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phlebotoomy
phlebotomy :)
| Question | Answer |
|---|---|
| Semi fowler's position | used for patients who have a fainting history. back of the patient table lowered 45 degrees or laying down. |
| cleaning the site | clean with 70% alcohol pads, moving in concentric circles of increasing diameter starting from the anticipated needle insertion site. |
| evacuated tube method | most commonly used technique. uses a straight double-ended needle and color-coded vacuum tubes made from glass or plastic. |
| syringe method | not commonly performed in ambulatory care. requires a needle (the same used for injections) and a sterile syringe from 3 cc to 20 cc. requires blood transfer system and color coded vacuums. |
| butterfly method | used for smaller or more fragile veins in the dorsal hand but can be used in the antecubital area. needles are smaller gauge (25-26) have "butterfly" wings on each side. also long tubing |
| tourniquet | apply 3-4 inches above the venipuncture site. never leave on longer than 1 minute. extended time can lead to increased patient discomfort, accumulation of platelets in restricted veins, nerve damage. |
| locating vein | if it takes longer than 60 seconds remove the tourniquet and allow blood flow to return to normal (approx. 2 mins). |
| hemolysis | the rupture of red blood cells, which is commonly caused by performing phlebotomy with too small needle gauge or shaking the blood tubes too hard. blood appears a serum cherry color and cant be tested. |
| anchor vein | by grasping firmly with the thumb 1 inch below the draw site and holding the skin taut. |
| needle insertion | hold the needle/sleeve unit in the dominant hand and insert needle with the bevel facing upward at an angle of 15-30 degrees. |
| after blood colletion | gently invert vacuum tubes to mix the blood and chemical additives. label tubes immediately following procedure and confirm with patient that label is correct. |
| syringe method performance | grasp barrel of syringe and pull back on the plunger slowly until required amount is filled. doing it too quickly can cause the vein to collapse. |
| after syringe method | place vacuum tubes in a tube rack for transfer of blood from syringe. transfer collected blood to vacuum tube with safety device. invert vacuum tubes. label tubes and verify with patient |
| tube inversions | completely turn the tube upside down and return it upright. invert 3-10 time according to manufacturer instructions. do not shake or forcefully invert tubes. |
| tourniquet application | place under arm, pull up and cross, pull on end taut then pinch at base to trap tension, tuck tail underneath taut tourniquet, release. |
| yellow | sodium polyanethol sulfonate (SPS) for blood culture specimen collections in microbiology |
| light blue | sodium citrate (anticoagulant), coagulation studies |
| red | plastic: clot activator, glass: no additive (plain) serum determinations in chemistry, used for routine blood donor screening and diagnostic testing of serum for infectious diseases |
| gold or tiger top (red-grey) | serum separator tube (SST), clot activator, thixotropic gel, ( same use as red) |
| green | sodium heparin, lithium heparin, for plasma determinations in chemistry |
| lavender | EDTA (anticoagulant) whole blood hematology determinations, routine immunohematology testing, and blood donor screening. |
| gray | potassium oxalate and sodium fluoride, glucose testing (GTT) |
| order of draw | yellow, light blue, red, gold, green, lavender, gray |
Created by:
elshalance
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