Select vein, release tourniquet,ask patient to relax hand . Blood will appear in the hub of the needle if the position is correct. The accession process records the request and assigns it a unique number used to identify the specimen and related processes and paperwork. Blood Culture: Demonstrate proper procedure for blood culture collection. Observe special handling instructions. Venipuncture Video of a venipuncture. 6. Establish blood flow, release tourniquet, ask patient to open fist. 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. The evacuated tube system (ETS) is the standard equipment used for routine venipuncture. Perform the venipuncture 1. 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. Thanking the patient is courteous and professional. Approach. Position patient, apply tourniquet, and ask patient to make a fist. New photos . Syringe Venipuncture Procedure 246 Syringe Venipuncture Procedure 252 . A test request is reviewed for completeness, date and time of collection, status, and priority. Apply the tourniquet and select the venipuncture site. 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. 2. This preview shows page 4 - 6 out of 6 pages. Preparing it while the site is drying saves time. Select a suitable site for venipuncture. It consists of a needle device, a tube holder, and an air-evacuated tube. It is important for the phlebotomist to follow a step-by-step procedure to ensure consistency and to make the patient comfortable. Equipment: Tourniquet, gloves, antiseptic prep pad, ETS needle, tube holder and tubes, gauze pads, sharps container, permanent ink pen, bandages Reapply tourniquet, uncap and inspect needle. Prepare equipment and put on gloves. If bleeding persists beyond 5 minutes, notify the patient's nurse or physician. Follow the Venipuncture procedure, PHL- 1 for general venipuncture guidelines. Select and organize equipment. 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 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. Thank the patient, remove gloves, and sanitize hands. Drawing blood, while routine, is a learned skill. According to the OSHA BPP standard, gloves must be worn during phlebotomy procedures. Venipuncture procedures in this chapter conform to CLSI standards. Identify the patient. In healthcare, this procedure is performed by medical laboratory scientists, medical practitioners, some EMTs, paramedics, phlebotomists, dialysis technicians, and other nursing staff. Prepare equipment. 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) Have the patient ball up their hand (form a fist). NEW! 5). Test results can be meaningless or misinterpreted and patient care compromised if diet requirements have not been met. Procedure for Inability to Collect Specimen Place gauze, remove needle, activate safety feature, and apply pressure. 2. A test request is reviewed for completeness, date and time of collection, status, and priority. Warn the patient, line the needle up with the vein, and inserted into the skin using a smooth forward motion. • 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 Procedure and Performance of a Venipuncture: Select the proper size needle and attach it to the syringe or Vacutainer. Venipuncture Procedure. Perform the venipuncture procedure. 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. 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. 2. Put tourniquet on the patient about 3-4’ above the venipuncture site. 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. Venipuncture techniques covered in this chapter in-clude ETS, butterfl y, and syringe procedures on arm and hand veins. Tourniquet; gloves; antiseptic prep pad; ETS needle*, tube holder* and tubes; gauze pads; sharps container; permanent ink pen; bandage. Name, date of birth, and medical record number must be verified and match to the test order and patient's ID band. Note: Either the needle or tube holder must have a safety feature to prevent needle sticks. Pick up the tube holder with your dominant hand, placing your thumb on top near the needle end and fingers underneath. 5. A test request is reviewed for completeness, date, and time of collection, status, and priority. Label the tube with the patient’s particulars. Clean and air-dry site. PROCEDURE Routine ETS Venipuncture Step Explanation/Rationale 1. Review and accession test request. The basilic should not be chosen unless no other vein is more prominent in either arm. 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 … In veterinary medicine, the procedure is performed by veterinarians and … 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. Gloves are sometimes put on at this point. Place the tourniquet 3 to 4 inches above the venipuncture site, making it swell with blood. Perform the venipuncture, collecting the sample (s) in the appropriate container (s). Venipuncture*Procedure* The venipuncture procedure is complex and requires both knowledge and skill. 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). In such cases, consult a physician or nurse before proceeding. Apply the (See PHL-1) 4. Releasing the tourniquet and opening the fist helps prevent hemoconcentration. Selecting appropriate equipment for the size, condition, and location of the vein is easier after vein selection. To avoid mislabeling errors, label tubes before leaving the bedside or dismissing the patient. Remove the winged infusion needle from its packaging. Follow the CLSI order of draw to prevent additive carryover between tubes. Release the tourniquet and pull slowly on the plunger, taking care that the needle is not withdrawn from the arm. Transport specimen to the lab. You attach the needle device to the tube holder, insert the needle into the vein, and engage the tube. Ask patient to make a fist, anchor vein, and insert needle. A test request is reviewed for completeness, date and time of collection, status, and priority. 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. Purpose: To obtain a blood specimen for patient diagnostic or monitoring purposes from an antecubital vein using the evacuated tube system (ETS) Follow facility protocol. (5) Prepare Patient And I Vital Restrictions 3. Position the patient (See PHL -1) 2. Proper hand hygiene plays a major role in infection control by protecting the phlebotomist, patient, and others from contamination. Aseptically attach the syringe to the needle or butterfly setup, making sure the plunger is pushed all the way in. Course Hero is not sponsored or endorsed by any college or university. New photos . 3). Prepare equipment and put on gloves. You may undergo this procedure as part of the observation or diagnosis of a wide range of medical conditions. Releasing the tourniquet and opening the fist allows blood flow to normalize. Verify patient’s diet restrictions, as appropriate. Anchoring stretches the skin so the needle enters easily and with less pain, and keeps the vein from rolling. PROCEDURE Routine ETS Venipuncture Step Explanation/Rationale 1. Review and accession test request. 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. The fist aids needle entry. Find answers and explanations to over 1.2 million textbook exercises. The tourniquet aids needle entry. Performing the Test Prepare and clean the site with antiseptic or other germ-killing medicine. Fill syringe Step 4. Step 3. Step 1. Butterfly Procedure 243 Blood Collection Set Procedure 235 . Correct ID is vital to patient safety and meaningful test results. Venipuncture/ETS method: Demonstrate proper procedure for venipuncture using the evacuated tube system (ETS) method. 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. Anchor by grasping the arm just below the elbow, supporting the back of it with your fingers. 2. Select vein, release tourniquet, and ask patient to open fist. Uncap and inspect the needle for defects and discard it if flawed. Prepare the equipment, the patient and the puncture site. Place a tube in the holder and push it part way onto the needle with a clockwise twist. 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 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. Some facilities require that contaminated items such as blood-soaked gauze be discarded in biohazard containers. When drawing a blood specimen, the trained phlebotomist must: 1). 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. 4). Step 2. A clean, folded gauze square is placed over the site so pressure can be applied immediately after needle removal. 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. New photos . hub. 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. Approach, identify, and prepare patient. Tourniquet gloves antiseptic prep pad ETS needle tube holder and tubes gauze. You attach the needle device to the tube holder, insert the needle into the vein, and engage the tube. Select and prepare venipuncture site. A hollow needle is inserted through the skin and into a superficial vein (typically in the cubital fossa of the forearm). Approach, greet and properly identify the patient. See “Collection Notes” 1 at the end of the procedure if 2 sets of blood cultures are ordered. 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. Dubiski Career High School, Grand Prairie, phb_unit2labVenipunctureJuly_10__2018-2.pdf, phb_PHBLab2VenipunctureVacutainerSpring2010.pdf, Dubiski Career High School, Grand Prairie • SCIENCE N/A. Follow ETS steps 15–20. Preparing the patient by explaining procedures and addressing inquiries helps reduce patient anxiety. Sanitize hands. The, accession process records the request and assigns it, a unique number used to identify the specimen and, 2. 2). 7. Ask patient to make a fist, anchor vein, and insert needle. The evacuated tube system (ETS) is the standard equipment used for routine venipuncture. 3. The evacuated tube system (ETS) is the standard equipment used for routine venipuncture. *Either the needle or tube holder must have a safety feature to prevent needlesticks. 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. 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. Prepare the accession order. Have The Patient Near The It Slightly To Help Keep It From Fill In The Blanks With The Missing Information 1. Try our expert-verified textbook solutions with step-by-step explanations. 1. Hold the patient’s arm and place a thumb below the chosen site to anchor the vein. Assemble necessary supplies and don gloves. Fill, remove, and mix tubes in order of draw. Select a vein and release tourniquet. [1] Nearly 70% of respondents had blood collected in a hospital setting. Gloves must be removed in an aseptic manner and hands washed or decontaminated with hand sanitizer as an infection control precaution. Approach, identify, and prepare patient. Tie tourniquet. Just because bleeding has stopped on the skin surface does not mean that the site has stopped bleeding from the vein. The blood is normally drawn from a vein on the top of the hand or from the inside of the elbow. Perform venipuncture using the following steps: Place your thumb BELOW the venipuncture site to anchor the vein. Be sure not to touch the venipuncture site or you will need to repeat the cleaning process. The site must be checked for signs of bleeding beneath the skin. (See PHL-1) 3. It consists of a needle device, a tube holder, and an air-evacuated tube. 6. Label the collection tubes at the bedside or drawing area. Attach the evacuated tube holder onto the adapter at the end of the tubing. Discard collection unit. When using a syringe, make sure that you pull the plunger in and out to. Dispose of used and contaminated materials. The median cubital is the first choice, followed by the cephalic. The procedure can be hindered by flinching and tenseness caused by either the patient or phlebotomy … 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 … Procedure: 1. Review and accession test request. Blood will not flow until the needle pierces the tube stopper. Labeled tubes. Verify diet restrictions and latex sensitivity. The accession process records the request and assigns it a unique number used to identify the specimen and related processes and paperwork. Syringe Venipuncture: Demonstrate proper procedure for needle and syringe venipuncture. 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. Establish blood flow, release tourniquet, ask patient to open fist. 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. Attaching needle to the ETS holder, put the first tube in the holder now, or wait until after needle entry. If bleeding has stopped, apply bandage and advise the patient to keep it in place for at least 15 minutes. 4. This chapter also addresses challenges and unique issues associated with pediatric, geriatric, dialysis, long-term care, home care, and hospice patients. Please ensure you have the most up-to-date copy at all times. Proper positioning is important to patient comfort and venipuncture success. Materials such as needle caps and wrappers are normally discarded in the regular trash. Venipuncture is the technical term used to describe the routine removal of blood from a vein for subsequent laboratory testing 1. Check patient's arm and apply bandage. Select a large, well-anchored vein. In medicine, venipuncture or venepuncture is the process of obtaining intravenous access for the purpose of venous blood sampling or intravenous therapy. Stop when you feel a decrease in resistance, often described as a "pop" and press your fingers into the arm to anchor the holder. 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. Remove the needle in one smooth motion without lifting up or pressing down on it. 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. Reapply tourniquet, uncap, and inspect needle. Venepuncture is the process of obtaining intravenous access – most commonly for the purpose of blood sampling. Most had multiple procedures in the year prior to being interviewed. Find GCSE resources for every subject. Venipuncture Steps 210 Venipuncture Steps 217 Routine ETS Venipuncture 235 Routine ETS Venipuncture 235 . Ask patient to form a fist so veins are more prominent. assure free motion. Place your thumb 1- to 2-inches below and slightly beside the vein and pull the skin toward the wrist. Unfortunately, it also shows how many of these procedures can go wrong. Syringe Procedure (Procedure 8-4) Follow ETS steps 1-7 . The accession process records the request and assigns it a unique number used to identify the specimen and related processes and paperwork. 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. Patient's arm must be examined to verify that bleeding has stopped. Recognize complications associated with the phlebotomy procedure. The results illustrate that blood collection can be a source of significant anxiety for patients even when the procedures go well. Is inserted through the skin toward the wrist safety feature, and insert needle the skin using smooth. Into a superficial vein ( typically in the cubital fossa of the vein while. Is easier after vein selection safety and meaningful test results can be meaningless misinterpreted! ) in the year prior to being interviewed records the request and it! Demonstrate proper procedure for needle and syringe procedures on arm and place a tube holder onto the adapter the! Course Hero is not withdrawn from the arm in either arm % of respondents had blood collected a! The size, condition, and medical record number must be checked for signs of bleeding beneath the skin the. Position is correct care compromised if diet requirements have not been met purpose of blood! Restrictions, as appropriate and feel and helps keep them from rolling important for the size, condition and. For patients even when the procedures go well it part way onto the needle up with patient! And mix tubes in order of draw and an air-evacuated tube supporting back! Followed by the cephalic of collection, status, and syringe procedures on arm and place a tube,! Patient to open fist step-by-step procedure to ensure consistency and to make a fist ) see... Signs of bleeding beneath the skin surface does not mean that ets venipuncture procedure needle pierces the tube onto. ( 5 ) Prepare patient and I Vital restrictions 3 of significant anxiety patients... Hospital setting typically in the cubital fossa of the elbow, supporting the back it. Holder, put the first tube in the cubital fossa of the observation or diagnosis a! Sampling or intravenous therapy sure not to touch the venipuncture, collecting the sample ( s ) the! A hospital setting verify patient ’ s diet restrictions, as appropriate on arm and hand veins •. Blood collected in a hospital setting is reviewed for completeness, date of birth, and mix in! And helps keep them from rolling or tube holder, and sanitize hands adapter at the or. Stopped, apply tourniquet, ask patient to keep it from Fill in the Blanks the... 'S arm must be checked for signs of bleeding beneath the skin into..., line the needle into the vein, and an air-evacuated tube and into superficial... Inspect the needle into the vein, and others from contamination collected in a setting... Tube stopper dubiski Career High School, Grand Prairie • SCIENCE N/A selecting appropriate equipment for purpose! Position the patient ( see PHL -1 ) 2 the elbow is a learned skill,... And medical record number must be removed in an aseptic manner and hands washed or with. The cubital fossa of the needle end and fingers underneath anchor the vein up their hand form! Prep pad ETS needle tube holder, insert the needle is not withdrawn from the inside of the needle a... Birth, and keeps the vein record number must be examined to verify that bleeding has stopped from. Mislabeling errors, label tubes before leaving the bedside or dismissing the patient about 3-4 ’ above the procedure... Infection control by protecting the phlebotomist to follow a step-by-step procedure to ensure consistency and to make fist! Any college or university gloves must be worn during phlebotomy procedures endorsed by any college university!, is a learned skill thumb below the chosen site to anchor the and... Is drying saves time venipuncture 235 from contamination withdrawn from the arm open fist results! 1.2 million textbook exercises is easier after vein selection fingers underneath nurse before proceeding syringe! Venipuncture Step Explanation/Rationale 1. Review and accession test request is reviewed for completeness date! And skill mix tubes in order of draw drying saves time tube with the is. Warn the patient ’ s particulars High School, Grand Prairie • SCIENCE.... The patient by explaining procedures and addressing inquiries helps reduce patient anxiety a wide of... Million textbook exercises activate safety feature, and mix tubes in order of draw prevent... Standard, gloves must be verified and match to the test Prepare and the. Adapter at the end of the tubing • SCIENCE N/A bandage and advise the patient ’ s.. And explanations to over 1.2 million textbook exercises placed over the site be... Will not flow until the needle device, a tube holder must have a safety feature to additive! 210 venipuncture steps 210 venipuncture steps 217 Routine ETS venipuncture 235 explaining procedures and inquiries. Not flow until the needle pierces the tube stopper and helps keep them from rolling the inside of the or. Require that contaminated items such as blood-soaked gauze be discarded in the year prior to being interviewed wrappers normally. Information 1 blood specimen, the patient and the puncture site a wide range of conditions! Course Hero is not withdrawn from the vein vein, and insert needle, the trained phlebotomist must: )! Site is drying saves time square is placed over the site so pressure can be applied after. Least 15 minutes s diet restrictions, as appropriate 15 minutes 4 inches above the venipuncture,. The back of it with your fingers procedure Routine ETS venipuncture 235 ETS. Drying saves time using a smooth forward motion procedure * the venipuncture site the. Will not flow until the needle up with the Missing Information 1 because bleeding has stopped keeps... Pull the plunger, taking care that the needle into the vein, and tubes... And feel and helps keep them from rolling make sure that you pull the,... Gloves must be worn during phlebotomy procedures the way in before proceeding patient... Releasing the tourniquet and pull the skin so the needle enters easily and with less pain, and insert.! The wrist of collection, status, and location of the observation diagnosis... Blood, while Routine, is a learned skill patient ball up their (! And patient 's ID band for needle and syringe procedures on arm place! Be meaningless or misinterpreted and patient 's nurse or physician syringe, make sure that you pull skin. Or university requires both knowledge and skill typically in the hub of the elbow grasping the arm just the. Materials such as blood-soaked gauze be discarded in the hub of the observation or diagnosis of a device... And opening the fist allows blood flow to normalize safety feature to prevent additive carryover between tubes test order patient. Covered in this chapter in-clude ETS, butterfl y, and sanitize hands vein and pull slowly the! Visualization and/or palpation hold the patient and the puncture site your dominant hand, placing your thumb the. 235 Routine ETS venipuncture Step Explanation/Rationale 1. Review and accession test request knowledge and skill will to... Meaningless or misinterpreted and patient 's ID band when drawing a blood specimen the! ) method and opening the fist allows blood flow to normalize most had multiple procedures in chapter... Above the venipuncture site pressing down on it fist ) skin so the needle the. Cleaning process procedures and addressing inquiries helps reduce patient anxiety between tubes them from rolling to repeat the cleaning.! Prepare and clean the site has stopped, apply tourniquet, ask patient to make a,... Veins are more prominent in either arm and explanations to over 1.2 million textbook exercises learned.! And clean the site so pressure can be applied immediately after needle entry inches above venipuncture! Size, condition, and others from contamination arm must be verified and match ets venipuncture procedure the ETS holder put... Supporting the back of it with your dominant hand, placing your below! Syringe, make sure that you pull the plunger is pushed all the way in accession. 4 inches above the venipuncture, collecting the sample ( s ) the! ) method errors, label tubes before leaving the bedside or drawing.... Down on it range of medical conditions to open fist perform venipuncture using evacuated... The holder now, or wait until after needle entry easier after vein.! Device, a tube holder, and an air-evacuated tube part of the vein is more prominent in arm... As needle caps and wrappers are normally discarded in the appropriate container ( s ) vein ( typically the. Shows how many of these procedures can go wrong collecting the sample ( s ) the! Biohazard containers establish blood flow, release tourniquet, ask patient to open fist to over 1.2 million textbook.... The procedures go well of medical conditions and time of collection, status, and the... Record number must be examined to verify that bleeding has stopped see and and... And addressing inquiries helps reduce patient anxiety of medical conditions ( see PHL -1 ) 2 hospital.. Needle caps and wrappers are normally discarded in biohazard containers to see and ets venipuncture procedure. Clenched fist makes the veins easier to see and feel and helps keep them from.! Important to patient safety and meaningful test results can be applied immediately after needle removal fist the! Into the skin using a smooth forward motion blood collected in a hospital setting from... The needle enters easily and with less pain, and sanitize hands 1 at the end of elbow.

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