Phlebotomy part 3

Standard needle size (syringe/vacuum)

20, 21, or 22 gauge needle that is 1 to 1.5 inches long

Winged infusion/butterfly method needle/tube size

21, 23, or 25 gauge needle. 6 to 12 inch tube

Order of draw

Yellow, light blue, plain red, green, lavender, and gray

Yellow

Additive is sodium polyanethol sulfonate (SPS) and is used for blood culture

Light blue

Additive is sodium citrate (anticoagulant) and is used for plasma

Pain red

No additive. It is used for serum testing, immunology, serology, blood bank, and chemistry

Green

Additive is sodium/lithium heparin and is used for plasma (lithium cannot be used for WBC count. Sodium can’t be used for electrolytes)

Lavender

Additive is ethylenediaminetetraacetic acid (EDTA) (anticoagulant) and is used for whole blood

Gray

Additive is potassium oxalate/sodium fluoride (anticoagulant) and is used for plasma, glucose and alcohol levels

How long should a tourniquet be applied for initially?

2 minutes maximum

Angle of insertion for butterfly method

10 to 30 degrees. 5 to 10 degrees for hand or small veins

What is an acceptable vein

A vein that doesn’t roll

How long to apply pressure with gauze/cotton after venipuncture?

3 to 5 minutes

Where to insert needle

1/4 inch below vein location

Syringe appearance

Made of plastic and are between 5 and 10 mL

Angle to insert needle for syringe method

15 to 30 degrees. Closer to 45 degrees for obese patients. Avoid 90 degree angle insertions

What does OSHA require regarding phlebotomy?

Label blood testing tray red or with biohazard symbol

What is used to collect small amounts of blood from fragile or thin veins?

Syringe method

With which method can you perform a venipuncture from the hand or forearm?

Butterfly method