This document discusses blood collection procedures including venipuncture and capillary puncture. It covers equipment, patient preparation, performing the procedures, complications, and special considerations for pediatric patients. Venipuncture involves using a tourniquet, antiseptic, needles and evacuated collection tubes to draw blood from veins. Capillary puncture uses specialized equipment to collect small blood samples from finger or heel sticks. Patient safety and quality specimens are emphasized.
All about blood collection and handling, lecture notes to Medical Laboratory Students at Medical Laboratory Technology, Middle Technical University, Baqubah, Iraq
Phlebotomy for Medical Laboratory Professionals Ravi Kumudesh
SELECTING SITES
Antecubital area most often accessed
Hand or wrist
Remember: 2 arms
Use tip of index finger on non-dominant hand to palpate area to feel for the vein
COLLECTION SITE PROBLEMS
Indwelling lines:
Hickman catheters
Heparin locks
Used to administer medication
Only nurse may access these lines
Can obtain blood: called a ‘line draw’
Must clear line of heparin contamination by discarding first 5-10 cc of blood
All about blood collection and handling, lecture notes to Medical Laboratory Students at Medical Laboratory Technology, Middle Technical University, Baqubah, Iraq
Phlebotomy for Medical Laboratory Professionals Ravi Kumudesh
SELECTING SITES
Antecubital area most often accessed
Hand or wrist
Remember: 2 arms
Use tip of index finger on non-dominant hand to palpate area to feel for the vein
COLLECTION SITE PROBLEMS
Indwelling lines:
Hickman catheters
Heparin locks
Used to administer medication
Only nurse may access these lines
Can obtain blood: called a ‘line draw’
Must clear line of heparin contamination by discarding first 5-10 cc of blood
Upon completion of this chapter, you should be able to:
List the information required on a requisition form.
Describe computer use in phlebotomy.
Describe the supplies and general equipment required for phlebotomy.
Describe the components of the evacuated tube system.
Explain the proper method for needle disposal.
Upon completion of this chapter, you should be able to:
List the information required on a requisition form.
Describe computer use in phlebotomy.
Describe the supplies and general equipment required for phlebotomy.
Describe the components of the evacuated tube system.
Explain the proper method for needle disposal.
Learn the essential skill of intravenous cannulation. Check out the latest in our series about surviving the early days of your medical internship.
We know from experience how difficult the first days can be, and we're here to share the benefit of our own experiences.
Pediatric IV cannulation is insertion of cannula into the vein for the purpose of administering medications / Infusion therapy / Transfusion of blood and its products /Nutrition to childrens
Collecting blood samples and other biological specimens is crucial to the understanding, prevention, and treatment of disease. However, from the patient’s perspective, it can also be painful, unnerving, frightening, and inconvenient.
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
Acetabularia Information For Class 9 .docxvaibhavrinwa19
Acetabularia acetabulum is a single-celled green alga that in its vegetative state is morphologically differentiated into a basal rhizoid and an axially elongated stalk, which bears whorls of branching hairs. The single diploid nucleus resides in the rhizoid.
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
Introduction to AI for Nonprofits with Tapp NetworkTechSoup
Dive into the world of AI! Experts Jon Hill and Tareq Monaur will guide you through AI's role in enhancing nonprofit websites and basic marketing strategies, making it easy to understand and apply.
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
Biological screening of herbal drugs: Introduction and Need for
Phyto-Pharmacological Screening, New Strategies for evaluating
Natural Products, In vitro evaluation techniques for Antioxidants, Antimicrobial and Anticancer drugs. In vivo evaluation techniques
for Anti-inflammatory, Antiulcer, Anticancer, Wound healing, Antidiabetic, Hepatoprotective, Cardio protective, Diuretics and
Antifertility, Toxicity studies as per OECD guidelines
Honest Reviews of Tim Han LMA Course Program.pptxtimhan337
Personal development courses are widely available today, with each one promising life-changing outcomes. Tim Han’s Life Mastery Achievers (LMA) Course has drawn a lot of interest. In addition to offering my frank assessment of Success Insider’s LMA Course, this piece examines the course’s effects via a variety of Tim Han LMA course reviews and Success Insider comments.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
2. 2Blood Collection
1. Discuss venipuncture equipment and personal protective equipment.
Also, explain the purpose of a tourniquet, how to apply it, and the
consequences of improper tourniquet application.
2. Discuss antiseptics, explain why the stopper colors on vacuum tubes
differ, and state the correct order of the draw.
3. Discuss the needles and supplies used in phlebotomy.
4. Discuss needle safety and postexposure needlestick follow-up.
3. 3
5. Complete the following related to routine venipuncture:
Discuss patient preparation for routine venipuncture.
List in order the steps of a routine venipuncture.
Detail patient preparation for venipuncture that shows sensitivity to the patient’s
rights and feelings.
Perform a venipuncture using the vacuum tube method, syringe, and winged-
infusion (butterfly) assembly.
6. Discuss possible solutions to venipuncture complications.
7. List situations in which capillary puncture would be preferred over
venipuncture, and discuss the equipment used.
4. 4
8. Perform a capillary puncture.
9. Discuss pediatric phlebotomy, including typical childhood
behavior and parental involvement during phlebotomy and
general guidelines for pediatric venipuncture.
10. Describe handling and transport methods for blood after
collection.
5. Introduction to Phlebotomy
The practice of drawing blood
Used primarily to diagnose and monitor a patient’s
condition
Training requirements to perform blood drawing
5
8. Personal Protective Equipment (PPE)
Vinyl gloves available if the patient or phlebotomist
has a latex allergy
Gloves may put on after vein palpation, but before the
preparation of site
Tourniquet should be tied no longer than one minute
8
9. Tourniquets
Application of tourniquet is very helpful in locating
veins in antecubital region and any other area that
may be drawn for venipuncture
Single-use, nonlatex tourniquets are available and
currently are recommended to:
Reduce cross-contamination between patients and
healthcare workers
Help prevent nosocomial infections
Prevent latex exposure
9
11. Antiseptics
Venipuncture site must be cleansed with an antiseptic
The most common type is 70% isopropyl alcohol
Alcohol should remain on the skin 30 to 60 seconds
11
12. Evacuated Collection Tubes
Evacuated tube (Vacutainer) system consists of
evacuated tubes of various sizes that have color-coded
tops
Vacuum in each tube draws a measured amount of
blood into tube
Be sure to match the needle gauge to size of tube
Consult manual provided by laboratory to make sure
you are drawing right amount of blood for test
12
13. Tube Additives
All tubes except the red-topped ones contain an
additive
Anticoagulants are added to prevent blood from clotting
Ethylenediaminetetraacetic acid (EDTA) prevents platelet
clumping and preserves the appearance of blood cells for
microscopic examination
Clot activators promote blood clotting
13
14. Order of the Draw
Specified order must be followed so that material from
previous tube is not transferred to the next tube
Carryover of additives can alter samples and cause
result errors
Same order applies to filling of tubes when blood is
collected in syringe
14
15. Order of the Draw
Blood culture bottles (sterile)
Light blue top (contain sodium citrate)
Red top or gold top
Green top
Lavender top (contain EDTA anticoagulant)
Gray top
15
16. Types of Needles and
Supplies
Used in Phlebotomy
Know which needle and which tube or syringe should
be used in each situation
All needles used in phlebotomy are sterile, disposable,
and used only once
Inspect each needle cover for intact seal
Hub, shaft with bevel, and lumen (hole) make up
needle
Gauge of lumen; higher number for smaller lumen
16
17. Syringes
Used when there is a concern that strong vacuum in a
stoppered tube might collapse the vein
Syringe needle fits on the end of the barrel and comes
in different gauges
Must be transferred immediately to another tube or it
will clot in syringe barrel
Special transfer tube adapter is used to transfer blood
to Vacutainer tube
17
18. Needle Safety
Needle injuries can lead to serious or fatal infections
with blood-borne pathogens such as hepatitis B virus
(HBV), hepatitis C virus (HCV), or human
immunodeficiency virus (HIV)
Best practice for preventing needlestick injuries after
phlebotomy is to use safety needles that are activated
with one hand immediately after use
18
20. Steps to Protect Against Needlesticks
Do not use needles when safe, effective alternatives
are available
Help your employer select and evaluate devices with
safety features
Use devices with safety features provided by your
employer
Never recap a contaminated needle
Plan for safe handling and disposal before beginning
any procedure using needles
20
21. Steps to Protect Against Needlesticks
Dispose of used needles and needle holders promptly
in sharps disposal containers
Report all needlesticks and other sharps-related
injuries promptly
Tell your employer about hazards from needles that
you observe in your work environment
Participate in blood-borne pathogen training and
follow recommended infection prevention practices,
including obtaining hepatitis B vaccination
21
22. Postexposure Needlestick
Follow-Up
Wound inspected and washed for 10 minutes with
antimicrobial soap or antiseptic
Reported to supervisor and incident report completed
Referred to physician for confidential assessment and
follow-up care
Interim testing may be performed and counseling
should be offered
22
23. Patient Preparation for
Venipuncture
Requisition form should include:
Patient’s name
Date of birth
Identification number
Name of the provider making the request
Type of test requested
Test status (timed, fasting, stat, and so forth)
23
24. Preparing for the
Venipuncture
Seat patients (or have them lie down) and ask them to
extend the arm
Inspect arms and ask if they have a preference and select
vein
Other sites may be used, like the back of a hand or foot if
necessary
Place the tourniquet 3 to 4 inches above the elbow
Have patients make fist and palpate for vein
24
26. Performing the Venipuncture
Remove the tourniquet after locating a vein
Assemble all equipment needed, open sterile packets,
sanitize hands
Reapply the tourniquet to quickly relocate a vein
Put on gloves, cleanse the antecubital area with
alcohol, have the patient clench fist
Anchor the vein and insert needle into vein at 15-
degree angle
Pull back on the syringe plunger or push the
evacuated tube into a double-pointed needle
26
27. Completing the
Venipuncture
Continue to draw the specimen, filling each tube
Invert each tube several times after removal, before
placing it in the rack
Near the end of the draw, release tourniquet and
remove final vacuum tube
Remove needle quickly, and apply gauze and pressure
to site
Activate safety device to cover needle
Bandage when the bleeding stops
27
28. Winged Infusion Set
(Butterfly Needle)
Used with children and elderly patients due to their
narrow veins
The tubing minimizes the strength of the vacuum, which
prevents the collapse of fragile veins
Also used to draw blood from the hands of adults
28
29. Problems Associated
with Venipuncture
Hematoma (bruise) at puncture site
Discontinue procedure, apply pressure and then ice
Fainting (syncope)
Nerve damage is uncommon; avoid basilic vein and
blind probing
29
30. Specimen Recollection
Unlabeled or mislabeled specimen
Insufficient quantity
Defective tube
Incorrect tube used for the test ordered
Hemolysis
Clotted blood in an anticoagulated specimen
Improper handling
30
31. Capillary Puncture
Older adult patients
Pediatric patients (especially younger than age 2)
Patients who require frequent glucose monitoring
Patients with burns or scars in venipuncture sites
Obese patients
Patients receiving intravenous (IV) therapy
31
33. Capillary Puncture
Patients who have had a mastectomy
Patients at risk for venous thrombosis
Patients who are severely dehydrated
Tests that require a small volume of blood
33
35. Site Selection
In adults and children (older than 1 year), capillary
puncture sites include ring or middle finger
Dermal puncture of an infant should be done on heel
of foot
For children younger than 2 years of age, dermal
puncture is performed on medial or lateral areas of
plantar surface of heel or on plantar surface of ring or
middle finger
35
36. Patient Preparation
Similar to preparation for venipuncture
Gloves, cleanse the finger well with alcohol prep pad
36
37. Collecting the Specimen
After the dermis is punctured, wipe away the first drop
of blood with sterile gauze
Fill containers according to the manufacturer’s
directions
Touch container to the drop of blood, not skin
Once containers are filled, have the patient apply
pressure to sterile gauze on puncture site
37
38. Specimen Handling
Capillary collection containers are often too small to
label
Remove stopper from a red-topped tube, insert
capillary tube, replace stopper, and label tube
Microtubes have plastic plugs and may be placed in a
labeled tube or zipper-lock bag
38
39. Pediatric Phlebotomy
Performed only by personnel trained in techniques for
pediatric phlebotomy
Must gain the child’s and parent’s confidence
Ask the parent about the child’s previous experiences
and how the child may react
If the parent cannot help with necessary restraint, refer
to office policy
39
40. Pediatric Phlebotomy
Removing large amounts of blood may result in
anemia
Amount withdrawn must be recorded in the child’s
chart
Deep vein puncture can result in cardiac arrest,
hemorrhage, venous thrombosis, damage to tissues, or
infection
Avoid forceful restraint; topical anesthetics can reduce
pain
Be truthful about discomfort to the child, provide
tokens and praise for bravery
40
41. Handling the Specimen
After Collection
After collection, analytes in blood begin to decay
Blood may require processing (like centrifugation)
before being sent for analysis
Whole blood for automated blood counts should be
refrigerated and tested within 72 hours
Special services for transporting specimens to other
facilities
41
44. Chain of Custody
Chain of custody is a legal term that refers to the
ability to guarantee the identity and integrity of the
specimen from collection to reporting of test results
Process used to maintain and document the
chronologic history of a specimen
Collection kits are available that contain everything
needed for venipuncture, including the tube, needle,
chain of custody forms and seals, antiseptic, and even
tourniquet
44
45. Patient Coaching
Maintain a professional attitude, yet remain
sympathetic to the patient’s fears and anxiety
Identify your patient and explain what you are going to
do
Answer questions and perform procedure skillfully
before anxiety has time to set in
Follow patient’s suggestion in choosing site for
obtaining a blood specimen
45
46. Legal and Ethical Issues
and Patient-Centered Care
Because skin is penetrated, drawing blood becomes a
surgical procedure and is subject to the laws and
regulations of surgery
Be sure to follow the procedures as written
May want to ask patients how they would prefer to be
addressed
Always be respectful, professional, and patient-focused
46
