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PHLEBOTOMY Chapter 6
ART OF COLLECTING BLOOD
Advanced Skills for Health Care Providers, Barbara Acello, Thomson Delmar, 2007
OBJECTIVES
Spell and define key termsList factors that effect the condition of
the veinsHow to select a vein for venipunctureHow to clean and puncture the skinExplain why standard precautions are
used during phlebotomy procedures, and list PPE to wear
OBJECTIVES CONTINUED.
• Explain the similarities and differences between the vacuum-tube and syringe and needle methods of drawing blood
• List 8 precautions to take regarding venipuncture site selections
• List two common complications of venipuncture
Objectives continued
Demonstrate how to:Apply a tourniquet, dilate a vein, and
perform a venipunctureCollect a specimen using the vacuum-tube
system, needle and syringe, and butterfly and syringe methods
KEY TERMS
Phlebotomy- collecting blood
Venipuncture- act of puncturing a vein with a needle
Thrombophlebitis- inflammation of a vein with blood clot formation
Lumen- inside diameter of the needle
Bevel- slant at the end of the needle
Key Terms
Hemolysis- breaking of fragil blood cellsVacutainer- vacuum tube with a needle
attachedButterfly- winged infusion needleKelly Clamp- curved clamp with teeth
Key Terms
Hematoma - blood filled bruise caused by a broken blood vessel
Anticoagulants - blood thinning medications
Antecubital space - area in front of elbowto separate liquids from solids within the tubes
Key Terms
Septicemia- systemic infection
Aerobic microbes- pathogens that can live only in the presence of oxygen
Anaerobic microbes - pathogens that live without oxygen
Phlebotomy
Phlebotomy means collecting bloodVenipuncture is the act of puncturing a
vein with a needleBefore performing this procedure, check the requisition slip and make sure you understand the procedure you will be using. Gather all necessary equipment or supplies in advance.
Phlebotomy continued
To perform venipuncture, you must first select a vein
• Age • Illness• Dehydration• Previous needle sticks
all affect the condition of the veins
Factors that affect condition of the veins
Age:• Young adults have many veins to choose
from
• Veins in the elderly are often limited; they may roll or break upon puncture
• Children may be difficult because they move during the procedure.
STANDARD PRECAUTIONS
Always apply the principles of standard
precautions when performing phlebotomy Most health care facilities require
workers to wear long-sleeved lab coats or
gowns when drawing blood which must be
fluid-resistant Always wear gloves and pull the cuffs of
your gloves over the cuffs of your sleeves
Risk of Contamination
The risk of contamination is
increased if you must transfer
blood from one container to
another, such as a syringe to a
test tube.
HOW TO CLEAN AND PUNCTURE THE SKIN
Clean the site with alcohol in a circular motion
Allow alcohol to dry Reapply the tourniquet without touching
prepped area Insert needle with bevel facing up Hold skin taunt below prep site Insert needle at a 15 degree angle, And
advance slowly
HOW TO SELECT A VEIN FOR VENIPUNCTURE
• Veins in the forearm (antecubital space) are usually larger and straighter than those in other areas; this is the most common site for adults.
• If unable to find one in the forearm you could use veins in the hand
HOW TO SELECT A VEIN FOR VENIPUNCTURE (continued)
• You must be able to see or feel a vein
• A good vein will feel springy, and stand out when the tourniquet is tightened
Locating a Vein
Vacutainer
Biohazard Container
Blood Collecting Tubes
Methods of Drawing Blood
Tourniquet
• The tourniquet causes the veins to fill with blood
• Apply the tourniquet tightly enough to make the veins stand out
PRECAUTIONS TO TAKE
1) An arm with an IV2) An infected or edematous area3) Area with a rash4) Extremity with a shunt, graft, or dialysis
device5) Affected arm of a stroke6) Side of a mastectomy7) Site of previous injury or hematoma8) Burned or scarred area
COMPLICATIONS OF VENIPUNCTURE
1) Hematoma most common complication
2) Bleeding from the site
3) Ecchymosis- bruise
4) Signs and symptoms of phlebitis
5) Signs and symptoms of generalized infection
6) Signs and symptoms of air embolis