Equipment and Site Selection

What do we use to clean standard venipuncture sites?

Alcohol wipes or ethyl alcohol wipes

What percent alcohol do we typically use to clean standard venipuncture sites?

70% alcohol

What do we typically use for blood culture venipuncture site cleaning?

1% to 10% povidone-iodine swab sticks or chlorhexidine gluconate and 2 gauze pads

What do we use to clean a venipuncture site if we are testing blood-alcohol level?

A non-alcoholic antiseptic (NOT povidone-iodine or chlorhexidine gluconate)

How long do serum tubes need to clot for before being centrifuged?

30-60 min

How long does plasma need to wait before being centrifuged?

__ MAY be immediately centrifuged

What does a centrifuged plasma tube look like?

Looks like a centrifuged serum tube

What is the last-resort venipuncture site?

Basilic Vein (Pinky Side)

What is the best venipuncture site?

Median Cubital Vein

What is the venipuncture site that is better than the hand but not the first pick?

Cephalic Vein (Thumb side)

What is the venipuncture site that is better than the Basilic vein but worse than the Cephalic Vein?

Dorsal Metacarpal Vein(s)

Where should you draw on a patient that has had a Mastectomy on both sides?

Top of the hand

How should you accommodate a patient with Arthritis?

Provide padding for the patient and find a position that is comfortable for them

When should you raise your voice at a patient?

When the patient log mentions hearing loss or they mention they can’t hear you

How can you confirm that a patient with hearing loss has heard your instructions?

Have the patient repeat back what you said

How should you accommodate a patient with visual impairment?

Remove tripping hazards and do not get in the way of their cane or working dog

How should you accommodate a patient with a movement impairment?

Lock the brakes and treat the wheelchair like it is a part of them — NEVER move their chair without asking them first

How should you accommodate a patient with a memory impairment?

Demonstrate patience and repeat your answers back to them. If in doubt of consent, work with their nurse to provide consent

What assumptions can you make about a patient?

Never make assumptions that an older adult experiences any limitations. Treat every interaction as a normal one unless they express verbally that they cannot understand you

How can you keep an infant safe during blood collection?

Place them on their side to reduce choking

Why should you confirm if your phlebotomy tray has the supplies necessary to perform the tests?

It can increase the chances of cross-contamination and delay a blood collection

What should you do if your patient says they have fragile or damaged skin?

Use a different type of tourniquet

What pressure should you raise a blood pressure cuff to?

40 mm Hg

How high up should the tourniquet be from the venipuncture site?

3-4 inches

What is the longest a tourniquet should stay on for?

60 seconds

Hemoconcentration

Excessive collection of blood in the area

Hemolyze

Destruction of red blood cells

What happens if you use a needle that is too small?

Increased change of hemolyzation and procedure takes longer

Why is the Median Cubital Vein the best Venipuncture Site

It is located near the antecubital region and is well anchored