10 mL. Do not bend, break, recap, or resheath needles to avoid accidental needle puncture or splashing of contents. If you stick yourself with a contaminated needle: Remove your gloves and dispose of them properly. This requisition form must contain the proper information in order to process the specimen. Proper Handling of an Uncooperative Patient in an Outpatient Setting Akron. Even if several vials of blood have to be drawn it usually amounts to no more than one ounce. Similarly, it's quite easy to get lost in a "Wikipedia wormhole." Indeed, Wikipedia's depth is infinite, as you link from subject to subject, never able to stop. 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). Concentrations of fluids and medications could affect baseline test results. Apply firm pressure for more than 5 minutes. Label all appropriate tubes at the patient bedside. A. Last draw - additive tubes in this order: SST (red-gray or gold top). Wipe away the first drop of blood, which tends to contain excess tissue fluid. 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. Dry the cleaned area with a dry cotton sponge. 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. Asking the patient about their previous blood draw experiences is beneficial, especially if they are a hard stick and know which area works best.

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