what sites should be avoided when performing venipuncture quizlet

\u00a9 2023 wikiHow, Inc. All rights reserved. Avoid areas of hematoma. C. sterile gauze pads Needles should be placed in a proper disposal unit IMMEDIATELY after their use. Never draw from a thrombosed or scarred vein. Tourniquet - Wipe off with alcohol and replace frequently. BD Eclipse black-capped) have a smaller diameter and may be more suitable for smaller veins. Filter paper should touch only the blood and not the heel or finger. Never attempt venipuncture in an artery. Avoid excessive probing ("fishing"). 4. Through a combination of revolutionary treatments and extraordinary patient experiences, our care does more than heal. Focus on what you do best, and find someone who can help you communicate that with your target market. 2011-2023 Phlebotomy Coach. Label all appropriate tubes at the patient bedside. Re-secure the tourniquet to increase venous filling. 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. 4. Located in the antecubital fossa, the median cubital vein is a well anchored, stable vein that rarely rolls during venipuncture. Dispose of contaminated materials in appropriate waste receptacles. However, if there is no alternative and an arm with an IV line in place must be used for venipuncture, try to choose a site away from and below the location of the IV. Make the cut across the heelprint lines so that a drop of blood can well up and not run down along the lines. After assembling the appropriate equipment, follow the next steps to perform a proper venipuncture. Clinical and Laboratory Standards Institute. C. Iodine Venipuncture can also happen when patients have intravenous (IV) lines started. Proper Handling of an Uncooperative Patient in an Outpatient Setting Akron. For example, serum cortisol levels are highest in early morning but are decreased in the afternoon. Ernst, Dennis J. together for emotional support and understanding across multiple locations to reach you in the community where you live. Position the patient. antecubital fossa What are the best veins for venipuncture? Phlebitis can also occur as a result of vein trauma during insertion, use of an inappropriate I.V. 2009;18(2):117-139. apply pressure for at least 10 minutes. 2. Follow the procedure as outlined above for greeting and identifying the patient. Phlebotomy is the practice of drawing blood from patients to gather data about their health. Needle disposal unit - needles should NEVER be broken, bent, or recapped. When using a syringe avoid drawing the plunger back too forcefully. If blood is not obtained, change the position of the needle carefully by moving it forward or backward. 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. -use correct angle of needle insertion The patient should make a fist without pumping the hand. 6. While the median cubital, cephalic, and basilic veins are the most popular draw sites for blood draws, phlebotomists may resort to other draw sites if their ability to draw is restricted. -tourniquet Mix and label all appropriate tubes at the patient bedside. Phlebitis is inflammation of a vein. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. Dispose of needles immediately upon removal from the patient's vein. Label the collection tubes at the bedside or drawing area. (a) How would you prepare tetracaine from the corresponding aniline derivative, ArNH2_22? var zf_perma = zf_ifrm_data[0]; What are the complications that can occur when performing a venipuncture? 10. A. Syringe The sides and the tip of the. d.appendChild(f); Avoid excessive pressure that may squeeze tissue fluid into the drop of blood. Previous puncture sites should be avoided. When finished, elevate the heel, place a piece of clean, dry cotton on the puncture site, and hold it in place until the bleeding has stopped. As a countermeasure, phlebotomists. Finally, when the necessary blood is collected, the needle will be removed and properly disposed of in a Sharps container and the puncture site will be covered to stop the bleeding. Label the specimens before leaving the patients bedside. Place labeled specimens in zip lock bag and deliver to the laboratory as soon as possible. Areas of fingers and heels that are cold, swollen, scarred or covered with a rash, should be avoided. D. all of the above, Common causes of hematomas that form during a venipuncture include: Certain other sites should also be avoided. Airborne precautions may be considered to provide a level of safety against infectious diseases such as tuberculosis, influenza, and COVID-19. 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. In other words, there is no need for another venipuncture procedure. Cleanse the heel with alcohol prep, then dry with a sterile 22 as alcohol can influence testresults. Pre-warm the region of the vein to reduce vasoconstriction and increase blood flow. Patients in these populations are often nervous and may flail their limbs. 3. 23-gauge needles (e.g. var prevIframeHeight = iframe.style.height; C. at a mastectomy site Do not use excessive pressure or heavy massaging because the blood may become diluted with tissue fluid. IF AN INCOMPLETE COLLECTION OR NO BLOOD IS OBTAINED: Change the position of the needle. Factitious biochemical measurements resulting from hematologic conditions. Capillary specimens are collected in microtainers with colored caps that are used to. World Health Organization. The basic patient rights endorsed by the JCAHO follow in condensed form are given below. D. All of the above, Needles are sterile until: What caution should you observe when using a Vacutainer? The patient has the right to refuse participation in such activity. Coagulation tests (protime and prothrombin time), Tube is designed to contain no contaminating metals, Trace element testing (zinc, copper, lead, mercury) and toxicology, Antiglycolytic agent preserves glucose up to 5 days, HLA tissue typing, paternity testing, DNA studies, Inactivates thrombin and thromboplastin; contains virtually no lead. Contains acid citrate dextrose. B. the insertion site has stopped bleeding Prepare the equipment, the patient and the puncture site. While most patients veins are compatible with a standard needle gauge, others require a butterfly needle. Safely dispose of potentially infectious materials. Cannula/fistula/heparin lock - hospitals have special policies regarding these devices. However, drawing blood from the hand is affiliated with higher levels of pain and less control. What is the most common site for blood sampling? Using a sterile lancet, make a skin puncture just off the center of the finger pad. Stress: May cause transient elevation in white blood cells (WBC's) and elevated adrenal hormone values (cortisol and catecholamines). Procedure for Capillary Puncture of the Heel: A heel puncture is performed on the lateral or medial plantar surface of the, foot. 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. The creatine kinase (CK), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), and platelet count may increase. Once you establish blood flow, slightly modify your hand position to stabilize the needle against the arm and prevent further movement. 2. followed pre-lab instructions. ; worn to protect the patient and the phlebotomist. A variety of techniques can be employed to reduce pain and anxiety. The first attempt is the antecubital fossa area, starting with the median cubital vein, then the cephalic vein, and the basilic vein. Also found in the antecubital fossa, the basilic vein serves as a last resort for blood draws. Some images used in this set are licensed under the Creative Commons through Flickr.com.Click to see the original works with their full license. A commercial heel warmer may be used. If superficial veins are not readily apparent, you can force blood into the vein by massaging the arm from wrist to elbow, tap the site with index and second finger, apply a warm, damp washcloth to the site for 5 minutes, or lower the extremity over the bedside to allow the veins to fill. catheter size for the vein, or prolonged use of the same I.V. You should not perform this technique unless you are certain that the needle is in the immediate vicinity of the vein. B. Betadine A test that has been ordered may be cancelled due to problems unrelated to drawing the specimen, and these are the most common causes for cancellations: A test may be cancelled due to a technical problem in the specimen collection process: Identification of the specimen is suspect. Wipe away the first drop of blood with a piece of clean, dry cotton. Background: Venipuncture is the most common invasive medical procedure performed by health care providers. Forward completed/dry collections to the laboratory as soon as possible. Keep in mind that elderly patients often have fragile veins. Extremity is edematous. Back the needle out until the bevel is just below the skin. var zf_ifrm_ht_nw = ( parseInt(zf_ifrm_data[1], 10) + 15 ) + "px"; Consult the nursing unit or your facility's resources prior to drawing from an IV or PICC line or performing venipuncture on an arm with an IV line in place. 2006;52(5-6):217-30. The first step to choosing the right vein is to select the appropriate needle gauge. The recommended location for blood collection on a newborn baby or infant is the heel. Sanders AM, Agger WA, Gray AM, Fischer CM, Kamprud EA. Asking the patient about their previous blood draw experiences is beneficial, especially if they are a hard stick and know which area works best. -obvious skin infection (including newly tattooed areas). Hard and dense structures may be nerves or tendons. 7. Position the infant with the head slightly elevated. You will be redirected once the validation is complete. 6. B. sterilized and reused PST (light green top). doi: 10.1002/14651858.CD005179.pub3. Enzymes, proteins, lipids, iron, and calcium are significantly increased with changes in position. Cap, rotate and invert the microtainer to mix the blood collected. if ( (iframe.src).indexOf('formperma') > 0 && (iframe.src).indexOf(zf_perma) > 0 ) { Previous puncture sites should be avoided. Avoid bruising the infant's heel when obtaining blood. A requisition form must accompany each sample submitted to the laboratory. Begin by selecting the proper, approved lancet, such as: BD Microtainer Quikheel Lancet, 2.5 mm for full-term babies (green), BD Microtainer Quickheel Preemie Lancet, 1.75 mm for neonatal, Unistick2 Neonatal 18G, 1.2mm Lancet for neonatal babies less than, Prepare the heel by cleaning it with a Chlorhexadine wipe. The upper extremity on the side of a previous mastectomy - test results may be affected because of lymphedema. Have an assistant stabilize the arm by firmly locking the elbow joint. Nursing Personnel. 10. Have the patient hold a small gauze pad over the puncture site for a couple of minutes to stop the bleeding. var d = document.getElementById("zf_div_SBGg-3DTNCwt65i9A6n_zU3SneyGD89SSqM_7F_nCas"); This vein lies close to the surface of the skin and there is not a large nerve supply. C. After all specimens have been collected The upper extremity on the side of a previous mastectomy - test results may be affected because of lymphedema. Summarize the problems that may be encountered in accessing a vein, including the procedure to follow when a specimen is not obtained. 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. Hematoma - may cause erroneous test results. If the patient is sitting in a phlebotomy chair, make sure they are sitting upright with their back against the chair. Our courses are designed to provide students with the skills and knowledge necessary to work in a variety of medical settings including: Hospitals, Clinical Laboratories, Clinics, Physicians Offices, Blood Banks and much more. The fluid may dilute the specimen, so collect from the opposite arm. Avoid excessive pressure that may squeeze tissue fluidinto the drop of blood. Label the specimens before leaving the patients bedside. })(); The cephalic vein is a safe secondary option if the median cubital vein is not working. -use a smaller gauge needle 9. By holding the needle either by the plastic wings or the hub, phlebotomists can achieve a shallower angle, typically 10-15 degrees. 1. This image may not be used by other entities without the express written consent of wikiHow, Inc.
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