Phlebotomy & Venipuncture

Product Description:

Phlebotomy & Venipuncture 

  

PHLEBOTOMY PROCEDURE ILLUSTRATED 

DIFFERENT TYPES OF COLLECTION TUBES FOR PHLEBOTOMY

Describe and perform the venipuncture process including:

Proper patient identification procedures.

Proper equipment selection and use.

Proper labeling procedures and completion of laboratory requisitions.

Order of draw for multiple tube phlebotomy.

Preferred venous access sites, and factors to consider in site selection, and ability to differentiate between the feel of a vein, tendon and artery.

Patient care following completion of venipuncture.

Safety and infection control procedures.

Quality assurance issues.

Identify the additive, additive function, volume, and specimen considerations to be followed for each of the various color coded tubes.

List six areas to be avoided when performing venipuncture and the reasons for the restrictions.

Summarize the problems that may be encountered in accessing a vein, including the procedure to follow when a specimen is not obtained.

List several effects of exercise, posture, and tourniquet application upon laboratory values.

 VENIPUNCTURE PROCEDURE

The venipuncture procedure is complex, requiring both knowledge and skill to perform. Each phlebotomist generally establishes a routine that is comfortable for her or him.

Several essential steps are required for every successful collection procedure:

1. Identify the patient.

2. Assess the patient's physical disposition (i.e. diet, exercise, stress, basal state).

3. Check the requisition form for requested tests, patient information, and any special requirements.

4. Select a suitable site for venipuncture.

5. Prepare the equipment, the patient and the puncture site.

6. Perform the venipuncture.

7. Collect the sample in the appropriate container.

8. Recognize complications associated with the phlebotomy procedure.

9. Assess the need for sample recollection and/or rejection.

10. Label the collection tubes at the bedside or drawing area.

11. Promptly send the specimens with the requisition to the laboratory.

LABELING THE SAMPLE

Automated systems may include labels with bar codes.

YOU WILL LEARN ABOUT YOUR EQUIPMENT:

Evacuated Collection Tubes - The tubes are designed to fill with a predetermined volume of blood by vacuum. The rubber stoppers are color coded according to the additive that the tube contains.

Various sizes are available. Blood should NEVER be poured from one tube to another since the tubes can have different additives or coatings (see illustrations at end).

Needles - The gauge number indicates the bore size: the larger the gauge number, the smaller the needle bore. Needles are available for evacuated systems and for use with a syringe, single draw or butterfly system.

Holder/Adapter - use with the evacuated collection system.

Tourniquet - Wipe off with alcohol and replace frequently.

Alcohol Wipes - 70% isopropyl alcohol.

Povidone-iodine wipes/swabs - Used if blood culture is to be drawn.

Gauze sponges - for application on the site from which the needle is withdrawn.

Adhesive bandages / tape - protects the venipuncture site after collection.

Needle disposal unit - needles should NEVER be broken, bent, or recapped. Needles should be placed in a proper disposal unit IMMEDIATELY after their use.

Gloves - can be made of latex, rubber, vinyl, etc.; worn to protect the patient and the phlebotomist.

Syringes - may be used in place of the evacuated collection tube for special circumstances.

ORDER OF DRAW

PROCEDURAL ISSUES

PATIENT'S BILL OF RIGHTS 

VENIPUNCTURE SITE SELECTION 

PROCEDURE FOR VEIN SELECTION 

PERFORMANCE OF A VENIPUNCTURE 

 

 A properly labeled sample is essential so that the results of the test match the patient. The key elements in labeling are:

Patient's surname, first and middle.

Patient's ID number.

NOTE: Both of the above MUST match the same on the requisition form.

Date, time and initials of the phlebotomist must be on the label of EACH tube.

THE FOLLOWING ARE NEEDED FOR ROUTINE VENIPUNCTURE:

Blood collection tubes must be drawn in a specific order to avoid cross-contamination of additives between tubes. The recommended order of draw for plastic vacutainer tubes is:

1. First - blood culture bottle or tube (yellow or yellow-black top)

2. Second - coagulation tube (light blue top). If just a routine coagulation assay is the only test ordered, then a single light blue top tube may be drawn. If there is a concern regarding

3. contamination by tissue fluids or thromboplastins, then one may draw a non-additive tube first, and then the light blue top tube.

4. Third - non-additive tube (red top)

5. Last draw - additive tubes in this order:

   1. SST (red-gray or gold top). Contains a gel separator and clot activator.

   2. Sodium heparin (dark green top)

   3. PST (light green top). Contains lithium heparin anticoagulant and a gel separator.

   4. EDTA (lavender top)

   5. ACDA or ACDB (pale yellow top). Contains acid citrate dextrose.

   6. Oxalate/fluoride (light gray top)

NOTE:Tubes with additives must be thoroughly mixed. Erroneous test results may be obtained when the blood is not thoroughly mixed with the additive.

 

PLUS SO MUCH MORE....

 

ALL VIDEO INSTRUCTION