Phlebotomy Venipuncture Steps - PowerPoint Presentation

Slide1

Phlebotomy

Venipuncture

Steps

Identify the Patient

Assess the patient’s physical disposition (i.e. fasting, stressed)Check the requisition form for requested tests, patient information and any special requirements.

Select suitable site.

Prepare the equipment and the patient and puncture site.

Perform venipuncture

Collect the sample in appropriate container

Recognize complications

Assess need for sample recollection and/or rejection

Label collection tubes at bedside or drawing area

Promptly send the specimens with the requisition to the lab

Requisition Form

Must accompany each sample submitted to the lab

Must contain proper information Requisition Form

Essential Elements of Requisition form

Patient’s surname, first name and middle initial

Patient’s ID numberPatient’s date of birth and sexRequesting physician’s complete nameSource of specimenDate and time of collection

Initial’s of phlebotomist

Indicating the test(s) requested

Labeling Sample

Proper labeling ensures the results of the test match the patient.

Key elements:Patient's surname, first and middlePatient's ID number(Both of the above must match the same on the requisition form.)Date, time and initials of the phlebotomist must be on the label of each tube

Materials needed for

Venipuncture

Evacuated Collection tubesNeedlesHolder/AdapterTourniquetAlcohol WipesPovidone-iodine wipes/swabs

Gauze sponges

Adhesive bandages/tape

Needle disposal unit

Gloves

Syringes

Order of Draw

Must be drawn in a specific order to avoid cross-contamination of additives between tubes.

First- blood culture bottle or tube (yellow or yellow-black top)Second –coagulation tube (light blue top)Third- non-additive tube (red top)Last draw- additive tubes in this order:

1. SST (red-gray or gold top) Gel separator and clot activator

Order of the draw

2. Sodium heparin (dark green top)

3. PST ( light green top). Contains lithium heparin anticoagulant and a gel separator.4. EDTA (lavender top)5. ACDA or ACDB (pale yellow top). Contains acid citrate dextrose.6. Oxalate/fluoride (light gray top

*Tubes with additives must be thoroughly mixed. Erroneous test results may be obtained when the blood is not thoroughly mixed with the additive.

ID Patient

ID yourself and indicate procedureAsk patient for full name and always check the armband or bracelet.

Do not draw blood if armband or bracelet missing.Talk to the patient while drawing blood to ease anxiety

Site selection

Median cubital

and cephalic veins of the armBasilic vein on the dorsum of the arm or dorsal hand veinsFeet last resort

Areas to avoid

Extensive scars from burns and surgery

Upper extremity on side of previous mastectomyHematomaIV fluids/blood transfusionsLinesCannula/fistula/heparin lockEdematous

extremeties