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

-antiseptic swabs 2009;18(2):117-139. LTD: Performing a Capillary Puncture Version 7, General Guidelines for a Capillary Puncture: Capillary punctures are ideal for, small children when only a small volume of blood is needed. Loosen the tourniquet. As a countermeasure, phlebotomists anchor the vein with their hand to stabilize it for the draw. Any attempt to repeat a puncture at the same site increases the risk of complications. Venipuncture can also happen when patients have intravenous (IV) lines started. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. Therefore, an arm containing an IV should not be used to draw blood specimens if it can be avoided. D. discarded in the trash, True or False? Hematoma - A venipuncture should not be performed on a hematoma, regardless of how small it may be. This vein can be found along the upper arm to the thumb, but it is commonly drawn from the forearm or antecubital fossa area. A. standards Because most laboratory specimens contain bacteria, it is not necessary to wash hands before collecting them, The tourniquet applied prior to venipuncture is removed: Fill the microtainer tube(s) as needed. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. Never draw from a thrombosed or scarred vein. jugular) or a central venous catheter is out of the scope of practice of a certified phlebotomist and should only be performed by a physician or advanced nurse. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. Using a sterile lancet, puncture the fingertip in the fleshy part of the finger, slightly to the sideof the center and across (perpendicular to) the grooves of the fingertip. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. B. Hematoma Let's take a quick, high-level look at the venipuncture procedure. A face mask reduces risk for blood culture specimen contamination. 6. Do not use the central portion of the heel because you might injure the underlying bone, which is close to the skin surface. Uman LS, Birnie KA, Noel M, et al. This makes every subsequent poke harder and harder because scar tissue is more fibrous and tougher to puncture. Greet the patient and identify yourself and indicate the procedure that will take place. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. How can you decrease the risk of hematoma formation? A commercial heel warmer may be used. -test tubes The patient who is at ease will be less focused on the procedure. Do not use excessive pressure or heavy massaging because the blood may become diluted with tissue fluid. Cannula/fistula/heparin lock - hospitals have special policies regarding these devices. Subcutaneous tissue feels squishy and muscle feels hard. Apply the tourniquet 3-4 inches above the selected puncture site. Pediatric Pointers. Center for Phlebotomy Education, Inc. Ernst, Dennis J. and Catherine Ernst. PROBLEMS OTHER THAN AN INCOMPLETE COLLECTION: A hematoma forms under the skin adjacent to the puncture site - release the tourniquet immediately and withdraw the needle. Use of hair nets and face masks to decrease blood culture contamination rates. Clean up any blood spills with a disinfectant such as freshly made 10% bleach. Punctures to the posterior curvature of the heel cab cause damage to the bones. BD Eclipse green-capped) is used for most routine and uncomplicated venipunctures. Assess the need for sample recollection and/or rejection. Serum iron levels tend to drop during the day. diet, exercise, stress, basal state). 70% isopropyl alcohol wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. Mix and label all appropriate tubes at the patient bedside. Switch to the other arm if you can't find anything. https://www.ncbi.nlm.nih.gov/books/NBK138650/pdf/Bookshelf_NBK138650.pdf (Accessed June 13, 2022). Watch for formation of a hematoma. Copyright 2023 - PhlebotomyU | Website Design & SEO by, Phlebotomy: 5 Tips on Finding Difficult Veins. (a) the electric power required. Capillary punctures are not suitable for blood culture testing and most coagulation tests. Determine the final temperature of the R-134a and the final specific internal energy. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. Allow it to air, Grasp the finger, and using a sterile lancet, press firmly against the finger. Precautions include a medical grade face mask. C. sterile gauze pads Examples of labeled collection tubes are shown below: THE FOLLOWING ARE NEEDED FOR ROUTINE VENIPUNCTURE: Evacuated Collection Tubes - The tubes are designed to fill with a predetermined volume of blood by vacuum. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. 3. Adjust the height and swivel the chair to ensure your body is in line with the vein. What are the gold top containers used for? Cap, rotate and invert the microtainer to mix the blood collected. This article has been viewed 43,712 times. The first step to choosing the right vein is to select the appropriate needle gauge. The venipuncture procedure is complex, requiring both knowledge and skill to perform. This article was co-authored by Matt Garcia. The upper extremity on the side of a previous mastectomy - test results may be affected because of lymphedema. Dalal BI, Brigden ML. B. the insertion site has stopped bleeding A requisition form must accompany each sample submitted to the laboratory. Hard and dense structures may be nerves or tendons. Place a pillow under the patient's arm if additional support is needed. After the third attempt, further medical directions must be sought with the attending physician before proceeding. Take enough time to assess the vein before beginning the venipuncture procedure. Have the patient drink fluids if dehydrated. Here phlebotomists will typically choose from three veins: the median cubital vein, the cephalic vein or the basilic vein. Tip: If you realize you've collected in the wrong order of draw, remove the tube, insert the correct one, fill it halfway before discarding it, then insert a new tube and fill it completely. Extensive scarring or healed burn areas should be avoided Specimens should not be obtained from the arm on the same side as a mastectomy. Edematous extremities with swollen tissue alter the results. Why? What is the best position to perform venipuncture in? An electric motor draws a current of 10 amp with a voltage of 110V110 \mathrm{~V}110V. The output shaft develops a torque of 10.2Nm10.2 \mathrm{~N} \cdot \mathrm{m}10.2Nm and a rotational speed of 1000 RPM. How many time should you invert them? In some instances, the legs or feet are required for use, but a physician or doctor should be completing the draw, not a phlebotomist. 8. Most reference ranges are based on normal laboratory test values for: Healthy people in a basal state. 1. Clin Biochem. Blood is commonly obtained from the median cubital vein on the anterior forearm. 2. Transferring a sample from one collection tube to another or mixing blood from different collection tubes must be avoided. Butterflies are incredibly valuable tools for tackling difficult draws, owing to their precision, shorter shaft length, and maneuverability. Answer. Reasonable informed participation in decisions involving the patient's health care. 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} The basic patient rights endorsed by the JCAHO follow in condensed form are given below. The first drop contains excess tissue fluid and must be wiped away. Capillary Specimens may be collected on filter paper and sent to lab for testing for. Procedure for Capillary Puncture of the Heel: A heel puncture is performed on the lateral or medial plantar surface of the, foot. Stop the procedure and remove the needle if: Thanks to all authors for creating a page that has been read 43,712 times. Obtain from the practitioner complete and current information about diagnosis, treatment, and any known prognosis, in terms the patient can reasonably be expected to understand. -obvious skin infection (including newly tattooed areas) -extensive scarring -don't use same side as mastectomy -avoid previous hematoma -avoid arm w/ fistula/cannula -edamtous extremity What is the most common site for blood sampling? There are some slight risks associated with venipuncture which may include excessive bleeding, feeling light-headed, fainting, nerve damage, hematoma (accumulation of blood under the skin), and infection. -use a smaller gauge needle Some images used in this set are licensed under the Creative Commons through Flickr.com.Click to see the original works with their full license. Applyan adhesive bandage. The content of this article is not intended to be a substitute for professional medical advice, examination, diagnosis, or treatment. Squeeze puncture site to promote bleeding. Forward completed/dry collections to the laboratory as soon as possible. Remove the needle from the patient's arm using a swift backward motion. 8. The 2nd (index) finger tends to have thicker, callused skin. 2019;95(1):15-19. doi: 10.1016/j.diagmicrobio.2019.04.001. The sides and the tip of the, Select the proper approved lancet: The BD Microtainer Contact-Activated, Lancet 1.5 mm (lavender) is used for glucometers and the BD Microtainer, Contact-Activated Lancet 2.0 mm (blue) is used any time you need more, Prepare the finger by cleaning it with a Chlorhexadine wipe. (See, The chlorhexidine is a concern for the premature babies in NICU as it can, be absorbed through the skin. What are some of the reasons to draw blood? 1. Give an example of each. Concentrations of fluids and medications could affect baseline test results. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. Various sizes are available. 23-gauge needles (e.g. Which element has the highest ionization energy? This image may not be used by other entities without the express written consent of wikiHow, Inc.
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