Materials such as needle caps and wrappers are normally discarded in the regular trash. Most had multiple procedures in the year prior to being interviewed. The site must be checked for signs of bleeding beneath the skin. Gloves are sometimes put on at this point. Select and organize equipment. Establish blood flow, release tourniquet, ask patient to open fist. Position the draw site for best visualization and/or palpation. Attach the evacuated tube holder onto the adapter at the end of the tubing. 2. 2). 6. Patient's arm must be examined to verify that bleeding has stopped. When drawing a blood specimen, the trained phlebotomist must: 1). Venipuncture Steps 210 Venipuncture Steps 217 Routine ETS Venipuncture 235 Routine ETS Venipuncture 235 . Pick up the tube holder with your dominant hand, placing your thumb on top near the needle end and fingers underneath. In medicine, venipuncture or venepuncture is the process of obtaining intravenous access for the purpose of venous blood sampling or intravenous therapy. Thank the patient, remove gloves, and sanitize hands. Please ensure you have the most up-to-date copy at all times. Unfortunately, it also shows how many of these procedures can go wrong. Place gauze, remove needle, activate safety feature, and apply pressure. Cleaning the site with an antiseptics such as 70% isopropyl alcohol helps avoid contaminating the specimen or patient with skin surface bacteria picked up by the needle during venipuncture. Follow the Venipuncture procedure, PHL- 1 for general venipuncture guidelines. Venipuncture*Procedure* The venipuncture procedure is complex and requires both knowledge and skill. Release the tourniquet and pull slowly on the plunger, taking care that the needle is not withdrawn from the arm. Put tourniquet on the patient about 3-4’ above the venipuncture site. 4). Follow the CLSI order of draw to prevent additive carryover between tubes. This chapter also addresses challenges and unique issues associated with pediatric, geriatric, dialysis, long-term care, home care, and hospice patients. The tourniquet aids needle entry. New photos . Discard collection unit. Grasp the holder's flanges with your middle and index fingers, pulling back slightly to keep the holder from moving, and push the tube into the needle with your thumb. Attach the appropriate needle to the hub by removing the plastic cap over the small end of the needle and inserting into the hub, twisting it tight. Exposure to latex can trigger a life-threatening reaction in those allergic to it, so it is vital that no latex items be used on a latex sensitive patient or even brought into the room. Warn the patient, line the needle up with the vein, and inserted into the skin using a smooth forward motion. Equipment: Tourniquet, gloves, antiseptic prep pad, ETS needle, tube holder and tubes, gauze pads, sharps container, permanent ink pen, bandages New photos . The accession process records the request and assigns it a unique number used to identify the specimen and related processes and paperwork. A test request is reviewed for completeness, date and time of collection, status, and priority. hub. PROCEDURE Routine ETS Venipuncture Step Explanation/Rationale 1. Review and accession test request. According to the OSHA BPP standard, gloves must be worn during phlebotomy procedures. A hollow needle is inserted through the skin and into a superficial vein (typically in the cubital fossa of the forearm). Gloves must be removed in an aseptic manner and hands washed or decontaminated with hand sanitizer as an infection control precaution. Label the tube with the patient’s particulars. Selecting appropriate equipment for the size, condition, and location of the vein is easier after vein selection. In such cases, consult a physician or nurse before proceeding. Butterfly Procedure 243 Blood Collection Set Procedure 235 . Syringe Venipuncture: Demonstrate proper procedure for needle and syringe venipuncture. Dispose of used and contaminated materials. Review and accession test request. Venipuncture Procedure. According to CLSI standards, the tourniquet should be released as soon as possible after blood begins to flow and should not be left on longer than 1 minute. The primary choice for a routine venipuncture that will be performed on an adult or an older child is a blood collection system that consists of a holder (or adapter), a needle that is pointed on both ends, and evacuated blood collection tubes. Venipuncture procedures in this chapter conform to CLSI standards. Venipuncture Video of a venipuncture. PROCEDURE Routine ETS Venipuncture Step Explanation/Rationale 1. Review and accession test request. 4. Venipuncture Procedure • Always have the patient lying or seated in a safe place – When available, patients should be in a chair with a locking arm for support and to prevent falls if the patient loses consciousness – Patients may be drawn while seated in a Aseptically attach the syringe to the needle or butterfly setup, making sure the plunger is pushed all the way in. Establish blood flow, release tourniquet, ask patient to open fist. Name, date of birth, and medical record number must be verified and match to the test order and patient's ID band. Be sure not to touch the venipuncture site or you will need to repeat the cleaning process. Tie tourniquet. Select a suitable site for venipuncture. Prepare equipment. Just because bleeding has stopped on the skin surface does not mean that the site has stopped bleeding from the vein. Prepare the accession order. Procedure and Performance of a Venipuncture: Select the proper size needle and attach it to the syringe or Vacutainer. Perform the venipuncture procedure. Position the patient (See PHL -1) 2. Prepare the equipment, the patient and the puncture site. Prompt delivery to the laboratory protects specimen integrity and is typically achieved by personal delivery, transportation via a pneumatic tube system, or by a courier service. 2. Procedure 4: Routine ETS Venipuncture Purpose: To obtain a blood specimen for patient diagnostic or monitoring purposes from an antecubital vein using the evacuated tube system (ETS) Equipment: Tourniquet, gloves, antiseptic prep pad, ETS needle, tube holder and tubes, gauze pads, sharps container, permanent ink pen, bandages Note: Either the needle or tube holder must have a safety feature to … *Either the needle or tube holder must have a safety feature to prevent needlesticks. Correct ID is vital to patient safety and meaningful test results. Clean and air-dry site. The procedure can be hindered by flinching and tenseness caused by either the patient or phlebotomy … Thanking the patient is courteous and professional. Dermal Puncture vs Venipuncture In some situations, the phlebotomist will make the decision if a blood specimen will be obtained by dermal puncture or venipuncture. D. 8-2 Routine ETS Venipuncture Procedure* E. 8-3 Venipuncture of a Hand Vein Using a Butterfly and ETS Holder Procedure* F. 8-4 Needle-and-Syringe Venipuncture Procedure* G. 9-1 Performing Venipuncture Below an IV Procedure H. 9-2 Steps to Follow if a Patient Starts to Faint During Venipuncture Procedure Identify the patient. Remove the winged infusion needle from its packaging. The accession process records the request and assigns it a unique number used to identify the specimen and related processes and paperwork. Position patient, apply tourniquet, and ask patient to make a fist. 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