(5) Prepare Patient And I Vital Restrictions 3. Apply the tourniquet and select the venipuncture site. Be sure not to touch the venipuncture site or you will need to repeat the cleaning process. Exposure to latex can trigger a life-threatening reaction in those allergic to it, so it is vital that no latex items be used on a latex sensitive patient or even brought into the room. Fill, remove, and mix tubes in order of draw. Label the tube with the patient’s particulars. Correct ID is vital to patient safety and meaningful test results. You attach the needle device to the tube holder, insert the needle into the vein, and engage the tube. [1] Syringe Venipuncture Procedure 246 Syringe Venipuncture Procedure 252 . 5. Gloves must be removed in an aseptic manner and hands washed or decontaminated with hand sanitizer as an infection control precaution. The evacuated tube system (ETS) is the standard equipment used for routine venipuncture. A clenched fist makes the veins easier to see and feel and helps keep them from rolling. In medicine, venipuncture or venepuncture is the process of obtaining intravenous access for the purpose of venous blood sampling or intravenous therapy. Question: Chat 259 152 Unit Blood Collection Procedures SKILLS DRILL 8-3: ROUTINE ETS VENIPUNCTURE (Text Procedure 3-2) Pin In The Banks With The Missing Information Steps 1. Review And (1) Request Th Le Ar 2. Perform venipuncture using the following steps: Place your thumb BELOW the venipuncture site to anchor the vein. Proper positioning is important to patient comfort and venipuncture success. NEW! It consists of a needle device, a tube holder, and an air-evacuated tube. Unfortunately, it also shows how many of these procedures can go wrong. Review and accession test request. The fist aids needle entry. PROCEDURE Routine ETS Venipuncture Step Explanation/Rationale 1. Review and accession test request. Blood Culture: Demonstrate proper procedure for blood culture collection. (See PHL-1) 3. If bleeding has stopped, apply bandage and advise the patient to keep it in place for at least 15 minutes. • Venipuncture – The process of collecting or “drawing”blood from a vein – Covered in this chapter: • How to correctly identify all types of patients • How to safely obtain high-quality blood specimens • Venipuncture procedures: ETS, butterfly, & syringe procedures on arm & hand veins 4). According to OSHA, the needle and the tube holder must go into the sharps container as a unit because removing a needle from a holder exposes the user to sharps injury. Drawing blood, while routine, is a learned skill. The accession process records the request and assigns it a unique number used to identify the specimen and related processes and paperwork. The right approach for a successful patient encounter, includes a professional bedside manner, being, organized and efficient, and looking for signs that, convey important inpatient information or infection-, Correct ID is vital to patient safety and meaningful, test results. In such cases, consult a physician or nurse before proceeding. Clean and air-dry site. Labeled tubes. Follow facility protocol. Venipuncture/ETS method: Demonstrate proper procedure for venipuncture using the evacuated tube system (ETS) method. Please ensure you have the most up-to-date copy at all times. To avoid mislabeling errors, label tubes before leaving the bedside or dismissing the patient. Prepare equipment. Reapply tourniquet, uncap and inspect needle. You may undergo this procedure as part of the observation or diagnosis of a wide range of medical conditions. New photos . Check patient's arm and apply bandage. See “Collection Notes” 1 at the end of the procedure if 2 sets of blood cultures are ordered. assure free motion. Prepare the accession order. Grasp the holder's flanges with your middle and index fingers, pulling back slightly to keep the holder from moving, and push the tube into the needle with your thumb. Prepare the equipment, the patient and the puncture site. Apply the This preview shows page 4 - 6 out of 6 pages. Tourniquet; gloves; antiseptic prep pad; ETS needle*, tube holder* and tubes; gauze pads; sharps container; permanent ink pen; bandage. Approach. Have The Patient Near The It Slightly To Help Keep It From Fill In The Blanks With The Missing Information 1. Venipuncture Video of a venipuncture. Place gauze, remove needle, activate safety feature, and apply pressure. 2. Attaching needle to the ETS holder, put the first tube in the holder now, or wait until after needle entry. When drawing a blood specimen, the trained phlebotomist must: 1). New photos . 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. Step 3. In medicine, venipuncture or venepuncture is the process of obtaining intravenous access for the purpose of intravenous therapy or for blood sampling of venous blood.In healthcare, this procedure is performed by medical laboratory scientists, medical practitioners, some EMTs, paramedics, phlebotomists, dialysis technicians, and other nursing staff. Follow the CLSI order of draw to prevent additive carryover between tubes. Note: Either the needle or tube holder must have a safety feature to prevent needle sticks. Transport specimen to the lab. Releasing the tourniquet and opening the fist helps prevent hemoconcentration. Test results can be meaningless or misinterpreted and patient care compromised if diet requirements have not been met. Letting the site dry naturally permits maximum antiseptic action, prevents contamination caused by wiping, and avoids stinging on needle entry and specimen hemolysis from residual alcohol. Step 1. If bleeding persists beyond 5 minutes, notify the patient's nurse or physician. Syringe Venipuncture: Demonstrate proper procedure for needle and syringe venipuncture. 2. Thank the patient, remove gloves, and sanitize hands. Question: Uallit Blood Collection Procedures The Following Are Highlights From The Procedure For Venipuncture Of A Hand Vein Using A Butterfly And ETS Holder SKILLS DRILL 8-5: HIGHLIGHTS OF HAND VENIPUNCTURE PROCEDURE (Text Procedure 8-3) Or Armrest. Approach, greet and properly identify the patient. Place your thumb 1- to 2-inches below and slightly beside the vein and pull the skin toward the wrist. Sanitize hands. Put tourniquet on the patient about 3-4’ above the venipuncture site. This chapter also addresses challenges and unique issues associated with pediatric, geriatric, dialysis, long-term care, home care, and hospice patients. Warn the patient, line the needle up with the vein, and inserted into the skin using a smooth forward motion. Select vein, release tourniquet, and ask patient to open fist. D. 8-2 Routine ETS Venipuncture Procedure* E. 8-3 Venipuncture of a Hand Vein Using a Butterfly and ETS Holder Procedure* F. 8-4 Needle-and-Syringe Venipuncture Procedure* G. 9-1 Performing Venipuncture Below an IV Procedure H. 9-2 Steps to Follow if a Patient Starts to Faint During Venipuncture Procedure The evacuated tube system (ETS) is the standard equipment used for routine venipuncture. Prepare equipment and put on gloves. Purpose: To obtain a blood specimen for patient diagnostic or monitoring purposes from an antecubital vein using the evacuated tube system (ETS) Release the tourniquet and pull slowly on the plunger, taking care that the needle is not withdrawn from the arm. Reapply tourniquet, uncap, and inspect needle. Ask patient to make a fist, anchor vein, and insert needle. A test request is reviewed for completeness, date, and time of collection, status, and priority. It is important for the phlebotomist to follow a step-by-step procedure to ensure consistency and to make the patient comfortable. 3. 2). Remove the needle in one smooth motion without lifting up or pressing down on it. A hollow needle is inserted through the skin and into a superficial vein (typically in the cubital fossa of the forearm). Place the tourniquet 3 to 4 inches above the venipuncture site, making it swell with blood. When using a syringe, make sure that you pull the plunger in and out to. A tourniquet placed 3- to 4-inches above the antecubital area enlarges veins and makes them easier to see, feel, and enter with a needle. Attach the evacuated tube holder onto the adapter at the end of the tubing. Step 2. Some facilities require that contaminated items such as blood-soaked gauze be discarded in biohazard containers. Anchor by grasping the arm just below the elbow, supporting the back of it with your fingers. The site must be checked for signs of bleeding beneath the skin. A test request is reviewed for completeness, date and time of collection, status, and priority. Select vein, release tourniquet,ask patient to relax hand . Course Hero is not sponsored or endorsed by any college or university. Approach, identify, and prepare patient. In such cases, consult the physician or, nurse before proceeding.Exposure to latex can trigger life-, threatening reaction in those allergic to it, so it is vital that. Place the patient's arm downward in a straight line from shoulder to wrist to aid in vein selection and avoid reflux as tubes are filled. According to CLSI standards, the tourniquet should be released as soon as possible after blood begins to flow and should not be left on longer than 1 minute. Most had multiple procedures in the year prior to being interviewed. A test request is reviewed for completeness, date and time of collection, status, and priority. Ask patient to form a fist so veins are more prominent. It consists of a needle device, a tube holder, and an air-evacuated tube. Position the draw site for best visualization and/or palpation. Procedure: 1. Nearly 70% of respondents had blood collected in a hospital setting. A clean, folded gauze square is placed over the site so pressure can be applied immediately after needle removal. Approach, identify, and prepare patient. Just because bleeding has stopped on the skin surface does not mean that the site has stopped bleeding from the vein. The results illustrate that blood collection can be a source of significant anxiety for patients even when the procedures go well. Perform the venipuncture procedure. 5). Tourniquet gloves antiseptic prep pad ETS needle tube holder and tubes gauze. PROCEDURE Routine ETS Venipuncture Step Explanation/Rationale 1. Review and accession test request. The median cubital is the first choice, followed by the cephalic. Venipuncture*Procedure* The venipuncture procedure is complex and requires both knowledge and skill. Videos: Venipuncture of a Hand Vein Using a Butterfly and ETS Holder Videos: Venipuncture Using a Needle and Syringe Videos: Venipuncture Using the Evacuated Tube System (ETS Venipuncture) Aseptically attach the syringe to the needle or butterfly setup, making sure the plunger is pushed all the way in. The blood is normally drawn from a vein on the top of the hand or from the inside of the elbow. You attach the needle device to the tube holder, insert the needle into the vein, and engage the tube. The procedure can be hindered by flinching and tenseness caused by either the patient or phlebotomy … The basilic should not be chosen unless no other vein is more prominent in either arm. Proper hand hygiene plays a major role in infection control by protecting the phlebotomist, patient, and others from contamination. Equipment: Tourniquet, gloves, antiseptic prep pad, ETS needle, tube holder and tubes, gauze pads, sharps container, permanent ink pen, bandages The accession process records the request and assigns it a unique number used to identify the specimen and related processes and paperwork. Dermal Puncture vs Venipuncture In some situations, the phlebotomist will make the decision if a blood specimen will be obtained by dermal puncture or venipuncture. Name, date of birth, and medical record number must be verified and match to the test order and patient's ID band. Name, DOB, and MR number must be, verified and matched to the test order and, inpatient’s IDband.Preparing the patient by, explaining procedures and addressing inquiries, patient care compromised if diet requirements have, not been met. Step 4. It consists of a needle device, a tube holder, and an air-evacuated tube.Once the tube is punctured by engaging the tube onto the needle, the negative pressure causes suction to … Anchoring stretches the skin so the needle enters easily and with less pain, and keeps the vein from rolling. Dubiski Career High School, Grand Prairie, phb_unit2labVenipunctureJuly_10__2018-2.pdf, phb_PHBLab2VenipunctureVacutainerSpring2010.pdf, Dubiski Career High School, Grand Prairie • SCIENCE N/A. Procedure and Performance of a Venipuncture: Select the proper size needle and attach it to the syringe or Vacutainer. Hold the patient’s arm and place a thumb below the chosen site to anchor the vein. The primary choice for a routine venipuncture that will be performed on an adult or an older child is a blood collection system that consists of a holder (or adapter), a needle that is pointed on both ends, and evacuated blood collection tubes. Remove the winged infusion needle from its packaging. Follow ETS steps 15–20. A test request is reviewed for completeness, date and time of collection, status, and priority. In veterinary medicine, the procedure is performed by veterinarians and … Venipuncture Steps 210 Venipuncture Steps 217 Routine ETS Venipuncture 235 Routine ETS Venipuncture 235 . Perform the venipuncture 1. Venipuncture Procedure. Position patient, apply tourniquet, and ask patient to make a fist. Find answers and explanations to over 1.2 million textbook exercises. (See PHL-1) 4. Pick up the tube holder with your dominant hand, placing your thumb on top near the needle end and fingers underneath. Performing the Test Prepare and clean the site with antiseptic or other germ-killing medicine. Venipuncture is the technical term used to describe the routine removal of blood from a vein for subsequent laboratory testing 1. The accession process records the request and assigns it a unique number used to identify the specimen and related processes and paperwork. 4. Stop when you feel a decrease in resistance, often described as a "pop" and press your fingers into the arm to anchor the holder. Venepuncture is the process of obtaining intravenous access – most commonly for the purpose of blood sampling. Fill additive tubes until the vacuum is exhausted to ensure correct blood to additive ratio and mix them immediately upon removal from the holder using 3 to 8 gentle inversions (depending on type and manufacturer) to prevent clot formation. Assemble necessary supplies and don gloves. Establish blood flow, release tourniquet, ask patient to open fist. Fill syringe *Either the needle or tube holder must have a safety feature to prevent needlesticks. Venipuncture Procedure • Always have the patient lying or seated in a safe place – When available, patients should be in a chair with a locking arm for support and to prevent falls if the patient loses consciousness – Patients may be drawn while seated in a Attach the appropriate needle to the hub by removing the plastic cap over the small end of the needle and inserting into the hub, twisting it tight. Identify the patient. Thanking the patient is courteous and professional. Tie tourniquet. Select a vein and release tourniquet. 6. Prepare equipment and put on gloves. Venipuncture techniques covered in this chapter in-clude ETS, butterfl y, and syringe procedures on arm and hand veins. Uncap and inspect the needle for defects and discard it if flawed. Verify diet restrictions and latex sensitivity. Materials such as needle caps and wrappers are normally discarded in the regular trash. Have the patient ball up their hand (form a fist). New photos . The right approach for a successful patient encounter includes a professional bedside manner, being organized and efficient, and looking for signs that convey important inpatient information or infection control precautions. Blood will not flow until the needle pierces the tube stopper. Ask patient to make a fist, anchor vein, and insert needle. 7. The, accession process records the request and assigns it, a unique number used to identify the specimen and, 2. Select a suitable site for venipuncture. 3). Recognize complications associated with the phlebotomy procedure. Selecting appropriate equipment for the size, condition, and location of the vein is easier after vein selection. Observe special handling instructions. Procedure for Inability to Collect Specimen Place a tube in the holder and push it part way onto the needle with a clockwise twist. Label the collection tubes at the bedside or drawing area. Patient's arm must be examined to verify that bleeding has stopped. In healthcare, this procedure is performed by medical laboratory scientists, medical practitioners, some EMTs, paramedics, phlebotomists, dialysis technicians, and other nursing staff. The tourniquet aids needle entry. Find GCSE resources for every subject. Follow the Venipuncture procedure, PHL- 1 for general venipuncture guidelines. Dispose of used and contaminated materials. Venipuncture procedures in this chapter conform to CLSI standards. 6. Select a large, well-anchored vein. Gloves are sometimes put on at this point. Discard collection unit. For accurate results, some specimens require special handling such as cooling in crushed ice (e.g., ammonia), transportation at body temperature (e.g., cold agglutinin), or protection from light (e.g., bilirubin). The evacuated tube system (ETS) is the standard equipment used for routine venipuncture. Procedure 4: Routine ETS Venipuncture Purpose: To obtain a blood specimen for patient diagnostic or monitoring purposes from an antecubital vein using the evacuated tube system (ETS) Equipment: Tourniquet, gloves, antiseptic prep pad, ETS needle, tube holder and tubes, gauze pads, sharps container, permanent ink pen, bandages Note: Either the needle or tube holder must have a safety feature to … hub. 2. Blood will appear in the hub of the needle if the position is correct. Position the patient (See PHL -1) 2. Select and prepare venipuncture site. Preparing the patient by explaining procedures and addressing inquiries helps reduce patient anxiety. Perform the venipuncture, collecting the sample (s) in the appropriate container (s). Releasing the tourniquet and opening the fist allows blood flow to normalize. Preparing it while the site is drying saves time. According to the OSHA BPP standard, gloves must be worn during phlebotomy procedures. Immediately apply pressure to the site with your free hand while simultaneously activating the needle safety feature with the other hand to prevent the chance of a needlestick. Cleaning the site with an antiseptics such as 70% isopropyl alcohol helps avoid contaminating the specimen or patient with skin surface bacteria picked up by the needle during venipuncture. Verify patient’s diet restrictions, as appropriate. Prompt delivery to the laboratory protects specimen integrity and is typically achieved by personal delivery, transportation via a pneumatic tube system, or by a courier service. Syringe Procedure (Procedure 8-4) Follow ETS steps 1-7 . 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