Unit+5-Lecture+2-Alternate+Methods+of+Phlebotomy

Introduction

• Title: Alternate Methods of Phlebotomy

• Context: Unit 5 - Lecture 2

Overview of Phlebotomy

• Definition: Phlebotomy is the process of collecting blood for disease diagnosis.

• Key Skills in Blood Collection:

  • Treat patients/clients courteously.

  • Label blood samples with patient information.

  • Obtain specimens successfully with minimal pain.

  • Refer to Lecture #1 for proper procedures with patients.

Alternate Methods

• Syringe Method:

  • Less pressure on the vein.

  • Phlebotomist has more control over blood flow.

  • Higher cost associated with equipment.

  • Safety risks exist.

• Winged Infusion Set (Butterfly Needle):

  • Expensive but associated with few safety issues.

  • Best for patients with fragile veins.

• Capillary Puncture:

  • Necessary method for infants and children.

  • Limited blood volume collected.

  • Can be messy.

Supplies for Syringe Method

• Required Supplies:

  • Syringe

  • Safety needle

  • Transfer device

  • Tubes required for tests ordered.

Steps for the Syringe Method - Blood Obtaining

• Tourniquet Application:

  • Slows blood flow, making veins more prominent.

  • Inquire about latex allergies before using latex tourniquet.

  • Apply for a maximum of two minutes to prevent hemoconcentration.

Venipuncture - Vein Locations

• Locations for Venipuncture:

  1. Median Cubital

  2. Basilic

  3. Cephalic

  4. Median

Locating Veins

• Palpation Technique:

  • Tap with two fingers to help locate vein.

Preparation of Puncture Site

• Site Preparation:

  • Remove the tourniquet after site selection and cleanse area.

  • Recommended antiseptic: 70% isopropyl alcohol.

  • Allow alcohol to air dry; do not touch the site again until needle insertion.

  • Gather and prepare all needed equipment while site is drying.

Equipment for Syringe Method

• Equipment Examples Needed:

  • Sterile needle and syringe.

  • Transfer device, tubes for tests.

Steps for Venipuncture by Syringe

• Open packages of sterile needle and syringe; attach needle as necessary.

• Enhance plunger movement to prevent sticking.

• Select proper tubes for the test.

• Apply tourniquet while noting vein location.

• Anchor the vein if needed; do not touch the area of needle insertion.

Inserting the Needle

• Hold needle at a 15-30° angle, aligned with the vein.

• Remove needle cap just before puncturing with bevel facing upward.

• Feel for resistance and then the "pop" as the vein is entered.

• Look for "flashback" in the syringe hub to confirm entry into the vein.

Completing Blood Draw

• Once desired amount of blood is collected:

  • Release the tourniquet.

  • Cover the needle with gauze and withdraw from the arm.

  • Apply pressure to the site immediately and cover the needle with a safety shield.

  • Attach transfer devices and fill appropriate tubes, following order of draw.

Syringe Method - Transfer Device

• Use a transfer device to manage sample collection effectively.

After Care of Puncture Site

• Instruct patient to press on the puncture site for 2-5 minutes with arm extended.

• Ensures bleeding stops and prevents hematoma formation.

• Cover site with a band-aid or coban; instruct removal in 15-20 minutes.

Blood Tube Filling Order

• Order of fill using transfer device:

  • Blood culture tubes (sterile)

  • Coagulation tube (light blue)

  • Non-additive tube (red)

  • Heparin tube (green)

  • EDTA tube (lavender or purple)

  • Oxalate/fluoride tube (gray)

Final Steps in Venipuncture

• Label tubes with initials, time, and date.

• Check the patient's arm for bleeding; apply adhesive bandage/coban to the site.

• Dispose of syringe and needle in a sharps container.

• Clean up the area and wash hands before leaving the patient’s room.

Winged Infusion Method

• Suitable for children and geriatric patients with fragile veins.

• Needle gauges: 21-23; smaller veins require smaller gauge needles.

• Needle length typically ½ to ¾ inch to accommodate lower insertion angle.

Procedure for Venipuncture with Winged Infusion Method

• Follow similar procedures as with syringe or vacutainer methods using the wings to guide the needle into the vein.

• Look for “flashback” in the tube to confirm needle placement.

• Once placement is confirmed, fill required tubes using the vacutainer hub.

• Complete venipuncture as previously discussed, disengaging the last tube before needle removal.