MLSP2

Venipuncture

Refers to the process of collecting or “drawing” blood from a vein of the patient for laboratory testing purposes

• Syringe • Evacuated Tube System • Butterfly

methods for venipuncture

• Syringe/Needles • Tourniquet • Evacuated Collection Tubes • Multisample Needle • Holder/Adapter • Alcohol (70% isopropyl) • Povidone-iodine • Dry Cotton/Gauze • Micropore • Gloves

Venipuncture Equipment

Vein Locating Device

portable devices that use infrared light to help health professionals locate and assess veins for safe venous access.

Tourniquet

constricting device applied to a patient’s arm prior to venipuncture with the aim of inflating the veins by restricting venous blood for a period of time

Needles

used for withdrawing blood samples. The 3 types of needles used in venipuncture are multisample, hypodermic and winged infusion

Needle Gauge

classified according to diameter of the lumen. The higher the number, the smaller the actual needle diameter

Evacuated Tube System

• closed collection system composed of multi-sample needle, tube holder and evacuated tubes, which prevents exposure to contaminants

• Blood is collected directly into the evacuated tube, eliminating the need for transfer of specimens and minimizing the risk of biohazard exposure INCLUDES: • Double-pointed needle • Needle holder • Color-coded evacuated tubes

• Age of the patient • Amount of Blood • Type of Sample

It is important to select the right gauge of the needle:

Syringe

• Routinely used for venipuncture range from 2 to 20 mL

• For single draw

• For drawing blood from patients with small or fragile veins

True

Blood drawn in a syringe is immediately transferred to appropriate evacuated tubes to prevent the formation of clots.

True

It is not acceptable to puncture the rubber stopper with the syringe needle and allow the blood to be drawn into the tube.

Needle Holders

• made of rigid plastic and may be designed to act as a safety shield for the used needle.

• Occupational Safety and Health Administration (OSHA) directs that holders must be discarded with the used needle.

Needle Disposable Systems

• To protect phlebotomists from accidental needlesticks by contaminated needles

• Rigid, puncture-resistant, leak-proof disposable “sharps” containers labeled BIOHAZARD that are easily sealed and locked when full.

Evacuated Tubes

- also known as Vacutainers and are available in glass and plastic.

- Contain a premeasured amount of vacuum for blood collection

- The amount of blood collected in an evacuated tube ranges from 1.8 to 15 mL and is determined by the size of the tube and the amount of vacuum present.

Anticoagulant

Commonly called blood thinners, chemical substances used to prevent blood clots

Special-use anticoagulants

Include acid citrate, dextrose, citrate phosphate dextrose, and sodium polyanethanol

Antiglycolytic agents

Substances that prevent breakdown of glucose by blood cells or glycolysis

Clot activators

Enhance coagulation in serum specimen tubes

Thixotropic gel separator

Inhibits cells from metabolizing substances and moves between cells and serum or plasma when centrifuged

Trace element-free tubes

Materials that are free of trace element contamination. Used for a variety of purposes such as trace element tests, toxicology studies, and nutrient determination

SPS(8-10x)

Additive for yellow

EDTA(8-10x)

Additive for Lavender/Pink

EDTA and Gel

Additive for White

Sodium Citrate(3-4x)

Additive for light blue

Clot activator(5x)

Additive for Red plastic tube

Heparin(8-10x)

Additive for Green

Fluoride(8-10x)

Additive for Gray

Oxalate(8-10x)

Additive for Black

Yellow-Light Blue-Red/Gold-Green-Lavender-Gray/Black

Right order of draw

Winged Blood Collection Sets

• for performing venipuncture from very small or very fragile veins often seen in children and in the geriatric population

*Reminder:

• Always hold the apparatus by the needle wings and not by the tubing.

Checking Requisition forms

- provide the phlebotomist with the information needed to correctly identify the patient, organize the necessary equipment, collect the appropriate samples, and provide legal protection.

- Patient’s name, age and gender

- Patient’s date of birth

- Patient’s location

- Ordering health-care provider’s name

- Tests requested

- Requested date and time of sample collection

15-30 degrees

Right degree to insert the needle

1-1.5 inch

Size of needle

Arterial Puncture

• Generally used for the determination of blood oxygen, carbon dioxide tension and blood pH (Blood Gas Analysis).

• Blood collected is called arterial blood or oxygenated blood

• Special training is required for this procedure

• Tourniquet is not required

• After removing the needle, apply moderate pressure with 2 x 2 sterile gauze until bleeding ceases

• Insert needle (still attached to syringe) in stopper to prevent air from entering needle

• Radial artery

• Femoral artery (fem tap)

• Brachial artery

• Scalp artery

• Umbilical artery

Sites for Arterial Puncture

Modified Allen’s test

• Before performing a radial artery puncture, the ______ is performed to determine if the ulnar artery is capable of providing collateral circulation to the hand.