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Module 3

Heme 1 -- Chapter 26 Blood Collection Test Review

What is the first thing you do before drawing a Pt's blood? Identify the Pt using two identifiers (Name and DOB or last 4 of ssn)
What is the purpose of using a tourniquet? Constriction of blood flow to engorge the vein as well as anchor the vein
Where is the tourniquet placed? 2-4" above the venipuncture site
Why is it important to not leave a tourniquet on for longer than one minute? Longer than one minute can cause hemolysis (destruction of blood); can lead to erroneous test results
What area of the arm is our primary focus for venipuncture? The antecubital space of the inner arm (inner crease)
What veins in the antecubital space should we palpate for? 1. Median Cubital (most accessible); 2. Cephalic (thumb side); 3. Basilic (medial/pinkie side)
What other sites can the MA perfom venipuncture if the antecubital space is not available? 1. Wrist (can be difficult due to tendons/ligaments and Pt discomfort); 2. Foot (not ideal due to potential for interstitial fluid interfering with results -- must document this location)
What does it mean to palpate and track a vein? Tapping for a vein followed by tracking to determine angle of needle insertion
What should be facing upward on the needle for proper blood draw? Bevel should always be facing upward and needle should be inserted swiftly and accurately
How long should pressure be applied after needle is removed? Minimum of 30 seconds, to ensure hemostasis (bleeding stops). Arm should remain straight. If these steps are followed you should not see a hematoma (bruise/ecchymosis)
When would we use a syringe for venipuncture? For a patient with tiny veins or potential for collapsing veins
When would we use a straight needle for venipuncture? For faster procedures
When would we use a butterfly (also known as winged infusion)? When precision is needed; small veins such as in the hand
What is important about the gauge of the needle? The smaller the gauge -- the larger the needle. Also note, the larger the vein -- the larger the needle.
Venipuncture needle sizes and colors(4): 21 -- Green (adults); 22 -- Black (adults); 23 Lt. Blue (pediatrics); 25 -- Royal Blue (infants) *colors can vary based on manufacturer*
In what order should we draw tubes? Always draw non-additive tubes prior to additives to ensure no cross-contamination and erroneous test results
What must be included on tube labels? Pt name; Pt DOB; Date/Time of draw; MA's initials
What must accompany every sample sent out to a laboratory? Requisition form
Does a Pt have the right to refuse testing/TX? Pt always has the right to refuse but the MA's job is to gently persuade the Pt as to the necessity of such testing/TX
What angle should the needle enter a vein for venipuncture? 15° - 30° angle
Where do we puncture for a capillary blood test? Pads of the 3rd and 4th fingers; against the grain of the finger print and never to the extreme lateral site of the fingers
Is it acceptable for an MA to draw blood from a port or fistula? MA's should never touch a port or fistula
What position should the Pt be in for venipuncture? Sitting upright in a sturdy chair (no wheels); feet firmly planted on the ground with arm of choice fully extended (straight) with opposite fist placed below elbow for additional support. Never allow Pt to be standing.
How should the site be cleaned prior to venipuncture? Swab site with 70% alcohol in concentric circles working outward; always allow to air dry (never blow on or fan dry)
What is the bore or lumen of the needle? Hole in the needle that allows blood to flow from vein to tube
Areas to be avoided during venipuncture site selection: Scars; side with mastectomy; hematoma; IV therapy/blood transfusions; lines; fistulas; edamatous extremeties
Created by: monkmaroni