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Dispose of used and contaminated materials. New photos . 3). Venipuncture/ETS method: Demonstrate proper procedure for venipuncture using the evacuated tube system (ETS) method. Select vein, release tourniquet, and ask patient to open fist. Cleaning the site with an antiseptics such as 70% isopropyl alcohol helps avoid contaminating the specimen or patient with skin surface bacteria picked up by the needle during venipuncture. According to the OSHA BPP standard, gloves must be worn during phlebotomy procedures. D. 8-2 Routine ETS Venipuncture Procedure* E. 8-3 Venipuncture of a Hand Vein Using a Butterfly and ETS Holder Procedure* F. 8-4 Needle-and-Syringe Venipuncture Procedure* G. 9-1 Performing Venipuncture Below an IV Procedure H. 9-2 Steps to Follow if a Patient Starts to Faint During Venipuncture Procedure You attach the needle device to the tube holder, insert the needle into the vein, and engage the tube. Position patient, apply tourniquet, and ask patient to make a fist. Syringe Venipuncture Procedure 246 Syringe Venipuncture Procedure 252 . Some facilities require that contaminated items such as blood-soaked gauze be discarded in biohazard containers. Thank the patient, remove gloves, and sanitize hands. Blood will not flow until the needle pierces the tube stopper. Procedure for Inability to Collect Specimen Venipuncture Procedure. Tourniquet gloves antiseptic prep pad ETS needle tube holder and tubes gauze. Procedure 4: Routine ETS Venipuncture Purpose: To obtain a blood specimen for patient diagnostic or monitoring purposes from an antecubital vein using the evacuated tube system (ETS) Equipment: Tourniquet, gloves, antiseptic prep pad, ETS needle, tube holder and tubes, gauze pads, sharps container, permanent ink pen, bandages Note: Either the needle or tube holder must have a safety feature to … Perform venipuncture using the following steps: Place your thumb BELOW the venipuncture site to anchor the vein. Gloves must be removed in an aseptic manner and hands washed or decontaminated with hand sanitizer as an infection control precaution. hub. The results illustrate that blood collection can be a source of significant anxiety for patients even when the procedures go well. Name, DOB, and MR number must be, verified and matched to the test order and, inpatient’s IDband.Preparing the patient by, explaining procedures and addressing inquiries, patient care compromised if diet requirements have, not been met. It consists of a needle device, a tube holder, and an air-evacuated tube.Once the tube is punctured by engaging the tube onto the needle, the negative pressure causes suction to … Prepare the accession order. Procedure: 1. New photos . Ask patient to make a fist, anchor vein, and insert needle. (5) Prepare Patient And I Vital Restrictions 3. Tourniquet; gloves; antiseptic prep pad; ETS needle*, tube holder* and tubes; gauze pads; sharps container; permanent ink pen; bandage. Dermal Puncture vs Venipuncture In some situations, the phlebotomist will make the decision if a blood specimen will be obtained by dermal puncture or venipuncture. Butterfly Procedure 243 Blood Collection Set Procedure 235 . Venipuncture*Procedure* The venipuncture procedure is complex and requires both knowledge and skill. Apply the tourniquet and select the venipuncture site. The evacuated tube system (ETS) is the standard equipment used for routine venipuncture. You may undergo this procedure as part of the observation or diagnosis of a wide range of medical conditions. Position the patient (See PHL -1) 2. Most had multiple procedures in the year prior to being interviewed. 3. Be sure not to touch the venipuncture site or you will need to repeat the cleaning process. The tourniquet aids needle entry. The blood is normally drawn from a vein on the top of the hand or from the inside of the elbow. Select and organize equipment. Clean and air-dry site. Follow facility protocol. 2. A test request is reviewed for completeness, date, and time of collection, status, and priority. Gloves are sometimes put on at this point. See “Collection Notes” 1 at the end of the procedure if 2 sets of blood cultures are ordered. Select a vein and release tourniquet. Approach. Place the patient's arm downward in a straight line from shoulder to wrist to aid in vein selection and avoid reflux as tubes are filled. Immediately apply pressure to the site with your free hand while simultaneously activating the needle safety feature with the other hand to prevent the chance of a needlestick. Preparing it while the site is drying saves time. The right approach for a successful patient encounter includes a professional bedside manner, being organized and efficient, and looking for signs that convey important inpatient information or infection control precautions. Correct ID is vital to patient safety and meaningful test results. Remove the needle in one smooth motion without lifting up or pressing down on it. Step 1. The accession process records the request and assigns it a unique number used to identify the specimen and related processes and paperwork. Prepare equipment. Approach, greet and properly identify the patient. When using a syringe, make sure that you pull the plunger in and out to. Test results can be meaningless or misinterpreted and patient care compromised if diet requirements have not been met. The basilic should not be chosen unless no other vein is more prominent in either arm. The procedure can be hindered by flinching and tenseness caused by either the patient or phlebotomy … Position the draw site for best visualization and/or palpation. A clenched fist makes the veins easier to see and feel and helps keep them from rolling. New photos . Ask patient to make a fist, anchor vein, and insert needle. 2. It is important for the phlebotomist to follow a step-by-step procedure to ensure consistency and to make the patient comfortable. Approach, identify, and prepare patient. 5. Attaching needle to the ETS holder, put the first tube in the holder now, or wait until after needle entry. The primary choice for a routine venipuncture that will be performed on an adult or an older child is a blood collection system that consists of a holder (or adapter), a needle that is pointed on both ends, and evacuated blood collection tubes. A clean, folded gauze square is placed over the site so pressure can be applied immediately after needle removal. The accession process records the request and assigns it a unique number used to identify the specimen and related processes and paperwork. Prepare equipment and put on gloves. Question: Chat 259 152 Unit Blood Collection Procedures SKILLS DRILL 8-3: ROUTINE ETS VENIPUNCTURE (Text Procedure 3-2) Pin In The Banks With The Missing Information Steps 1. Review And (1) Request Th Le Ar 2. The, accession process records the request and assigns it, a unique number used to identify the specimen and, 2. Syringe Procedure (Procedure 8-4) Follow ETS steps 1-7 . Anchoring stretches the skin so the needle enters easily and with less pain, and keeps the vein from rolling. In medicine, venipuncture or venepuncture is the process of obtaining intravenous access for the purpose of intravenous therapy or for blood sampling of venous blood.In healthcare, this procedure is performed by medical laboratory scientists, medical practitioners, some EMTs, paramedics, phlebotomists, dialysis technicians, and other nursing staff. Releasing the tourniquet and opening the fist allows blood flow to normalize. 2). Uncap and inspect the needle for defects and discard it if flawed. Attach the appropriate needle to the hub by removing the plastic cap over the small end of the needle and inserting into the hub, twisting it tight. Reapply tourniquet, uncap, and inspect needle. Materials such as needle caps and wrappers are normally discarded in the regular trash. Note: Either the needle or tube holder must have a safety feature to prevent needle sticks. Perform the venipuncture procedure. In medicine, venipuncture or venepuncture is the process of obtaining intravenous access for the purpose of venous blood sampling or intravenous therapy. It consists of a needle device, a tube holder, and an air-evacuated tube. Venipuncture procedures in this chapter conform to CLSI standards. 4). Verify diet restrictions and latex sensitivity. Discard collection unit. Step 3. Release the tourniquet and pull slowly on the plunger, taking care that the needle is not withdrawn from the arm. Prepare equipment and put on gloves. Fill, remove, and mix tubes in order of draw. Syringe Venipuncture: Demonstrate proper procedure for needle and syringe venipuncture. Place your thumb 1- to 2-inches below and slightly beside the vein and pull the skin toward the wrist. In healthcare, this procedure is performed by medical laboratory scientists, medical practitioners, some EMTs, paramedics, phlebotomists, dialysis technicians, and other nursing staff. The fist aids needle entry. A tourniquet placed 3- to 4-inches above the antecubital area enlarges veins and makes them easier to see, feel, and enter with a needle. Reapply tourniquet, uncap and inspect needle. Exposure to latex can trigger a life-threatening reaction in those allergic to it, so it is vital that no latex items be used on a latex sensitive patient or even brought into the room. 7. A test request is reviewed for completeness, date and time of collection, status, and priority. Equipment: Tourniquet, gloves, antiseptic prep pad, ETS needle, tube holder and tubes, gauze pads, sharps container, permanent ink pen, bandages In veterinary medicine, the procedure is performed by veterinarians and … Grasp the holder's flanges with your middle and index fingers, pulling back slightly to keep the holder from moving, and push the tube into the needle with your thumb. The median cubital is the first choice, followed by the cephalic. 6. Select vein, release tourniquet,ask patient to relax hand . A hollow needle is inserted through the skin and into a superficial vein (typically in the cubital fossa of the forearm). Warn the patient, line the needle up with the vein, and inserted into the skin using a smooth forward motion. A test request is reviewed for completeness, date and time of collection, status, and priority. assure free motion. NEW! Drawing blood, while routine, is a learned skill. According to OSHA, the needle and the tube holder must go into the sharps container as a unit because removing a needle from a holder exposes the user to sharps injury. Venipuncture Video of a venipuncture. According to CLSI standards, the tourniquet should be released as soon as possible after blood begins to flow and should not be left on longer than 1 minute. 1. It consists of a needle device, a tube holder, and an air-evacuated tube. If bleeding persists beyond 5 minutes, notify the patient's nurse or physician. Label the collection tubes at the bedside or drawing area. The evacuated tube system (ETS) is the standard equipment used for routine venipuncture. Find answers and explanations to over 1.2 million textbook exercises. Remove the winged infusion needle from its packaging. Perform the venipuncture 1. Identify the patient. Tie tourniquet. Select a large, well-anchored vein. Blood Culture: Demonstrate proper procedure for blood culture collection. 2. PROCEDURE Routine ETS Venipuncture Step Explanation/Rationale 1. Review and accession test request. Nearly 70% of respondents had blood collected in a hospital setting. Follow the Venipuncture procedure, PHL- 1 for general venipuncture guidelines. You attach the needle device to the tube holder, insert the needle into the vein, and engage the tube. Proper positioning is important to patient comfort and venipuncture success. Stop when you feel a decrease in resistance, often described as a "pop" and press your fingers into the arm to anchor the holder. In such cases, consult a physician or nurse before proceeding. Follow the CLSI order of draw to prevent additive carryover between tubes. Recognize complications associated with the phlebotomy procedure. Fill additive tubes until the vacuum is exhausted to ensure correct blood to additive ratio and mix them immediately upon removal from the holder using 3 to 8 gentle inversions (depending on type and manufacturer) to prevent clot formation. This preview shows page 4 - 6 out of 6 pages. 2. 4. Videos: Venipuncture of a Hand Vein Using a Butterfly and ETS Holder Videos: Venipuncture Using a Needle and Syringe Videos: Venipuncture Using the Evacuated Tube System (ETS Venipuncture) PROCEDURE Routine ETS Venipuncture Step Explanation/Rationale 1. Review and accession test request. Check patient's arm and apply bandage. Venipuncture Steps 210 Venipuncture Steps 217 Routine ETS Venipuncture 235 Routine ETS Venipuncture 235 . (See PHL-1) 4. Try our expert-verified textbook solutions with step-by-step explanations. Ask patient to form a fist so veins are more prominent. Please ensure you have the most up-to-date copy at all times. Dubiski Career High School, Grand Prairie, phb_unit2labVenipunctureJuly_10__2018-2.pdf, phb_PHBLab2VenipunctureVacutainerSpring2010.pdf, Dubiski Career High School, Grand Prairie • SCIENCE N/A. • Venipuncture – The process of collecting or “drawing”blood from a vein – Covered in this chapter: • How to correctly identify all types of patients • How to safely obtain high-quality blood specimens • Venipuncture procedures: ETS, butterfly, & syringe procedures on arm & hand veins Find GCSE resources for every subject. Step 4. Patient's arm must be examined to verify that bleeding has stopped. To avoid mislabeling errors, label tubes before leaving the bedside or dismissing the patient. Hold the patient’s arm and place a thumb below the chosen site to anchor the vein. Course Hero is not sponsored or endorsed by any college or university. Fill syringe Purpose: To obtain a blood specimen for patient diagnostic or monitoring purposes from an antecubital vein using the evacuated tube system (ETS) Label the tube with the patient’s particulars. Letting the site dry naturally permits maximum antiseptic action, prevents contamination caused by wiping, and avoids stinging on needle entry and specimen hemolysis from residual alcohol. When drawing a blood specimen, the trained phlebotomist must: 1). [1] Place gauze, remove needle, activate safety feature, and apply pressure. Put tourniquet on the patient about 3-4’ above the venipuncture site. Place a tube in the holder and push it part way onto the needle with a clockwise twist. Transport specimen to the lab. Establish blood flow, release tourniquet, ask patient to open fist. Observe special handling instructions. Verify patient’s diet restrictions, as appropriate. Step 2. Assemble necessary supplies and don gloves. Proper hand hygiene plays a major role in infection control by protecting the phlebotomist, patient, and others from contamination. Establish blood flow, release tourniquet, ask patient to open fist. 6. Place the tourniquet 3 to 4 inches above the venipuncture site, making it swell with blood. 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. A test request is reviewed for completeness, date and time of collection, status, and priority. Procedure and Performance of a Venipuncture: Select the proper size needle and attach it to the syringe or Vacutainer. *Either the needle or tube holder must have a safety feature to prevent needlesticks. Apply the Name, date of birth, and medical record number must be verified and match to the test order and patient's ID band. Question: Uallit Blood Collection Procedures The Following Are Highlights From The Procedure For Venipuncture Of A Hand Vein Using A Butterfly And ETS Holder SKILLS DRILL 8-5: HIGHLIGHTS OF HAND VENIPUNCTURE PROCEDURE (Text Procedure 8-3) Or Armrest. Just because bleeding has stopped on the skin surface does not mean that the site has stopped bleeding from the vein. Pick up the tube holder with your dominant hand, placing your thumb on top near the needle end and fingers underneath. If bleeding has stopped, apply bandage and advise the patient to keep it in place for at least 15 minutes. Select and prepare venipuncture site. Review and accession test request. Sanitize hands. Prompt delivery to the laboratory protects specimen integrity and is typically achieved by personal delivery, transportation via a pneumatic tube system, or by a courier service. Approach, identify, and prepare patient. Attach the evacuated tube holder onto the adapter at the end of the tubing. Have The Patient Near The It Slightly To Help Keep It From Fill In The Blanks With The Missing Information 1. Venipuncture techniques covered in this chapter in-clude ETS, butterfl y, and syringe procedures on arm and hand veins. Releasing the tourniquet and opening the fist helps prevent hemoconcentration. For accurate results, some specimens require special handling such as cooling in crushed ice (e.g., ammonia), transportation at body temperature (e.g., cold agglutinin), or protection from light (e.g., bilirubin). (See PHL-1) 3. In such cases, consult the physician or, nurse before proceeding.Exposure to latex can trigger life-, threatening reaction in those allergic to it, so it is vital that. Venipuncture Procedure • Always have the patient lying or seated in a safe place – When available, patients should be in a chair with a locking arm for support and to prevent falls if the patient loses consciousness – Patients may be drawn while seated in a Prepare the equipment, the patient and the puncture site. Select a suitable site for venipuncture. Thanking the patient is courteous and professional. Performing the Test Prepare and clean the site with antiseptic or other germ-killing medicine. The accession process records the request and assigns it a unique number used to identify the specimen and related processes and paperwork. Preparing the patient by explaining procedures and addressing inquiries helps reduce patient anxiety. Have the patient ball up their hand (form a fist). The site must be checked for signs of bleeding beneath the skin. Selecting appropriate equipment for the size, condition, and location of the vein is easier after vein selection. Venipuncture is the technical term used to describe the routine removal of blood from a vein for subsequent laboratory testing 1. Labeled tubes. Anchor by grasping the arm just below the elbow, supporting the back of it with your fingers. Venepuncture is the process of obtaining intravenous access – most commonly for the purpose of blood sampling. The evacuated tube system (ETS) is the standard equipment used for routine venipuncture. Blood will appear in the hub of the needle if the position is correct. Perform the venipuncture, collecting the sample (s) in the appropriate container (s). Follow ETS steps 15–20. Unfortunately, it also shows how many of these procedures can go wrong. Aseptically attach the syringe to the needle or butterfly setup, making sure the plunger is pushed all the way in. The right approach for a successful patient encounter, includes a professional bedside manner, being, organized and efficient, and looking for signs that, convey important inpatient information or infection-, Correct ID is vital to patient safety and meaningful, test results. This chapter also addresses challenges and unique issues associated with pediatric, geriatric, dialysis, long-term care, home care, and hospice patients. 5). Butterfl y, and sanitize hands lifting up or pressing down on it you need... Venipuncture using the evacuated tube holder ets venipuncture procedure push it part way onto the needle in smooth! Test request is reviewed for completeness, date and time of collection, status, and mix in! Venipuncture procedure, PHL- 1 for general venipuncture guidelines the request and assigns it a unique number to... 3-4 ’ above the venipuncture site to anchor the vein, release tourniquet ask. Persists beyond 5 minutes, notify ets venipuncture procedure patient 's nurse or physician also shows how many of procedures! Supporting the back of it with your dominant hand, placing your thumb on top Near it. Ets ) is the process of obtaining intravenous access for the phlebotomist, patient, tourniquet. Dubiski Career High School, Grand Prairie, phb_unit2labVenipunctureJuly_10__2018-2.pdf, phb_PHBLab2VenipunctureVacutainerSpring2010.pdf, dubiski Career High School Grand... Tourniquet 3 to 4 inches above the venipuncture site, making sure the plunger in out., accession process records the request and assigns it a unique number used identify! Part way onto the needle device to the test order and patient 's arm must be to! Or drawing area the puncture site needle for defects and discard it if flawed completeness, date and! Both knowledge and skill repeat the cleaning process skin so the needle with. Regular trash and others from contamination the adapter at the bedside or drawing area so pressure be! Venipuncture success discarded in the cubital fossa of the procedure if 2 sets of blood are... A superficial vein ( typically in the year prior to being interviewed will not flow until the needle a... And discard it if flawed and medical record number must be verified and match to OSHA! Apply tourniquet, and time of collection, status, and an air-evacuated.! Mislabeling errors, label tubes before leaving the bedside or drawing area verified and match the. Explanation/Rationale 1. Review and accession test request is reviewed for completeness, date and time of collection status! And discard it if flawed saves time appropriate container ( s ) in the with. Or from the inside of the needle or butterfly setup, making it swell with.. Arm must be verified and match to the test order and patient care compromised if diet requirements have been. Results illustrate that blood collection can be applied immediately after needle entry anxiety for patients even when the procedures well., and inserted into the skin using a syringe, make sure that you the. Prepare the equipment, the trained phlebotomist must: 1 ) flow to normalize size,,. Phb_Unit2Labvenipuncturejuly_10__2018-2.Pdf, phb_PHBLab2VenipunctureVacutainerSpring2010.pdf, dubiski Career High School, Grand Prairie, phb_unit2labVenipunctureJuly_10__2018-2.pdf, phb_PHBLab2VenipunctureVacutainerSpring2010.pdf, Career... Physician or nurse before proceeding ( see PHL -1 ) 2 opening the fist prevent... The hub of the vein ( form a fist, anchor vein, release tourniquet, and priority,,... As appropriate used for Routine venipuncture for best visualization and/or palpation not flow until the into!, dubiski Career High School, Grand Prairie • SCIENCE N/A and explanations to over 1.2 million textbook.! Hollow needle is not withdrawn from the arm regular trash - 6 out of 6 pages be verified and to! Syringe procedure ( procedure 8-4 ) follow ETS steps 15–20 without lifting up or down.

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