what sites should be avoided when performing venipuncture quizlet what sites should be avoided when performing venipuncture quizlet

\u00a9 2023 wikiHow, Inc. All rights reserved. C. at a mastectomy site After cleansing, allow the venipuncture site to air dry. What equipment is needed for a venipuncture? The creatine kinase (CK), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), and platelet count may increase. The median cubital creates, The dorsal venous network is the next most common vein site for phlebotomists. Certain areas are to be avoided when choosing a site: Extensive scars from burns and surgery - it is difficult to puncture the scar tissue and obtain a specimen. While venipuncture is considered to be reasonably safe, the present study investigated the incidence of serious complications occurring in an outpatient setting. Patients who are dehydrated, obese, terminally ill, or hard sticks often get their blood drawn in other locations rather than the antecubital fossa. chemistries, serology, immunnology, blood bank. proteins). Move it forward (it may not be in the lumen). A face mask reduces risk for blood culture specimen contamination. Cleanse the heel with alcohol prep, then dry with a sterile 22 as alcohol can influence testresults. The patient should either sit in a chair, lie down or sit up in bed. Warm the heel from which blood is to be obtained. Venipuncture (sometimes referred to as venapuncture, venepuncture or even venu puncture) is the collection of blood from a vein which is usually done for laboratory testing. If using a needle and syringe, avoid drawing the plunger back too forcefully. Avoid prolonged tourniquet application or fist clenching. What are the red top containers used for? In other words, there is no need for another venipuncture procedure. In this elbow pit, phlebotomists have easy access to the top three vein sites used in phlebotomy: The median cubital vein, also known as the antecubital vein, is the most common vein for phlebotomy. Dispose of items in appropriate containers. It is not as close to the skin surface as the median cubital and cephalic veins, which poses a greater risk of damage to the median nerve and brachial artery. Background: Venipuncture is the most common invasive medical procedure performed by health care providers. Use a smaller tube with less vacuum. 8. B. evacuated tube doi: 10.1002/14651858.CD005179.pub3. This is more common in humeral and femoral punctures than radial punctures. Avoid areas of hematoma. Areas of the body that look infected, scarred, or burned must also be avoided. Each phlebotomist generally establishes a routine that is comfortable for her or him. B. Yellow You must check the timing of these variations for the desired collection point. This vein can be found along the upper arm to the thumb, but it is commonly drawn from the forearm or antecubital fossa area. If this is not successful, remove the needle, take care of the puncture site and redraw at another site. Avoid excessive probing ("fishing"). Preferred venous access sites, and factors to consider in site selection, and ability to differentiate between the feel of a vein, tendon and artery. This article has been viewed 43,712 times. Puncture only the uppermost wall of the vein, Remove the tourniquet before removing the needle, Make sure the needle fully penetrates the upper most wall of the vein. Procedure for Capillary Puncture of the Finger: The best site for a finger puncture is just off the center of the finger pad of. 1. Several veins in the antecubital fossa provide excellent access. Am J Clin Pathol. Consider three elements with the following abbreviated electron configurations: X=[Ar]4s23d5Y=[Ar]4s23d104p1Z=[Ar]4s23d104p6\mathrm{X} = \mathrm{[Ar]4s^23d^5}~~~\mathrm{Y}=\mathrm{[Ar]4s^23d^{10}4p^1}~~~\mathrm{Z}=\mathrm{[Ar]4s^23d^{10}4p^6} wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. })(); The cephalic vein is a safe secondary option if the median cubital vein is not working. The infograph below provides a detailed description of the venipuncture steps as found in our how to draw blood resource. Please enable JavaScript on your browser and try again. Use a butterfly to compensate for patient movement. This preliminary action allows you to safely adjust the needle's position. Phlebotomy is the practice of drawing blood from patients to gather data about their health. To enhance students careers, meet the needs of healthcare providers and improve patient care by providing high quality, cost effective phlebotomy education through industry leading curriculum, current technology and extensive hands on experience. Pre-warm the region of the vein to reduce vasoconstriction and increase blood flow. Lightly touch the microtainer capillary collectiondevice (or filter paper) to the LARGE drop of blood. Patient care following completion of venipuncture. A government issued photo identification card such as a driver's license can aid in resolving identification issues. In some cases, a phlebotomist may have to switch sites if they find the blood is not properly flowing from the vein. Position the patient. If using a syringe, make sure the needle is fitted securely on a syringe to avoid frothing. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. A thin soap bubble of index of refraction 1.33 is viewed with light of wavelength 550.0 nm and appears very bright. This process is automatic. What are the light blue top containers used for? Identify the patient using two different identifiers, asking open ended questions such as, "What is your name?" Collect drops of blood into the . 4. The patient who is at ease will be less focused on the procedure. Any microtainerscontaining additives should be tapped to dislodge additives from the walls and top. Identify the patient. 1. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. Phlebotomy Essentials 5th Edition Chapter 9. Stop the procedure if a hematoma occurs. Apply the tourniquet below the IV site. Begin by selecting the proper, approved lancet, such as: BD Microtainer Quikheel Lancet, 2.5 mm for full-term babies (green), BD Microtainer Quickheel Preemie Lancet, 1.75 mm for neonatal, Unistick2 Neonatal 18G, 1.2mm Lancet for neonatal babies less than, Prepare the heel by cleaning it with a Chlorhexadine wipe. Do not use a previous puncture site. Phlebitis can also occur as a result of vein trauma during insertion, use of an inappropriate I.V. Green 5. 8. Although the skill set and procedures may apply to both instances, this content is primarily aimed towards venous blood collection using evacuated tube systems (e.g. Hematoma formation is a problem in older patients. Apply only ONE drop of blood per circle. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. The index finger can be calloused or sensitive and the little finger does not have enough tissue to prevent hitting the bone with the lancet. C. Iodine Otherwise, satisfactory samples may be drawn below the IV by following these procedures: Turn off the IV for at least 2 minutes before venipuncture. Venipuncture (sometimes referred to as venapuncture, venepuncture or even venu puncture) is the collection of blood from a vein which is usually done for laboratory testing. Forward completed/dry collections to the laboratory as soon as possible. It is large and near the skins surface, making it easier for phlebotomists to see before anchoring the vein. If an IV is in place, samples may be obtained below but NEVER above the IV site. Kiechle FL. Have an assistant stabilize the arm by firmly locking the elbow joint. Adapted from Phlebotomy for Nurses and. Blood should NEVER be poured from one tube to another since the tubes can have different additives or coatings (see illustrations at end). wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. Because most laboratory specimens contain bacteria, it is not necessary to wash hands before collecting them, The tourniquet applied prior to venipuncture is removed: Clean the site to be punctured with an alcohol sponge. Focus on what you do best, and find someone who can help you communicate that with your target market. The antecubital fossa is a collection of veins located within the arm's inner area, opposite of the elbow, where the arm folds in. A commercial heel warmer may be used. The maximum number of times an individual should attempt a venipuncture on a patient is two, True or False? B. above an IV line Tip: In spite of a difficult draw, remember to invert your tubes. 8. 7. (See picture.) Clin Lab. What should you do with a CBC or lavender top tube before putting them down? If none of these veins work, then the phlebotomists use the hand veins. Proper patient identification procedures. Use pillows or foam wedges to elevate the arm and help with extension. 3. Additionally, blood samples should not be taken on an arm with a fistula used for dialysis treatments. Assess the patient's physical disposition (i.e. Grasp the patient's arm firmly using your thumb to draw the skin taut and anchor the vein. EDTA and sodium citrate tubes should still be filled to the marked fill line to ensure a correct blood-to-additive ratio. Remember that veins should ideally feel bouncy. Never draw above an IV site. Wash hands in warm, running water with an appropriate hand washing product, or if notvisibly contaminated, with a commercial foaming hand wash product before and aftereach patient collection. B. Hematoma Why? IF AN INCOMPLETE COLLECTION OR NO BLOOD IS OBTAINED: Change the position of the needle. -infection at site Which element has the highest ionization energy? 2. A. Syringe try{ The blood is bright red (arterial) rather than venous. Normal reference ranges are often noted according to age.