Phlebotomy – blood

I.Capillary Blood Collection

A.Assemble equipment.

1.Gauze or cotton balls.
2.Alcohol swabs, or 70% alcohol.
3.Sterile blood lancet.
4.Three capillary tubes (anticoagulated and plain). 5.Pencil and paper.
(In hospital you would have a requisition slip).
6.Gloves.

B.Select and prepare the site.

1.Massage the finger to increase circulation.
2.Vigorously clean area with 70% alcohol and let dry.

C.Puncture the finger using a firm, quick stick 2-3 mm. deep. (See Figure A)

D.Using a piece of dry Gauze, wipe the area dry. This allows the blood to form a rounded drop and not dribble over the side of the finger.

E.Collect at least three small capillary tubes full of blood without exerting undue pressure. (See Figure B)

F.Prevent further bleeding by placing a piece of gauze on puncture and ask patient to hold gauze until bleeding stops.

G.Label the specimens.

H.Date and initial the requisition slip.
II.Venous Blood Collection.

A.Syringe Method for Blood Collection

1.Assemble equipment.

a.Tourniquet.
b.Gauze or cotton balls.
c.70% alcohol or alcohol swabs.
d.Sterile needles.
e.10 cc. syringe.
f.Anticoagulated test tube.
g.Bandaid or surgical tape.
h.Marking pencil or pen.
i.gloves.

2.Select a potential site (refer to drawings of venous systems) and apply tourniquet with medium pressure and a quick release loop. (See Figure C and D)

3.Palpate vein and describe depth, size, and direction of vein at intended puncture site.

4.Clean area of puncture site vigorously with 70% alcohol swab. Scrub from center to outside of the site. Let dry.

5.Fix the vein in position by pulling skin taunt 1 inch below proposed entry.

6.Insert the needle firmly and deliberately at a 15o angle into the vein in exactly the same direction as the vein is running. (See Figure E and F)

7.Withdraw a minimum of 7 mls. whole blood by pulling back on
the plunger slowly.

8.Release the tourniquet and pick up the sterile piece of cotton.

9.Withdraw the needle and place cotton gently on puncture.

10.When the needle is out of the arm, firmly press cotton on puncture and ask patient to continue the pressure.

11.Transfer blood into anticoagulated test tube. Place the needle and the syringe in the disposable needle box or appropriate waste container.

12.Invert the tube 10-12 times. This mixes blood and anticoagulant.

13.Apply dressing, bandaid, or tape.

14.Label tubes with the patient’s name, date, and your initials.

B.Vacutainer Method for Blood Collection

1.Assemble equipment.

a.Tourniquet.
b.Gauze or cotton balls.
c.70% alcohol or alcohol swabs.
d.Double-pointed B-D needle, or any other appropriate needle. e.Plastic holder with guide line.
f.Evacuated glass tubes with rubber stoppers.
g.Bandaid or surgical tape.
h.Marking pencil or pen.
i.gloves.

2.Remove sheath from short end of needle (the covering) by
twisting and pulling simultaneously.

3.Screw needle into holder and tighten firmly.

4.Place tube in holder and push tube forward until top of stopper meets guide line. Do not push all the way.

5.Select a potential site (inside the elbow, hand, wrist, and foot) and apply tourniquet with medium pressure and a quick-release loop.

6.Palpate vein and describe depth, size, and direction of vein at intended puncture site.

7.Clean area of puncture site vigorously with 70% alcohol swab. Scrub from center to outside of the site. Let dry.

8.Fix the vein in position by pulling skin taunt 1 inch below proposed entry.

9.Insert the needle firmly and deliberately at a 15o angle into the vein in exactly the same direction as the vein is running.

10.Complete puncture of diaphragm by pushing tube forward with the same hand. If you are in the vein, blood will flow into the tube immediately.

11.Allow tube to fill. (If you are obtaining multiple specimens–2, 3, or more tubes–remove tube from rear cannula without moving needle in the arm. Slide the next tube on the rear cannula. Repeat the process as many times as necessary.)

12.Release the tourniquet and pick up the sterile piece of cotton.

13.Place cotton gently on puncture and withdraw the needle.

14.When needle is out of the arm, firmly press cotton on puncture and ask patient to continue pressure.

15.Remove tube from holder and invert tubes which contain anticoagulant 10-12 times.

16.Discard the needle properly in a biohazard waste container.

17.Apply dressing, bandaid, or tape.

18.Label tubes with the patient’s name, date, and your initials.

When blood is removed from a vein, it is called venipuncture or phlebotomy. Venipuncture should be performed with care. The veins of a patient are the main source of specimens for testing, the entry point of medications, and the site …

When blood is removed from a vein, it is called venipuncture or phlebotomy. Venipuncture should be performed with care. The veins of a patient are the main source of specimens for testing, the entry point of medications, and the site …

Phlebotomy: incision in vein for the purpose of drawing blood. Vacutainer tubes: sterile glass or plastic blood collection tube with a closure that is evacuated to create a vacuum inside the tube facilitating the draw of a predetermined volume of …

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1. Explain how additives are identified in blood collection tubes. By color of the tube top 2. List the 5 anticoagulants and their mode of action. EDTA, sodium citrate and potassium oxalate bind calcium. heparin inhibits conversion of prothrombin to …

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