Post-Puncture Bandaging

PhlebotomyU

What is the immediate post-puncture care after removing the needle?

Ask the patient to keep the arm straight and have them apply direct pressure on the puncture site using 2x2 cotton gauze

Whose responsibility is it to confirm bleeding has stopped, and when?

• It is the responsibility of the phlebotomist to assure that bleeding has entirely stopped after completion of the venipuncture

• Then they can bandage and release the patient

What are the bandaging options, in order of preference?

• All patients must be bandaged prior to leaving

• 2x2 cotton gauze and elastic dressing (Coban)

• Paper tape (2nd choice if Coban is not available)

• Band-Aid

What post-puncture care instructions must you give the patient?

Inform the patient not to remove the bandage for at least 15 minutes, but not to leave it on longer than 1 hour.

What is elastic dressing (Coban) made of?

A water-vapor permeable, non-woven polyester fabric made of polyester urethane, coated with a self-adherent substance

What property makes Coban different from tape or a Band-Aid?

• The self-adherent coating gives the bandage the ability to stick to itself but not to skin or clothing

• It stays in place once applied, and can maintain limited but significant levels of bandage pressure (compression bandage)

Which patients is elastic dressing primarily used for?

• Patients on anticoagulant therapy

• Patients with bleeding disorders

• Allergies

• Dermatitis

• Eczema

• Fragile skin

Why do you not bandage an infant, and what do you do instead?

• A bandage is a choking hazard for infants

• Apply pressure until bleeding stops

• After a heel stick, refer to lab’s usual procedures

Why is elastic dressing used on geriatric patients?

• Geriatric patients tend to have thin skin that can tear when an adhesive bandage is removed

• Elastic dressing sticks to itself and not to the skin