what sites should be avoided when performing venipuncture quizlet

\u00a9 2023 wikiHow, Inc. All rights reserved. Hold the baby's foot firmly to avoid sudden movement. 10. https://www.osha.gov/laws-regs/standardinterpretations/2007-10-26 and https://www.osha.gov/OshDoc/data_BloodborneFacts/bbfact03.pdf (Accessed June 13, 2022). The service requires full cookie support in order to view this website. As a countermeasure, phlebotomists. Blood should NEVER be poured from one tube to another since the tubes can have different additives or coatings (see illustrations at end). To request course information, contact PhlebotomyU today. 11. The 2nd (index) finger tends to have thicker, callused skin. hemorrhage or hematoma at site of puncture, remove tourniquet C. placed in the sharps container Of course, the phlebotomist may understand this, however, the patient may not. 6. Most reference ranges are based on normal laboratory test values for: Healthy people in a basal state. }catch(e){} www.mlo-online.com is using a security service for protection against online attacks. 4. 2013 Oct 10;(10):CD005179. Hematoma - may cause erroneous test results. Avoid bruising the infant's heel when obtaining blood. He previously worked in a high-volume outpatient lab and is currently employed in an acute care hospital and Level III trauma center in downtown Vancouver. If blood is not obtained, change the position of the needle carefully by moving it forward or backward. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. Edematous extremities - tissue fluid accumulation alters test results. In this elbow pit, phlebotomists have easy access to the top three vein sites used in phlebotomy: The median cubital vein, also known as the antecubital vein, is the most common vein for phlebotomy. By signing up you are agreeing to receive emails according to our privacy policy. If using a needle and syringe, avoid drawing the plunger back too forcefully. Clin Lab. 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. Avoid placing sample onhot surfaces such as bili-lights or monitors. Remove the first glove so that it turns inside out during removal A phlebotomy technician is preparing to dispose of contaminated sharps. However, do not use too high a temperature warmer, because baby's skin is thin and susceptible to thermal injury. increase the circulation of blood to the area. But since each patient's medical condition varies, so does their veins. The most common complications are bleeding at the puncture site or hematoma formation. 3. Sites to avoid: Extensive scarring from burns or surgery The upper extremity on the side that a mastectomy was performed. What are the gold top containers used for? What Is Venipuncture? Procedures, Risks & Fears - Phlebotomy Coach The needle should form a 15 to 30 degree angle with the surface of the arm. PDF Venipuncture - Central Zone - Alberta Health Services Dorsal hand veins are often utilized for intravenous infusions but are viable options for blood draw sites. Occupational Safety and Health Administration, United States Department of Labor. 2. Veins sometimes roll away from the point of the needle and puncture site. apply pressure for at least 10 minutes. Step 3: Venipuncture. For operation at steady state, determine for the motor, each in kW\mathrm{kW}kW Hold a gauze pad over the puncture site for a couple of, minutes to stop the bleeding, and then tie gauze around the foot. 5. This is a general guide for troubleshooting a venipuncture scenario in which blood flow is not initially established upon needle insertion. This type of venipuncture procedure is a little different, and sometimes can be a little more involved. A. in the region of a hematoma Puncture no deeper than 2.4mm (approximately 0.1 inches). Press down on the gauze once the needle is out of the arm, applying adequate pressure to avoid formation of a hematoma. The median cubital vein is used the most for its accessibility. Practice hygiene for the patient's protection. 9. The median cubital vein, a superficial vein that forms a connection point between the cephalic and basilic veins of the arm is large, and therefore easier to see and feel. Lippi G, Salvagno GL, Montagnana M, Franchini M, Guidi GC. This process is automatic. Procedures and Devices for the Collection of Diagnostic Capillary Blood. PROBLEMS OTHER THAN AN INCOMPLETE COLLECTION: A hematoma forms under the skin adjacent to the puncture site - release the tourniquet immediately and withdraw the needle. Kiechle FL. -infection at site Because of contacts with sick patients and their specimens, it is important to follow safety and infection control procedures. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. The infograph below provides a detailed description of the venipuncture steps as found in our how to draw blood resource. B. the insertion site has stopped bleeding -use correct angle of needle insertion How to Avoid Dangerous Websites - Lifewire Additionally, a hematoma may compress the nerve and lead to long-term damage. Using the requisition for reference, ask a patient to provide additional information such as a birthdate. If using a syringe, make sure the needle is fitted securely on a syringe to avoid frothing. Sites that should be avoided include areas with extensive scarring, healed burns, inflamed sites, edematous sites, previous puncture sites, earlobes and thumbs. Never attempt venipuncture in an artery. Collect drops of blood into the collectiondevice by gently massaging the finger. If the blood flow is diminished, repeat the capillary PUNCTURE to complete the collection. 8. Squeeze puncture site to promote bleeding. 2. 8. Patches of purple or yellow may suggest bruising after a recent venipuncture. Try rotating the arm to better expose the cephalic or basilic vein. Most commonly, venipuncture will be performed on the Antecubital Fossa, or the inside of the elbow. While this may be effective in some difficult draws, the risk of a needlestick injury is higher if the patient has a withdrawal reflex and the needle recoils back into your finger. Inadvertently nicking a nerve causes intense pain. Position the patient with the arm extended to form a straight-line form shoulder to wrist. Dry the cleaned area with a dry cotton sponge. Never draw blood through a hematoma. Phlebotomy issues and quality improvement in results of laboratory testing. Do not bend, break, recap, or resheath needles to avoid accidental needle puncture or splashing of contents. An electric motor draws a current of 10 amp with a voltage of 110V110 \mathrm{~V}110V. The output shaft develops a torque of 10.2Nm10.2 \mathrm{~N} \cdot \mathrm{m}10.2Nm and a rotational speed of 1000 RPM. Track marks are not only found on IV drug users, but also on chronically ill patients requiring repeated vascular access and blood draws and may be a sign of an anticipated difficult draw. Uman LS, Birnie KA, Noel M, et al. Follow the procedure as outlined above for greeting and identifying the patient. avoid sites of extensive scarring (burns, surgery, injuries) If the patient is sitting in a phlebotomy chair, make sure they are sitting upright with their back against the chair. Anxiety that results in hyperventilation may cause acid-base imbalances, and increased lactate. Blood collection tubes must be drawn in a specific order to avoid cross-contamination of additives between tubes. For an inpatient DO NOT DRAW BLOOD IF THE ARMBAND OR BRACELET IS MISSING. Check for timing instructions for drawing the appropriate samples. are known to vary lab results of some analytes. B. collection device Airborne precautions may be considered to provide a level of safety against infectious diseases such as tuberculosis, influenza, and COVID-19. If you stick yourself with a contaminated needle: Remove your gloves and dispose of them properly. Second - coagulation tube (light blue top). This seats the bevel into the lumen of the vein, and is also the technique used to insert an IV catheter. NOTE:Tubes with additives must be thoroughly mixed. The puncture should be made perpendicular to the ridges of the fingerprint so that the drop of blood does not run down the ridges. 3. iframe.style.height = zf_ifrm_ht_nw; ROUTINE CAPILLARY PUNCTURE BLOOD COLLECTION GUIDELINES. Through a combination of revolutionary treatments and extraordinary patient experiences, our care does more than heal. Complications of venipuncture | How to avoid | Aimvein site. very small or difficult vein, Ch 46 Phlebotomy & Ch 47 Hematology (MULTIPLE, Chapter 47: Phlebotomy and Blood Collection, Positive and negative feedback & examples, Meds Vanessa doesn't need because she sleeps, Medical Terminology: Learning Through Practice, April Lynch, Jerome Kotecki, Karen Vail-Smith, Laura Bonazzoli. Avoid trauma and excessive probing. What caution should you observe when using a Vacutainer? Erroneous test results may be obtained when the blood is not thoroughly mixed with the additive. Apply the tourniquet approximately 4-5 finger-widths above the planned venepuncture site. Perform the venipuncture, collecting the sample(s) in the appropriate container(s). INR for patients on warfarin) are often knowledgeable on the veins that are most likely to work. Remember -- the rst vein found is not always the best vein. Lancets are disposed of in an appropriate sharps container as one unit. D. it is wiped with alcohol, Venipuncture at sites with each of the following could effect the results EXCEPT: Specimens from infants under the age of 6 months are typically collected by heelstick. Common Venipuncture Sites | Healthfully Phlebitis is inflammation of a vein. Expect that any discussion or consultation involving the patient's case will be conducted discretely and that individuals not directly involved in the case will not be present without patient permission. Never draw over scars or a new tattoo sites. The first drop contains excess tissue fluid and must be wiped away. if ( prevIframeHeight != zf_ifrm_ht_nw ) { Collect drops of blood into the collectiondevice by gently massaging the heel. 9. However, drawing blood from the hand is affiliated with higher levels of pain and less control. Wait 2 minutes before reapplying the tourniquet. A. EMLA }, false); Larger tube sizes typically provide for collection of samples from 6 to 10 mL. 1. Palpate and trace the path of veins with the index finger. What Is Venipuncture? The use of a tourniquet during a venipuncture procedure makes: The most common site(s) for the venipuncture procedure is/are the following: The tourniquet should not be left on a patient more than 1 minute when performing a venipuncture because it is uncomfortable and causes: The needle should always be inserted at the puncture site with the: The correct needle position for a venipuncture is a ______ degree angle with the bevel facing _____. Proper patient identification MANDATORY. B. Hematoma Once you establish blood flow, slightly modify your hand position to stabilize the needle against the arm and prevent further movement. Background: Venipuncture is the most common invasive medical procedure performed by health care providers. Collect the drops of blood into the collection device by gently massaging, Avoid excessive pressure that may squeeze tissue fluid into the drop of, When full, cap and then gently invert the collection device 5-10 times to, Hold a gauze pad over the puncture site for a short time to stop the, Dispose of the contaminated materials and lancet in the appropriate waste, Place a band-aid on the patients finger or have someone continue to hold, gauze on the finger. Finger - Usually the third or fourth finger is preferred in adults and children. This image may not be used by other entities without the express written consent of wikiHow, Inc.
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