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23 Jan 2021

Exposure to latex can trigger a life-threatening reaction in those allergic to it, so it is vital that no latex items be used on a latex sensitive patient or even brought into the room. Venipuncture/ETS method: Demonstrate proper procedure for venipuncture using the evacuated tube system (ETS) method. Select and organize equipment. Approach, greet and properly identify the patient. Venipuncture*Procedure* The venipuncture procedure is complex and requires both knowledge and skill. Transport specimen to the lab. According to CLSI standards, the tourniquet should be released as soon as possible after blood begins to flow and should not be left on longer than 1 minute. Label the collection tubes at the bedside or drawing area. Observe special handling instructions. New photos . Venipuncture Video of a venipuncture. Nearly 70% of respondents had blood collected in a hospital setting. Tourniquet gloves antiseptic prep pad ETS needle tube holder and tubes gauze. 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. The site must be checked for signs of bleeding beneath the skin. The procedure can be hindered by flinching and tenseness caused by either the patient or phlebotomy … Step 3. Be sure not to touch the venipuncture site or you will need to repeat the cleaning process. Blood will not flow until the needle pierces the tube stopper. See “Collection Notes” 1 at the end of the procedure if 2 sets of blood cultures are ordered. Select and prepare venipuncture site. You attach the needle device to the tube holder, insert the needle into the vein, and engage the tube. Venipuncture Steps 210 Venipuncture Steps 217 Routine ETS Venipuncture 235 Routine ETS Venipuncture 235 . Equipment: Tourniquet, gloves, antiseptic prep pad, ETS needle, tube holder and tubes, gauze pads, sharps container, permanent ink pen, bandages Select vein, release tourniquet,ask patient to relax hand . Tie tourniquet. Review and accession test request. Follow ETS steps 15–20. A test request is reviewed for completeness, date and time of collection, status, and priority. (See PHL-1) 3. Find answers and explanations to over 1.2 million textbook exercises. Step 4. Venipuncture is the technical term used to describe the routine removal of blood from a vein for subsequent laboratory testing 1. Follow facility protocol. A test request is reviewed for completeness, date and time of collection, status, and priority. Step 2. Follow the Venipuncture procedure, PHL- 1 for general venipuncture guidelines. The right approach for a successful patient encounter includes a professional bedside manner, being organized and efficient, and looking for signs that convey important inpatient information or infection control precautions. Prepare equipment and put on gloves. Prepare equipment and put on gloves. Course Hero is not sponsored or endorsed by any college or university. Venipuncture procedures in this chapter conform to CLSI standards. PROCEDURE Routine ETS Venipuncture Step Explanation/Rationale 1. Review and accession test request. Name, DOB, and MR number must be, verified and matched to the test order and, inpatient’s IDband.Preparing the patient by, explaining procedures and addressing inquiries, patient care compromised if diet requirements have, not been met. Attach the evacuated tube holder onto the adapter at the end of the tubing. Select a large, well-anchored vein. Position patient, apply tourniquet, and ask patient to make a fist. Some facilities require that contaminated items such as blood-soaked gauze be discarded in biohazard containers. Reapply tourniquet, uncap and inspect needle. Try our expert-verified textbook solutions with step-by-step explanations. You may undergo this procedure as part of the observation or diagnosis of a wide range of medical conditions. Have the patient ball up their hand (form a fist). Position the patient (See PHL -1) 2. The evacuated tube system (ETS) is the standard equipment used for routine venipuncture. Question: Uallit Blood Collection Procedures The Following Are Highlights From The Procedure For Venipuncture Of A Hand Vein Using A Butterfly And ETS Holder SKILLS DRILL 8-5: HIGHLIGHTS OF HAND VENIPUNCTURE PROCEDURE (Text Procedure 8-3) Or Armrest. Apply the A clenched fist makes the veins easier to see and feel and helps keep them from rolling. Drawing blood, while routine, is a learned skill. Position the draw site for best visualization and/or palpation. Select vein, release tourniquet, and ask patient to open fist. Proper positioning is important to patient comfort and venipuncture success. According to OSHA, the needle and the tube holder must go into the sharps container as a unit because removing a needle from a holder exposes the user to sharps injury. Approach, identify, and prepare patient. A clean, folded gauze square is placed over the site so pressure can be applied immediately after needle removal. Performing the Test Prepare and clean the site with antiseptic or other germ-killing medicine. In healthcare, this procedure is performed by medical laboratory scientists, medical practitioners, some EMTs, paramedics, phlebotomists, dialysis technicians, and other nursing staff. Place your thumb 1- to 2-inches below and slightly beside the vein and pull the skin toward the wrist. Proper hand hygiene plays a major role in infection control by protecting the phlebotomist, patient, and others from contamination. Select a vein and release tourniquet. Letting the site dry naturally permits maximum antiseptic action, prevents contamination caused by wiping, and avoids stinging on needle entry and specimen hemolysis from residual alcohol. Procedure 4: Routine ETS Venipuncture Purpose: To obtain a blood specimen for patient diagnostic or monitoring purposes from an antecubital vein using the evacuated tube system (ETS) Equipment: Tourniquet, gloves, antiseptic prep pad, ETS needle, tube holder and tubes, gauze pads, sharps container, permanent ink pen, bandages Note: Either the needle or tube holder must have a safety feature to … Procedure and Performance of a Venipuncture: Select the proper size needle and attach it to the syringe or Vacutainer. Please ensure you have the most up-to-date copy at all times. When drawing a blood specimen, the trained phlebotomist must: 1). Attaching needle to the ETS holder, put the first tube in the holder now, or wait until after needle entry. Venipuncture Procedure. When using a syringe, make sure that you pull the plunger in and out to. 1. The accession process records the request and assigns it a unique number used to identify the specimen and related processes and paperwork. Have The Patient Near The It Slightly To Help Keep It From Fill In The Blanks With The Missing Information 1. In medicine, venipuncture or venepuncture is the process of obtaining intravenous access for the purpose of intravenous therapy or for blood sampling of venous blood.In healthcare, this procedure is performed by medical laboratory scientists, medical practitioners, some EMTs, paramedics, phlebotomists, dialysis technicians, and other nursing staff. Establish blood flow, release tourniquet, ask patient to open fist. 3. Ask patient to make a fist, anchor vein, and insert needle. Syringe Venipuncture Procedure 246 Syringe Venipuncture Procedure 252 . 2. Uncap and inspect the needle for defects and discard it if flawed. Most had multiple procedures in the year prior to being interviewed. Question: Chat 259 152 Unit Blood Collection Procedures SKILLS DRILL 8-3: ROUTINE ETS VENIPUNCTURE (Text Procedure 3-2) Pin In The Banks With The Missing Information Steps 1. Review And (1) Request Th Le Ar 2. Approach. Test results can be meaningless or misinterpreted and patient care compromised if diet requirements have not been met. Clean and air-dry site. The, accession process records the request and assigns it, a unique number used to identify the specimen and, 2. *Either the needle or tube holder must have a safety feature to prevent needlesticks. 6. Put tourniquet on the patient about 3-4’ above the venipuncture site. Prepare equipment. Pick up the tube holder with your dominant hand, placing your thumb on top near the needle end and fingers underneath. Tourniquet; gloves; antiseptic prep pad; ETS needle*, tube holder* and tubes; gauze pads; sharps container; permanent ink pen; bandage. D. 8-2 Routine ETS Venipuncture Procedure* E. 8-3 Venipuncture of a Hand Vein Using a Butterfly and ETS Holder Procedure* F. 8-4 Needle-and-Syringe Venipuncture Procedure* G. 9-1 Performing Venipuncture Below an IV Procedure H. 9-2 Steps to Follow if a Patient Starts to Faint During Venipuncture Procedure Fill syringe The accession process records the request and assigns it a unique number used to identify the specimen and related processes and paperwork. A test request is reviewed for completeness, date and time of collection, status, and priority. 7. The median cubital is the first choice, followed by the cephalic. Remove the needle in one smooth motion without lifting up or pressing down on it. The blood is normally drawn from a vein on the top of the hand or from the inside of the elbow. New photos . NEW! Reapply tourniquet, uncap, and inspect needle. Prepare the accession order. The results illustrate that blood collection can be a source of significant anxiety for patients even when the procedures go well. It consists of a needle device, a tube holder, and an air-evacuated tube. 2). 5. Selecting appropriate equipment for the size, condition, and location of the vein is easier after vein selection. In such cases, consult a physician or nurse before proceeding. You attach the needle device to the tube holder, insert the needle into the vein, and engage the tube. Syringe Procedure (Procedure 8-4) Follow ETS steps 1-7 . Videos: Venipuncture of a Hand Vein Using a Butterfly and ETS Holder Videos: Venipuncture Using a Needle and Syringe Videos: Venipuncture Using the Evacuated Tube System (ETS Venipuncture) Grasp the holder's flanges with your middle and index fingers, pulling back slightly to keep the holder from moving, and push the tube into the needle with your thumb. A tourniquet placed 3- to 4-inches above the antecubital area enlarges veins and makes them easier to see, feel, and enter with a needle. Purpose: To obtain a blood specimen for patient diagnostic or monitoring purposes from an antecubital vein using the evacuated tube system (ETS) Establish blood flow, release tourniquet, ask patient to open fist. Perform the venipuncture, collecting the sample (s) in the appropriate container (s). Dispose of used and contaminated materials. 3). Perform the venipuncture 1. Procedure for Inability to Collect Specimen Hold the patient’s arm and place a thumb below the chosen site to anchor the vein. Approach, identify, and prepare patient. assure free motion. 2. The evacuated tube system (ETS) is the standard equipment used for routine venipuncture. Prepare the equipment, the patient and the puncture site. Perform the venipuncture procedure. Follow the CLSI order of draw to prevent additive carryover between tubes. Ask patient to make a fist, anchor vein, and insert needle. New photos . 2. Verify diet restrictions and latex sensitivity. It consists of a needle device, a tube holder, and an air-evacuated tube. If bleeding persists beyond 5 minutes, notify the patient's nurse or physician. According to the OSHA BPP standard, gloves must be worn during phlebotomy procedures. Verify patient’s diet restrictions, as appropriate. Fill additive tubes until the vacuum is exhausted to ensure correct blood to additive ratio and mix them immediately upon removal from the holder using 3 to 8 gentle inversions (depending on type and manufacturer) to prevent clot formation. Attach the appropriate needle to the hub by removing the plastic cap over the small end of the needle and inserting into the hub, twisting it tight. In veterinary medicine, the procedure is performed by veterinarians and … Sanitize hands. The primary choice for a routine venipuncture that will be performed on an adult or an older child is a blood collection system that consists of a holder (or adapter), a needle that is pointed on both ends, and evacuated blood collection tubes. The fist aids needle entry. Gloves are sometimes put on at this point. The right approach for a successful patient encounter, includes a professional bedside manner, being, organized and efficient, and looking for signs that, convey important inpatient information or infection-, Correct ID is vital to patient safety and meaningful, test results. This chapter also addresses challenges and unique issues associated with pediatric, geriatric, dialysis, long-term care, home care, and hospice patients. If bleeding has stopped, apply bandage and advise the patient to keep it in place for at least 15 minutes. It is important for the phlebotomist to follow a step-by-step procedure to ensure consistency and to make the patient comfortable. Note: Either the needle or tube holder must have a safety feature to prevent needle sticks. Apply the tourniquet and select the venipuncture site. The basilic should not be chosen unless no other vein is more prominent in either arm. (5) Prepare Patient And I Vital Restrictions 3. Dubiski Career High School, Grand Prairie, phb_unit2labVenipunctureJuly_10__2018-2.pdf, phb_PHBLab2VenipunctureVacutainerSpring2010.pdf, Dubiski Career High School, Grand Prairie • SCIENCE N/A. 2. The tourniquet aids needle entry. Place gauze, remove needle, activate safety feature, and apply pressure. Venepuncture is the process of obtaining intravenous access – most commonly for the purpose of blood sampling. PROCEDURE Routine ETS Venipuncture Step Explanation/Rationale 1. Review and accession test request. Place a tube in the holder and push it part way onto the needle with a clockwise twist. Recognize complications associated with the phlebotomy procedure. Releasing the tourniquet and opening the fist helps prevent hemoconcentration. Dermal Puncture vs Venipuncture In some situations, the phlebotomist will make the decision if a blood specimen will be obtained by dermal puncture or venipuncture. Gloves must be removed in an aseptic manner and hands washed or decontaminated with hand sanitizer as an infection control precaution. Correct ID is vital to patient safety and meaningful test results. Materials such as needle caps and wrappers are normally discarded in the regular trash. Identify the patient. The accession process records the request and assigns it a unique number used to identify the specimen and related processes and paperwork. 4). Anchoring stretches the skin so the needle enters easily and with less pain, and keeps the vein from rolling. Find GCSE resources for every subject. Labeled tubes. Check patient's arm and apply bandage. • Venipuncture – The process of collecting or “drawing”blood from a vein – Covered in this chapter: • How to correctly identify all types of patients • How to safely obtain high-quality blood specimens • Venipuncture procedures: ETS, butterfly, & syringe procedures on arm & hand veins Procedure: 1. Immediately apply pressure to the site with your free hand while simultaneously activating the needle safety feature with the other hand to prevent the chance of a needlestick. Just because bleeding has stopped on the skin surface does not mean that the site has stopped bleeding from the vein. In such cases, consult the physician or, nurse before proceeding.Exposure to latex can trigger life-, threatening reaction in those allergic to it, so it is vital that. Anchor by grasping the arm just below the elbow, supporting the back of it with your fingers. Venipuncture techniques covered in this chapter in-clude ETS, butterfl y, and syringe procedures on arm and hand veins. Patient's arm must be examined to verify that bleeding has stopped. Prompt delivery to the laboratory protects specimen integrity and is typically achieved by personal delivery, transportation via a pneumatic tube system, or by a courier service. 6. Blood will appear in the hub of the needle if the position is correct. Discard collection unit. Remove the winged infusion needle from its packaging. Thank the patient, remove gloves, and sanitize hands. Perform venipuncture using the following steps: Place your thumb BELOW the venipuncture site to anchor the vein. Blood Culture: Demonstrate proper procedure for blood culture collection. Butterfly Procedure 243 Blood Collection Set Procedure 235 . A test request is reviewed for completeness, date, and time of collection, status, and priority. (See PHL-1) 4. Stop when you feel a decrease in resistance, often described as a "pop" and press your fingers into the arm to anchor the holder. Place the tourniquet 3 to 4 inches above the venipuncture site, making it swell with blood. Unfortunately, it also shows how many of these procedures can go wrong. Name, date of birth, and medical record number must be verified and match to the test order and patient's ID band. Releasing the tourniquet and opening the fist allows blood flow to normalize. For accurate results, some specimens require special handling such as cooling in crushed ice (e.g., ammonia), transportation at body temperature (e.g., cold agglutinin), or protection from light (e.g., bilirubin). Cleaning the site with an antiseptics such as 70% isopropyl alcohol helps avoid contaminating the specimen or patient with skin surface bacteria picked up by the needle during venipuncture. 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