Dry the cleaned area with a dry gauze pad. Unscrew the needle directly into a puncture-proof container. Briefly list the steps involved in performing the venipuncture after the vein has been located by palpation and the tourniquet has been removed: Wait 2 minutes before reapplying the tourniquet Sanitize hands and put gloves on and cleanse antecubital area with alcohol wipes Do not touch the area after cleaning the area. 2. Place the gauze pad over the puncture site. 19. When performing a venipuncture on an infant, the amount of blood taken from the infant should be monitored to avoid. the 3 rd (middle) or 4 th (ring) finger of the hand. Using an improperly attached needle on a syringe so that frothing occurs as the blood enters the syringe. Please mark the location of the antecubital fossa: A. The purpose of applying a tourniquet when performing venipuncture is to make the patient's veins stand out. Assess the patient for such . 4. Perform venipuncture using the following steps: Place your thumb BELOW the venipuncture site to anchor the vein. 1. Click to see full answer. To become truly proficient in venipuncture techniques, you must. B. The CLSI standards recommend cleansing the site with friction using a clean gauze pad with 70% isopropyl alcohol solution or a commercially prepared alcohol pad. Notes. Areas that should be avoided for venipuncture include all of the following EXCEPT: a. hematomas b. deep cephalic veins c. edematous tissue d. tattoos Step-by-step solution Step 1 of 4 The hematoma's presence specifies that within the tissue the blood has accrued surrounding the vein in the process of venipuncture. The most common needle gauge used for venipuncture is ___________. What sites should be avoided when drawing blood? Ensure the patient's hand is open. Palpate the vein you have identified to assess if it is suitable: Tapping the vein and asking the patient to repeatedly clench their fist can make the vein easier to visualise and palpate. Apply the tourniquet for no longer than 1 min. Venipuncture STUDY PLAY Before performing venipuncture the nurse. The line must be flushed first. Avoid venipuncture on the side of breast surgery with axillary node dissection, after radiation therapy to that side, or with lymphedema. The alcohol should be applied using a circular target motion. 8.An angle of more than 15 degrees is used when performing venipuncture. 9.The needle is moved after inserting it. 3. Perform the venipuncture. While performing a venipuncture, the medical assistant removes the filled tubes, but forgets to remove the tourniquet prior to needle withdrawal. The donation sites should be organized in a way that ensures the safety of blood donors, staff and donated blood units, and avoids errors in the blood donation process. Blood culture is a microbiological procedure where a blood sample is placed . Main vein sites used by nurses veins of the extremities, arms are most commonly used. Proper Procedure for Drawing Beneath an IV. Using a needle with too small diameter (above 23 gauge) 2. 13. The ideal sites for venipuncture are typically in the cubital fossa of the forearm, which has the shape of an isosceles triangle with the biceps forming the base, and the lateral and medial groups of the antebrachial muscles forming the sides respectively 26) . VENIPUNCTURE SITE SELECTION: 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. Compress the venipuncture site for approximately 30 seconds. 11. The e-module mainly focuses on venipuncture at the antecubital fossa and students were instructed to find any appropriate site during their psychomotor skill testing. The adverse events that have been best documented are in blood transfusion services, where poor venepuncture practice or anatomical abnormality has resulted in haematoma . Routine Venipuncture. First draw up air equal to number of units and inject into NPH vial, repeat for Reg insulin vial. This technique pushes the bacteria away from the inside of the venipuncture site to the outside. At no time may phlebotomists perform venipuncture on an artery. The device used to hold the tube during venipuncture is known as: the tube holder, the barrel. Which of the following is the most likely result? Venipunctures, performed correctly, carry a low risk of any type of injury. The alcohol must be allowed to air dry for approximately one minute prior to venipuncture to properly disinfect site, prevent hemolysis of the specimen, and avoid Inspect the patient's arm for an appropriate venepuncture site: The median cubital vein in the antecubital fossa is commonly used for venepuncture. V. Variations Alternatives for venipuncture include drawing blood into a syringe in lieu of a vacutainer system. Hemoconcentration is a decrease in plasma volume and an abundance of blood cells . When using a syringe inserted into the line, blood must be withdrawn slowly to avoid hemolysis. 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. Avoid drawing blood from a hematoma. Before beginning any procedure, identify the patient accurately [3]. Serum tubes should be centrifuged in a timely manner according to protocol. Take enough time to assess the vein before beginning the venipuncture procedure. List the steps necessary to perform a capillary puncture in chronological order. What precautions should you take when performing a venipuncture to avoid exposure to blood? Assess the patient for such . Foot veins are a last resort because of the higher probability of complications. (See picture.) keeping the patient's arm in a downward position. To assess your expertise, consider downloading . The needle may enter above the vein, preventing puncture. Be careful not to withdraw the needle completely or else you risk losing the tube's vacuum and starting a hematoma when the bevel exits the skin. Venepuncture should be performed with care. Punctures done on the plantar surface can damage cartilage or bone. Apply the tourniquet approximately 4-5 finger-widths above the planned venepuncture site. and the adapter. 9. This preliminary action allows you to safely adjust the needle's position. It's a minimally invasive way to collect blood cells and plasma, the liquid component of blood, for analysis. Document that the venipuncture was performed distal to (below) an infusion site. 11. Alternative sites for venipuncture include cephalic vein and saphenous vein. 12. Choose a vein, other than the vein with the IV. State the special precautions which should be taken when performing venipuncture on veins of the hands, Question 4. 7. cannula insertion. 4- apply pressure to the venipuncture site to prevent hemolysis what should you do ? Therefore, we try to avoid any breaks in the skin (that can lead to infection) or any . Additional Considerations: Hemolysis: To prevent hemolysis when performing a venipuncture: Mix anticoagulated specimens thoroughly by inverting tube gently 5 to 10 times. 12). 2. 21G. Which one of the following steps would a veterinary assistant perform during venipuncture of the cephalic vein? Unsafe phlebotomy can cause adverse effects for patients; such effects are rare, but range from pain or bruising at the site of puncture, to fainting, nerve damage and haematoma. Common Venipuncture Sites: 13. Ask the patient's nurse to turn off the IV for about two minutes prior to the venipuncture procedure. Avoid drawing the syringe plunger back too forcibly. Outline steps for successful I.V. Draw up appropriate units from NPH very carefully as you can not return excess if too . However, if there is no alternative and an arm with an IV line in place must be used for venipuncture, try to choose a site away from and below the location of the IV. Prewarming the infant's heel (42 C for 3 to 5 minutes) is important to increase the flow of blood for collection. 4. Venipuncture requires good skills in order to perform the procedure not only . Position the patient's arm in a comfortable extended position that provides adequate access to the planned cannulation site. B. enter the vein with the needle at a 45 angle. 17 . Also avoid performing venipuncture in an extremity with an actual or a planned fistula access or one affected by stroke, injury, or deformity. The veins of a patient are the main source Release and remove the tourniquet. . It is not recommended that blood be drawn from the feet .The Providers permission is required to draw from this site. . 15). Choosing an appropriate site for venipuncture is crucial for a successful . The proper collection of capillary blood includes. Avoid areas of hematoma. Extensive scarring or healed burn areas should be avoided; Specimens should not be obtained from the arm on the same side as a mastectomy. The most commonly used site for a venipuncture is at the bend of the elbow, also called the antecubital fossa 1. From Venipuncture Avoiding nerve damage when performing a venipuncture requires using correct procedure during the blood draw. 5. Don your gloves 3. Talk now. C. use impermeable bedding material that keeps moisture near the skin. Serum is obtained from whole blood that has been centrifuged. In most circles, the terms venipuncture and phlebotomy are used interchangeably. 2 Know-How Whether you are performing a skin puncture or a venipuncture, some of the more challenging patients to draw blood from are children. Thus, 56% of all procedures in the neonatal unit are performed using capillary blood samples, making it the most frequent invasive procedure performed . Pulling the plunger of a syringe back too fast. 70% alcohol is allowed to dry on the venipuncture site because it kills most of the existing bacteria that could possibly contaminate the sample. Therefore, an arm containing an IV should not be used to draw blood specimens if it can be avoided. The information given here supplements that given in Chapters 2 and 3. However, some sites must be avoided due to the risk of complications and/or unnecessary pain to the patient. Select the vein site. If a patient is very angry and yells that the lab tests are a " waste of time , " which of t he following is the best first response ? finger should be avoided. Patient Assessment and Psychological Preparation Patient Information to Consider 5. COLLECTION & HANDLING TIPS Routine Venipuncture. C. recap used needles to avoid accidental needle punctures. Why is 70% alcohol allowed to dry on the venipuncture site? 2. a. attend instructional classes. a . C. The bend of the elbow, the outer side of the arm. The sides and the tip of the. 10. Never apply a tourniquet to an arm located on the same side of the body as a mastectomy or stroke If the arm contains an IV drip, it is preferable to draw from the other arm. 7.An angle of less than 15 degrees is used when performing venipuncture. 3. Wear gloves, be sure patient is laying down while taking blood ARTERY A blood vessel that carries blood from the heart to the capillaries CEPHALIC VEIN A superficial vein of the arm commonly used for venipuncture GAUGE A measure of the diameter of a needle Hold the baby's foot firmly to avoid sudden movement. 14. Inspect the needle and other equipment. Areas in which two veins join should be avoided where possible, as valves are often present. This causes patient discomfort. Define blood culture. B. occasionally wiping the site with a plain gauze pad to avoid the buildup of platelets. The blood is normally drawn from a vein on the top of the hand or from the inside of the elbow. Gather Equipment 4. Choose the best method for needle disposal.