Phlebotomy Flashcards by Alexandra Kristensen

phelobotomy

practice of drawing blood

required informed consent.

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shaft length

3/4 inch - 1/5 inches

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gauge

23-16 g

larger gauge = smaller needle

most common gauge = 21 g

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types of needles

Multisample (double ended)
syringe
winged infusion “butterflies”

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Order of draw:

Tube top color
additive

tests

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order of draw: 1
Color: yellow

additive: SPS - inhibits complement and phagocytosis

test: Blood culture

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order of draw: 2
Blue

additive: Sodium citrate

test: Coagulation tests

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Order of draw: 3
red

additive: clot activators (serum)

test: chemistry, serology, blood bank

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order of draw: 4

SST (gold/gray)

additive: clot activators and gel seperator (serum)

test: chemistru

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order of draw: 5
green

additive: heparin

test: Stat chemistry, ammonia, blood gases

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order of draw:
purple

additive: EDTA

Test CBC, ESR

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order of draw: 7
gray

addiitve; antiglycolytic agent
test: lactic acid, glucose, fasting blood sugar. blood alcohol

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greet and identify patient

check two patient identifiers (name and DOB)

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position and prepare patient

Fasting? Abstaining from medications?

NEVER draw blood from a standing patient ot sitting on a high stool

support the chosen arm under the elbow

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perform hand hygiene + gloves

wash/sanitize dry hands properly
put on gloves

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assembly equipment

required items:
- antiseptic pad
- torniquet
- needle
- adapter/syringe
- tubes
- gauze
- bandage/coban
- disposal system

apply tourniquet

3-4 inches above the puncture site
form an X

should NOT% be left on for over 1 min

Occludes venous flow NOT arterial flow

select the site

site should not be scarred, bruised or IV arm

palpate the vein

locate by palpitation, feel

push up and down with non dominant index finger
- feel small bounce back
- should not feel pulse or rigidity (artery or bone tendon)

8 .

clean the site

examine needle

blunted
barbed
obstruction
bent shaft

10.

perform venipuncture

anchor vein 1-2 inches below puncture site

insert needle
-15-30 degrees above skin

11.

fill first tube/remove touniquet

push in tube with non dominant hand

TORNIQUET must be removed before removing the needle

12.

advance and change tubes

mix 8-10 times

13.

prepare for needle removal make sure last tube is removed from adapter and TORNIQUET

14.

withdraw the needle

14.

withdraw the needle apply gauze to puncture site w pressure(non-dominant hand) hold for 3-5 min. prevents hematoma

15.

dispose of the used needle properly

label the tube 2 patient ID (name, DOB)

best veins for venipunctureare

located in antecubital fossa

1st choice of vein

Medial Cubital Vein - middle of arms surface / large and well anchored

2nd choice of vein

cephalic vein - same side of arm as the THUMB / not well anchored Best for obese pateints

3rd choice of vein

Basilic vein - same side of arm as pinky finger - even less anchored/ near briachial artery

antiseptic

any agent used to clean LIVING tissue 70% isoprpyl alcohol allow site to dry - "bacteriostatic action" - bacteriostatic - inhibits growth or reproduction of bacteria without killing

___ must be removed before the needle

tourniquet

if you have a problem with safety mechanism..

dispose of needle without safety