1 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use.

2 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. Chapter 7 Phlebotomy

3 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. Obligations Related to Performance of Phlebotomy Obligation to the patient –Make sure the patient understands the procedure to be performed. –Put the patient at ease. –Perform the procedure quickly and safely. –Use proper aseptic technique. –Properly dress the site. (continues)

4 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. Obligations Related to Performance of Phlebotomy (continued) Obligation to the lab –Always use aseptic techniques to prevent contamination –Label each blood sample correctly with the patient’s identification (continues)

5 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. Obligations Related to Performance of Phlebotomy (continued) Obligation to Self –Protect self from inadvertent exposure to blood specimens Knowing what is to be done Preparing for the procedure Performing the procedure step-by-step

6 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. Maintaining a Safe Environment Exposure Control Policy –Describes what to do if exposed to body fluids or specimens Have absolute knowledge of all equipment available to treat exposure. –Eyewash stations, hand washing areas, contents of first-aid kits, location of ointment, and adhesive strips or tape

7 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. Equipment For any test, gather the following basic equipment: –A set of gloves –An alcohol and iodine swab –Two 2 X 2 inch gauze pads –Tourniquet –Tape or adhesive strip –Vacuum collection tubes

8 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. Venipuncture Technique Verify the blood drawing order and patient information. Assess how cooperative the patient will be, fasting status, and medications. Locate a suitable vein; use a tourniquet if necessary. Put on a pair of disposable gloves. (continues)

9 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. Venipuncture Technique (continued) Open the packaging on all supplies. Prepare the site, wipe the skin with iodine, never going over the same spot twice. Repeat with an alcohol prep pad. Wipe the area from superior to inferior with a gauze pad. (continues)

10 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. Venipuncture Technique (continued) Warn the patient before inserting the needle Position the needle at a 25° to 30° angle Place the vacuum tube loosely inside the holder (do not push onto the needle) Insert needle until felt in the vein Advance vacuum tube onto the needle (continues)

11 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. Venipuncture Technique (continued) Once tubes have been filled, release the tourniquet and pull the last tube off of the needle and holder. Use the remaining gauze pad and apply gentle pressure to the site as the needle is withdrawn. Apply pressure for one minute (2-5 minutes if patient has a history of bleeding, or is on blood-thinning medication). (continues)

12 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. Venipuncture Technique (continued) Once bleeding stops, cover the site with adhesive strip or tape. Dispose of needle in a Sharps container with appropriate biohazard markings.

13 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. Venipuncture Technique (continued) Butterfly Needle –For blood cultures of difficult blood draws –Same equipment needed, minus the needle and holder –Butterfly needle and syringes are needed to draw the specimen. (continues)

14 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. Venipuncture Technique (continued) Complications and Hazards –Slight bruising –Large hematoma –Nerve damage –Infection (continues)

15 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. Venipuncture Technique (continued) Transporting can be done in several different ways: –Carry the specimen to the lab –Lab may retrieve specimen at a collection point –Pneumatic tubes