\u00a9 2023 wikiHow, Inc. All rights reserved. Patients who are dehydrated, obese, terminally ill, or hard sticks often get their blood drawn in other locations rather than the antecubital fossa. The most commonly used site for a venipuncture is at the bend of the elbow, also called the antecubital fossa 1. 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. (See Use of Band-Aids in the Post Phlebotomy. antecubital fossa What are the best veins for venipuncture? Procedures and Devices for the Collection of Diagnostic Capillary Blood. Cap, rotate and invert the microtainer to mix the blood collected. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. However, drawing blood from the hand is affiliated with higher levels of pain and less control. B. collection device Do not use the tip of the finger or the center of the finger. What are the helpful hints for finding veins? Warning: Make sure you are confident that the structure you're palpitating is indeed a vein. 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. 3. Procedure for Capillary Puncture of the Heel: A heel puncture is performed on the lateral or medial plantar surface of the, foot. 5. Never draw over scars or a new tattoo sites. Adjust the angle (the bevel may be against the vein wall). The median cubital vein and the cephalic vein in the wrist area should be avoided when possible. Wash hands in warm, running water with an appropriate hand washing product, or if notvisibly contaminated, with a commercial foaming hand wash product before and aftereach patient collection. Properly fill out appropriate requisition forms, indicating the test(s) ordered. Sometimes you may get initial blood flow, but then it stops when you change tubes. Blood clots, and the serum is separated by centrifugation, Chemistries, Immunology and Serology, Blood Bank (Crossmatch), Serum separator tube (SST) contains a gel at the bottom to separate blood from serum on centrifugation, Plasma Separating Tube (PST) with Lithium heparin, Anticoagulates with lithium heparin; Plasma is separated with PST gel at the bottom of the tube, Hematology (CBC) and Blood Bank (Crossmatch); requires. remove needle -laceration of vein Place blood collection equipment away from patients, especially children and psychiatric patients. Never attempt venipuncture in an artery. However, drawing blood from the hand is affiliated with higher levels of pain and less control. 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. Collect drops of blood into the collection device by gently massaging the finger. CLSI document H04-A6. PDF Selecting The Venipuncture Site - Yola Nursing Personnel. The use of a tourniquet during a venipuncture procedure makes: A. We use cookies to make wikiHow great. Areas of the body that look infected, scarred, or burned must also be avoided. The area of the arch should be avoided, as should the posterior, curvature of the heel; a puncture in these areas could cause injury to the, All babies in the neonatal unit must be warmed before performing a. puncture. -thrombosis Use a butterfly to compensate for patient movement. Notify your supervisor or patientsphysician if unsuccessful. A thin soap bubble of index of refraction 1.33 is viewed with light of wavelength 550.0 nm and appears very bright. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. Children, particularly under the age of 10, may experience pain and anxiety during the phlebotomy procedure. Povidone-iodine wipes/swabs - Used if blood culture is to be drawn. Last draw - additive tubes in this order: SST (red-gray or gold top). The vein may have collapsed; resecure the tourniquet to increase venous filling. Allsurfaces are cleaned daily with bleach. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. Needles are available for evacuated systems and for use with a syringe, single draw or butterfly system. Summarize the problems that may be encountered in accessing a vein, including the procedure to follow when a specimen is not obtained. Ernst, Dennis J. 5. var zf_ifrm_data = evntData.split("|"); Here phlebotomists will typically choose from three veins: the median cubital vein, the cephalic vein or the basilic vein. When there is an IV line present, blood can be drawn from this line. When the last tube to be drawn is filling, remove the tourniquet. Through a combination of revolutionary treatments and extraordinary patient experiences, our care does more than heal. But since each patient's medical condition varies, so does their veins. Thrombosed veins lack resilience, feel cord-like, and roll easily. Of course, the phlebotomist may understand this, however, the patient may not. Certain other sites should also be avoided. f.style.border="none"; try{ This article has been viewed 43,712 times. A. given to the patient Specimens; Approved StandardSixth Edition. D. mandates, The most common antiseptic used in venipuncture is: 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. Once you establish blood flow, slightly modify your hand position to stabilize the needle against the arm and prevent further movement. After assembling the appropriate equipment, follow the next steps to perform a proper venipuncture. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. What is the procedure to draw blood from an arm with an IV in it? A lab coat or gown must be worn during blood collection procedures. Label all specimens per accepted guidelines. Drawing blood from major vessels (e.g. -Vacutainer barrel Keep in mind that elderly patients often have fragile veins. 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. } Assess the need for sample recollection and/or rejection. Mix and label all appropriate tubes at the patient bedside. Interruptions and distractions during medical encounters and procedures should be avoided. 8. Allow to air dry. NOTE: The use of post-exposure prophylaxis following blood exposure to HIV has shown effectiveness (about 79%) in preventing seroconversion. 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. Hematoma formation is a problem in older patients. Anxiety that results in hyperventilation may cause acid-base imbalances, and increased lactate. This image may not be used by other entities without the express written consent of wikiHow, Inc.
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