what sites should be avoided when performing venipuncture quizletdewalt dcr025 fuse location
5. -Vacutainer barrel D. all of the above, Julie S Snyder, Linda Lilley, Shelly Collins, Zoology Chapter 16 & 17: Invertebrate Deutero. Dalal BI, Brigden ML. A. the tubes are filled and properly labeled -infection at site Follow the same procedure as for performing a finger, Order of Draw for a Capillary Puncture: Proper collection of tubes when. Contains lithium heparin anticoagulant and a gel separator. It is large and near the skins surface, making it easier for phlebotomists to see before anchoring the vein. Swiftly insert the needle through the skin and into the
lumen of the vein. The patient who is at ease will be less focused on the procedure. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. Choosing an appropriate site for venipuncture is crucial for a successful . {"smallUrl":"https:\/\/www.wikihow.com\/images\/thumb\/6\/68\/Troubleshoot-a-Difficult-Venipuncture-Step-1.jpg\/v4-460px-Troubleshoot-a-Difficult-Venipuncture-Step-1.jpg","bigUrl":"\/images\/thumb\/6\/68\/Troubleshoot-a-Difficult-Venipuncture-Step-1.jpg\/aid11732774-v4-728px-Troubleshoot-a-Difficult-Venipuncture-Step-1.jpg","smallWidth":460,"smallHeight":345,"bigWidth":728,"bigHeight":546,"licensing":" \u00a9 2023 wikiHow, Inc. All rights reserved. Automated systems may include labels with bar codes. and "What is your date of birth?". This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. While most patients veins are compatible with a standard needle gauge, others require a butterfly needle. Although the larger and fuller median cubital and cephalic veins of the arm are used most frequently, the basilic vein on the dorsum of the arm or dorsal hand veins are also acceptable for venipuncture. You may also remove the tube, wait a few seconds for blood flow to resume, and then engage a short drawtube. ACDA or ACDB (pale yellow top). var zf_ifrm_data = evntData.split("|"); The fifth finger tends to have less soft tissue overlying the bone. Phlebotomy is the practice of drawing blood from patients to gather data about their health. 5. Avoid puncturing a finger that is cold or cyanotic, swollen, scarred, or covered with a rash. (2017). If the patient is sitting in a phlebotomy chair, make sure they are sitting upright with their back against the chair. Lines - Drawing from an intravenous line may avoid a difficult venipuncture, but introduces problems. -tourniquet Cochrane Database Syst Rev. Patient identification is critical for safety. In some instances, the legs or feet are required for use, but a physician or doctor should be completing the draw, not a phlebotomist. f.src = 'https://forms.zohopublic.com/healthservicesacademy/form/RequestCourseInformationCPTIAccelerated/formperma/SBGg-3DTNCwt65i9A6n_zU3SneyGD89SSqM_7F_nCas?zf_rszfm=1'; Clin Chem Lab Med. } Capillary specimens are collected in microtainers with colored caps that are used to. therapy is usually associated with acidic or alkaline solutions or solutions that have a high osmolarity. Factitious biochemical measurements resulting from hematologic conditions. C. Scarring Phlebotomy is not a one size fits all; each patient is different and may have their blood drawn at other sites with varying needle sizes. Elderly patients often have fragile skin and veins that roll quite easily, When a vein rolls, the needle tends to push the vein aside rather than penetrating through. Carry out hand hygiene before and after each patient procedure, before putting on and after removing gloves. The median cubital vein and the cephalic vein in the wrist area should be avoided when possible. Blood Collection Techniques in Exotic Small Mammals. As always, properly fill out appropriate requisition forms, indicating the test(s) ordered. All rights reserved. 2019;95(1):15-19. doi: 10.1016/j.diagmicrobio.2019.04.001. Tip: Lowering the arm below the level of the heart may help to engorge the vessels. The first step to choosing the right vein is to select the appropriate needle gauge. 2004;24(4):979-96, vii. How should you have the patient position their arm after the venipuncture is complete? 2. D. it is wiped with alcohol, Venipuncture at sites with each of the following could effect the results EXCEPT: Follow the procedure as outlined above for greeting and identifying the patient. doi: 10.1002/14651858.CD005179.pub3. Even if several vials of blood have to be drawn it usually amounts to no more than one ounce. The first attempt is the antecubital fossa area, starting with the median cubital vein, then the cephalic vein, and the basilic vein. Avoid previous hematoma (draw distal of hematoma) Clin Lab Med. Have the patient drink fluids if dehydrated. Please enable JavaScript on your browser and try again. Nursing Personnel. Wear gloves and a lab coat or gown when handling blood/body fluids. Phlebotomists are considered to have occupational exposure to blood borne pathogens. 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. C. at a mastectomy site Proper patient identification procedures. For a detailed breakdown of each step of the venipuncture test scroll down. C. all disposable equipment has been discarded properly Hold the baby's foot firmly to avoid sudden movement. 3. Make the cut across the heelprint lines so that a drop of blood can well up and not run down along the lines. 6. Draw 5 ml of blood and discard before drawing the specimen tubes for testing. Puncture no deeper than 2.4mm (approximately 0.1 inches). NOTE:Tubes with additives must be thoroughly mixed. Patients who are dehydrated, obese, terminally ill, or hard sticks often get their blood drawn in other locations rather than the antecubital fossa. D. All of the above, Needles are sterile until: Remember that veins should ideally feel bouncy. Clinical and Laboratory Standards Institute. Wipe away the first drop of blood with a piece of clean, dry cotton. It is an employer's responsibility to provide, clean, repair, replace, and/or dispose of personal protective equipment/clothing. Areas of fingers and heels that are cold, swollen, scarred or covered with a rash, should be avoided. A. EMLA This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. Unlike the cephalic and basilic veins, the median cubital vein is not near major nerves or arteries. These may include listening to music or a story, watching a video, playing with a toy, having a parent provide distraction with talk or touch, using flash cards, and squeezing a rubber ball. 10. Apply firm
pressure for more than 5 minutes. 2013 Oct 10;(10):CD005179. Hematoma - may cause erroneous test results. 9. Whole blood specimens may not be able to be analyzed if microscopic clots are present. He previously worked in a high-volume outpatient lab and is currently employed in an acute care hospital and Level III trauma center in downtown Vancouver. iframe.style.height = zf_ifrm_ht_nw; Here phlebotomists will typically choose from three veins: the median cubital vein, the cephalic vein or the basilic vein. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. Lippi G, Blanckaert N, Bonini P, Green S, Kitchen S, Palicka V, Vassault AJ, Mattiuzzi C, Plebani M. Causes, consequences, detection, and prevention of identification errors in laboratory diagnostics. Any microtainerscontaining additives should be tapped to dislodge additives from the walls and top. 4. It is not uncommon for adults and children to feel some fear when having blood drawn, which is why any discussion of venipuncture should at least bring this topic to focus. A typical single vial contains about five milliliters, which is about one teaspoon. Also found in the antecubital fossa, the basilic vein serves as a last resort for blood draws. Include your email address to get a message when this question is answered. Valenstein PN, Sirota RL. are known to vary lab results of some analytes. antecubital fossa What are the best veins for venipuncture? Allow another large drop of blood to form. Back the needle out until the bevel is just below the skin. 3. A. 6. try{ B. Yellow If there is a concern regarding contamination by tissue fluids or thromboplastins, then one may draw a non-additive tube first, and then the light blue top tube. For an inpatient the nursing staff can be contacted to aid in identification prior to proceeding. Hyperextend the patient's arm. This image may not be used by other entities without the express written consent of wikiHow, Inc. \u00a9 2023 wikiHow, Inc. All rights reserved. Consult a specialist at the patient's own request and expense. Blood is commonly obtained from the median cubital vein on the anterior forearm. Fill the microtainer tube(s) as needed, adhering to the order of draw. Dispose of needles immediately upon removal from the patient's vein. 5. Potassium A phlebotomy technician is removing his gloves after a venipuncture procedure. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. 2. Refuse treatment to the extent permitted by law. C. Red Hemoconcentration: An increased concentration of larger molecules and formed elements in the blood may be due to several factors: Prolonged tourniquet application (no more than 1 minute). How To Draw Blood | A Step-by-Step Guide - Nurse.org Anxiety that results in hyperventilation may cause acid-base imbalances, and increased lactate. When would you use a butterfly/infustion set? Peripheral Intravenous Catheter Insertion - Video - JoVE Ask the patient to lie on their back. The patient has the right to refuse
participation in such activity. Select the proper approved lancet: The BD Microtainer Contact-Activated. Place blood collection equipment away from patients, especially children and psychiatric patients. Palpate and trace the path of veins with the index finger. Cleanse the fingertip of the 3rd (middle) or 4th (ring) finger with an alcohol prep. The most commonly used site for a venipuncture is at the bend of the elbow, also called the antecubital fossa 1. What angle should you insert the needle at? Allsurfaces are cleaned daily with bleach. Use of hair nets and face masks to decrease blood culture contamination rates. Also consider adjusting the angle of the needle. By holding the needle either by the plastic wings or the hub, phlebotomists can achieve a shallower angle, typically 10-15 degrees. Do not place too tightly or leave on more than 2 minutes (and no more than a minute to avoid increasing risk for hemoconcentration). Calculate H\Delta \mathrm { H }H of this reaction. A. the plastic sleeve is removed Significant increases can be found in total protein, aspartate aminotransferase (AST), total lipids, cholesterol, iron, Affects packed cell volume and other cellular elements. Performing a venipuncture on a child under one year of age . The median cubital vein, a superficial vein that forms a connection point between the cephalic and basilic veins of the arm is large, and therefore easier to see and feel. the 3 rd (middle) or 4 th (ring) finger of the hand. 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} 2017;50(10-11):568-573. Check for any allergies to antiseptics, adhesives, or latex by observing for armbands and/or by asking the patient. If it is then heated, what can you say about: b) how often the molecules hit the walls of the can. Do not use the central portion of the heel because you might injure the underlying bone, which is close to the skin surface. Dorsal hand veins are often utilized for intravenous infusions but are viable options for blood draw sites. Applyan adhesive bandage. Gloves are to be worn during all blood collection procedures, and changed betweenpatient collections. d.appendChild(f); It may be obstructing blood flow. The equipment used during the venipuncture test can vary, but the following are most commonly used for routine venipuncture: Phlebotomists may choose to draw blood from several different sites of the body. Inadvertently nicking a nerve causes intense pain. This image may not be used by other entities without the express written consent of wikiHow, Inc. \u00a9 2023 wikiHow, Inc. All rights reserved. Wipe away the first drop of blood with a sterile 22 gauze. Some DNS services support web filtering, too. The sides and the tip of the. Arteries
pulsate, are most elastic, and have a thick wall. Hematoma - may cause erroneous test results. He holds a Diploma in Medical Laboratory Assistance and is certified under the British Columbia Society of Laboratory Science. if( evntData && evntData.constructor == String ){ advantageous in certain adult populations, such as: those with severe burns, obese patients, those with thrombotic tendencies, and for point-of-care testing, when a small volume of blood is needed. Potential source of test error, particularly from hemolysis, Most lines are flushed with a solution of heparin to reduce the risk of thrombosis, Discard a sample at least three times the volume of the line before a specimen is obtained for analysis. This complication of peripheral I.V. f.style.width="100%"; wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. Do not use the tip of the finger or the center of the finger. The blood is bright red (arterial) rather than venous. This seats the bevel into the lumen of the vein, and is also the technique used to insert an IV catheter. The 6 Mistakes to Avoid When Building a Business Website (and - Medium Avoid excessive pressure that may squeeze tissue fluidinto the drop of blood. A lab coat or gown must be worn during blood collection procedures. 12. Using a sterile lancet, make a skin puncture just off the center of the finger pad. Do not attempt a capillary puncture more than twice. Free Flashcards about Phlebotomy Chapter 9 - StudyStack (See picture.) 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. Date, time and initials of the phlebotomist must be on the label of EACH tube. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws.
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