Steps to follow for phlebotomy with a SYRINGE!
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| Wash your hands, mentally go thru OSHA safety and bloodborne pathogens Guidelines | FIRST
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| 2. Assemble all equipment (blood tubes, transfer device, syringe,etc) Prepare needle/syringe. Break suction on syringe and remove all | SECOND
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| LABEL TUBES: with pts last name. Tap tube to loosen additives. Put in proper order to be filled for later | THIRD
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| Greet pt. verify correct pt by asking DOB. Explain Vp procedure. ask them which arm is most often used. you will check BOTH arms carefully to check for YOUR best site | FOURTH
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| Apply tourniquet snuggly 3-4 inches above bend in elbow. Have pt clench fist & support with fist | FIFTH
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| Palpate vein. trace the path/direction of each vein. Push down to feel "spring" in vein. | SIXTH
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| When veins feel fragile or pt reports that their veins collapse, we would draw with a syringe. But if veins feels healthy & strong.. choose evacuated method for your draw (will discuss late) | SEVENTH
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| Again, palpate your chosen vein. follow path and direction of vein. Find a "Landmark" to mark your puncture site. You want to find the fullest widest point of this vein to puncture into. remove tourniquet | EIGHTH
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| Cleanse site with alcohol in a cercular fashion. Start at center and go outward voering a 3" area. Let air dry. DO NOT blow or wipe dry with gauze. you CAN NOT touch site again-- w/out re-cleaning it | NINETH
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| Apply your glvoes while the alchol dries. Re-tie tourniquet | TENTH
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| Remove cap from needle (one handed). Hold syringe in dominant hand. needle must be bevel up. Hold a piece of gauze/cotton in your non-dominant hand | ELEVENTH
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| Anchor the vein using your thumb or fingers to stabilize it | 12th
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| Position needle at 15-25 degree angle at site. Needle should line up with the vein's path | THIRTEENTH
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| tell pt they will "feel a small stick". Gently but firmly push needle into vein at the fullest/widest part of the vein. You may see blood in th ehub of the needle/syringe | FOURTEENTH
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| do NOT change your grip on syringe. Gently pull back on the plunger using your anchor hand until blood starts to flow into your syringe. DO NOT MOVE the needle in the arm! pull slowly..if you pull too fast you will cause a suction to devlop in the syringe | FIFTEENTH
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| Pull SLOWLY on the plunger until the amount of blood needed is removed (usually 3-5ml) | SIXTEENTH
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| UNTIE THE TOURNIQUET. This must be done before you remove the needle to avoid causing a hematoma! | SEVENTEENTH
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| Place a dry sterile gauze/cotton ball at the vp site. As you withdraw the needle from the arm apply gentle pressure with the gauze/cotton ball. Do not push down while needle is still in the skin | EIGHTEENTH
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| Ask pt to apply pressure to puncture site for 1-5 minutes. Pt should be told "DO NOT BEND" their arm. If a hematoma begins to form, apply a cold pack | 19th
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| move blood into blood tubes. Use transer device unscrew needle using slot on top of sharps . Once needle been removed,atth syringe to transfer device. Insert&push the evacuated tube on device. never push on plunger of syringe. vacuum tube will suck itout | The vacuum tube will suck the blood from the syringe. if a transfer device is not at hand, insert the needle of the syringe into the top of the blood tube. Finish labeling tubes with date,time tests ordered & initials. Throw all equipment away correctly
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| check VP site. Stay w/pt until bleeding has stopped. Apply a bandaid to the site | 21st
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| Remvoe and throw away your gloves (reg. trash) and wash your hands. | 22nd
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| Chart procedure. Include date, time, which arm, which vein, what tubes drawn, any unusual pt reaction, and your name. Use Pt tolerated well. MA Student SMA" | 23rd
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| Process the blood specimen (separate serum,etc) as needed | 24th
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