Collection of blood samples Dr Khaled Mahran

Phlebotomy procedure illustrated The first step is always to identify the patient. Outpatient phlebotomy, as shown here, should take place with the patient seated.

The requisition form should be completely filled out, and the requisition must indicate the tests ordered.

Here is the equipment for performing phlebotomy. Barrier protection for the phlebotomist consists of the latex gloves.

The tourniquet is applied and the phlebotomist palpates for a suitable vein for drawing blood.

The area of skin is cleaned with a disinfectant, here an alcohol swab.

The vein is anchored and the needle is inserted.

The vacutainer tube is depressed into the needle to begin drawing blood.

Additional vacutainer tubes can be utilized. Determine what tests are ordered and what tubes will be necessary BEFORE you begin to draw blood, and determine the order of draw for the tubes.

When the final tube is being drawn, release the tourniquet. Then remove the tube, and remove the needle.

After the needle is removed from the vein, apply firm pressure over the site to achieve hemostasis.

Apply a bandage to the area.

Dispose of the needle into a sharps container that is close by.

Label the tubes, checking the requisition for the proper identification.

Finger-stick procedure illustrated Here is the equipment for fingersticks (heelsticks). The lancets come in different lengths. There are several standard microtainers utilized to collect fingerstick (or baby heelstick) blood. The purple cap is for hematology specimens and the green cap is for chemistry specimens. The dark brown-red microtainer protects a neonatal bilirubin sample from the light.

The proper location on the 3 rd or 4 th finger of the non- dominant hand for performing a fingerstick is outlined here between the green lines. The puncture should be made just off center and perpendicular to the fingerprint ridges. A puncture parallel to the ridges tends to make the blood run down the ridges and hamper collection.

The lancet is placed over the proper location on the finger and the puncture is made quickly.

A drop of blood appears at the puncture site.

The first drop of blood that may contain tissue fluid is wiped away.

The finger is gently massaged from base to tip and the blood drops are collected into the proper collection device.

The blood is mixed in microtainers with an additive.

Hematoma Note the small hematomas in the view above. In the view below, there has been more extensive subcutaneous hemorrhage, and even tearing of the skin from adhesive tape applied with a bandage.

Heelstick Two heelsticks have been performed on this baby. One of them has been performed correctly. One was performed improperly. × √