Lesson 1-12

Routine Venipuncture

Routine Venipuncture

• Phlebotomy• Superficial arm vein• Large sample of blood• Requires skill and experience• Preserve vein integrity

Venipuncture Supplies

• Needles– Various safety designs– 21 gauge, 1- to 1.5-inch length

• Needle holders• Vacuum tubes

– Anticoagulants and additives– Draw exact volume– Various sizes– Coded colors

Venipuncture Supplies

Venipuncture Supplies

Venipuncture Supplies • Syringes and safety needles

Venipuncture Supplies• Winged collection set with retractable

needle

Venipuncture Supplies

Safety Precautions

• Observe Standard Precautions– Wear gloves and other PPE– Use engineering controls– Use work practice controls– Use only safety collection devices

Quality Assessment

• Patient ID• Follow SOP manual

– Use correct tube(s)– Labels – Handling of specimen

Quality Assessment

• Use correct technique• Observe order of draw when filling

more than one type of tube• Avoid

– Hemoconcentration– Hemolysis

Select Equipment

• Vacuum tube(s)• Safety needle• Needle holder

Select Equipment• Order of draw

Prepare Patient

• Patient I.D.• Explain procedure• Support patient and arm• Be prepared!

Apply Tourniquet

• 3–4 inches above elbow

• Use quick release tie

• Do apply longer than 1 minute

Identify Suitable Vein• Veins commonly used

– Median cubital– Cephalic

• Palpate vein

Select Venipuncture Method• Vacuum tube and holder• Winged collection set• Syringe

– See Table 1-36

Perform Venipuncture• Alcohol-cleanse site• Observe needle bevel• Anchor vein• Puncture vein

Perform Venipuncture

• Insert vacuum tube into holder– Fill clot tube first– Invert filled anticoagulant tubes

Perform Venipuncture

• Release tourniquet• Remove vacuum tube from needle• Withdraw needle from vein• Apply pressure to site

Venipuncture ProcedureUsing Vacuum System

Complete Procedure

• Activate safety feature• Dispose of sharps immediately• Label tubes• Care for patient

Venipuncture ProcedureUsing Syringe

Venipuncture ProcedureUsing Winged Collection Set

In Case of Accident

• Immediately clean exposed area – Flood with water– Clean with antiseptic soap

• Report immediately to supervisor• Seek medical attention

Questions