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Obtain and Label Blood Specimens

Obtain and Label Blood Specimens. Introduction. Venipuncture is a technique that permits access to a vein so that a needle or catheter can be inserted, usually to withdraw a blood specimen or initiate an intravenous infusion

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Obtain and Label Blood Specimens

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  1. Obtainand Label Blood Specimens

  2. Introduction • Venipuncture is a technique that permits access to a vein so that a needle or catheter can be inserted, usually to withdraw a blood specimen or initiate an intravenous infusion • Venipuncture is a sterile procedure since the integrity of the skin is broken

  3. Terms and Definitions • Venipuncture • Palpate • Antecubital fossa • Anticoagulant • Hematoma

  4. Antecubital Area Vessels Cephalic Vein Median Cubital Vein Basilic Vein Veins Used for Drawing Blood

  5. Venipuncture Procedure • Universal precautions - hand wash & gloves • Strict adherence to the sharps policy • Verify the request to obtain specimen • Check the physician's orders • Select the proper specimen tube/s • Prepare label(s) • Perform a patient care hand wash/don gloves

  6. Stamp Label With Patient’s Addresograph Plate 20 000-00-0000 DP 210-221-4450 A1401TMC GAVIN, JAMES 07DEC55 M USA AD ENL SFC HHC 2/505th PIR TMC-OUTPATIENT RECORDS, FBNC

  7. Gather Equipment • Constricting band • Vacutainer holder or Syringe • Sterile disposable double-ended needle or Butterfly or Hypodermic needle • Betadine or alcohol wipe or sponge • Protective pad (chux) • Sterile 2 x 2-inch gauze sponge(s) • Band-Aid

  8. Venipuncture Equipment

  9. Assemble Holder & Needle • Put short end of needle into threaded hole in vacutainer holder • Screw tightly using clockwise motion

  10. Insert the Tube into the Holder • Insert stoppered end of the tube into holder • Do not push tube beyond the guideline • Inspect the needle for barbs, corrosion

  11. Identify Patient • Explain the procedure and purpose • Ask patient about allergies (i.e., iodine or alcohol). • Position the patient - sitting or lying • Never draw blood from a standing patient. • Position protective pad

  12. Apply Constricting Band • Apply with enough pressure to stop venous return • A radial pulse should be felt • Place latex tubing around limb about 2 inches above venipuncture site • If a commercial band is used, wrap it around limb and secure by overlapping velcro ends

  13. Apply Constricting Band • Instruct patient to clench and unclench his fist several times to trap blood and distend veins • Avoid veins that are infected, injured, irritated, or have an IV running distally.

  14. Palpate Selected Vein • Palpate along length of vein with index finger • Vein should have a spongy feel • Clean the skin • Do not re-palpate the vein after cleansing the skin.

  15. Prepare the Puncture Site • Cleanse area with betadine or alcohol using a circular motion • Do not touch the area once cleansed

  16. Prepare to Puncture the Vein • Remove protective cover from needle • Position needle in line with vein and grasp patient's arm below entry point with free hand • Place thumb of free hand 1 inch below entry site and pull skin taut toward hand

  17. 15 ° to 30 ° Puncture the Vein • Align needle bevel up • Pierce skin at a 15° to 30 ° angle • Decrease angle until parallel to skin surface, then pierce vein • If needle is withdrawn above skin surface, do not attempt venipuncture again with the same needle

  18. Puncture Vein • If unsuccessful • Release the constricting band • Place 2 x 2 gauze sponge over site • Quickly withdraw the needle and instruct the patient to elevate arm slightly and keeping the arm fully extended apply pressure to the site for 2 to 3 minutes. • Notify supervisor before attempting another venipuncture

  19. Single Tube Collections • When the tube is nearly full release the tourniquet • Remove the tube from the holder • DO NOT withdraw the needle before the constricting band is released

  20. Multiple Tube Collections • When the Tube Stops Filling Pull It Out of the holder • After the last tube stops filling remove from the holder • Release the tourniquet • DO NOT withdraw the needle before the tourniquet is released

  21. Complete the Procedure • Place 2 x 2 sponge over venipuncture site • Withdraw the needle smoothly and quickly • Immediately apply pressure to the site • Have patient elevate arm and apply pressure to site

  22. Complete the Procedure • If tube contains an anticoagulant or other additive, gently invert tube several times to mix with blood • Apply a Band-Aid to the venipuncture site • DO NOT unscrew needle from sleeve with hands • DO NOT recap needle • Dispose of needle into sharps

  23. Patient Comfort and Safety • Remove protective pad • Roll down patient's sleeve • If patient is in bed reposition and raise side rails • Remove all the equipment from area • Dispose of used supplies • Store reusable equipment and dispose of needle IAW local sharps SOP • Remove gloves and wash hands

  24. Dispose of the Needle in a Sharps Container

  25. Administrative Duties • Check and complete laboratory form IAW local SOP • Apply prepared label(s) • Document procedure IAW local SOP

  26. Summary • If venipuncture is done smoothly and properly, there should be little pain for the patient and little risk to medical personnel • The procedural steps are designed to ensure a properly drawn specimen • With practice, obtaining a blood specimen can become a smooth routine

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