Venepuncture is the procedure of inserting a needle into a vein to obtain blood samples. To perform venepuncture safely, one must understand relevant anatomy, how to select an appropriate vein and device, potential problems that may occur, and health and safety risks. The document outlines the indications for venepuncture, vein anatomy, factors to consider when selecting a vein, potential hazards, required equipment, and steps to perform the procedure correctly.
INTRAMUSCULAR INJECTION
IM Injection (Introduction, Definition, Purpose, Technique, Rights of Medication, Z-Track Method, Equipment, Procedure and Responsibilities)..
Here, we discuss about the intake output chart.
The intake output chart is a vital in patient care. By maintaining intake output chart we can monitor the improvement of the patient. So, here we provide about the intake output chart, indications, procedure, precautions, maintaining chart and more.
Please read it attentively and upgrade your professional knowledge and apply it to practice.
Thanks
A brief awareness and knowledge about the insertion of NGT nasogastric Tube and feeding through it.
It contains an introduction, procedure, equipment needed, method of feeding etc
Central Venous Catheter Care- A Nursing skill Tse Sona
- Shared on the request of al the delegates who attended and those who couldn't attend the webinar on "CVC care- A Nursing Skill'' due to limited seats. I hope it will be helpful to all
INTRAMUSCULAR INJECTION
IM Injection (Introduction, Definition, Purpose, Technique, Rights of Medication, Z-Track Method, Equipment, Procedure and Responsibilities)..
Here, we discuss about the intake output chart.
The intake output chart is a vital in patient care. By maintaining intake output chart we can monitor the improvement of the patient. So, here we provide about the intake output chart, indications, procedure, precautions, maintaining chart and more.
Please read it attentively and upgrade your professional knowledge and apply it to practice.
Thanks
A brief awareness and knowledge about the insertion of NGT nasogastric Tube and feeding through it.
It contains an introduction, procedure, equipment needed, method of feeding etc
Central Venous Catheter Care- A Nursing skill Tse Sona
- Shared on the request of al the delegates who attended and those who couldn't attend the webinar on "CVC care- A Nursing Skill'' due to limited seats. I hope it will be helpful to all
This slideshow introduces the basic concepts around intravenous cannulation. Whilst the context is midwifery this slideshow is also suitable for nurses and medical staff.
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
IV Cannulation Introducing a single dose of concentrated medication directly...ssuser3155141
Introducing a single dose of concentrated medication directly into the systemic circulation
“Or”
The introduction of a large amount of fluid & electrolytes and other nutrients into the body via veins.
PHLEBOTOMY
The process of collecting a blood sample is called
phlebotomy
This procedure is also known as Venipuncture
A person who performs phlebotomy is called a
phlebotomist, although doctors nurses, and medical
laboratory scientists.
BLOOD SPECIMEN COLLECTION AND PROCESSING
The first step in acquiring a quality lab. Test result for any
patient is the specimen collection procedure.
Blood specimen are obtained through capillary skin puncture
(finger, toe, heel), arterial , venous sampling.
VENIPUNCTURE
Venipuncture is the process of obtaining blood samples from veins
for lab testing
VENIPUNCTURE PROCEDURE STEPS
STEP 1:- Preparation of specimen collection material:
Following material should be readily available in the specimen
collection section-
Disposable syringes and needles or vacutainer systems.
Disposable lancets
Gauze pads or cotton
Tourniquet
70% (V/V) ethanol
Clean and dry wide mouth bottles
Leak- proof transportation bags and containers
A puncture-resistant sharp container
Blood collection tubes
VENIPUNCTURE PROCEDURE STEPS
STEP 1: Preparation of specimen collection material:
Sterile glass or plastic tubes with rubber caps
Vacuum-extraction blood tubes
Glass tubes with screw caps
Sterile glass or bleeding pack (collapsible) if large
quantities of blood are to be collected
well-fitting, non-sterile gloves
Laboratory specimen labels
Writing equipment
Laboratory forms
ORDER OF DRAW
To avoid cross-contamination, blood must be drawn and collected in
tubes in a specific order. This is known as the Order of Draw.
Blood culture
Blue tube for coagulation (Sodium Citrate)
Red No Gel
Gold SST (Plain tube w/gel and clot activator additive)
Green and Dark Green (Heparin, with and without gel)
Lavender (EDTA)
Pink - Blood Bank (EDTA)
Gray (Oxalate/Fluoride)
Black ( ESR)
VENIPUNCTURE PROCEDURE STEPS
Step 2:- Patient preparation:
Following instruction is given to the patient
patient should be on balanced diet at least for 2 to 3 days prior
to the test.
The day before sample collection, the patient should not drink
intoxicating substance, esp. alcoholic drinks and eat tobacco.
Patient should report to the lab. After fasting for 8-12 hrs.
Patient should not drink tea, or coffee or any other drinks
except one glassful of water.
VENIPUNCTURE PROCEDURE STEPS
Step 2 – Identify and prepare the patient
Where the patient is adult and conscious, follow the steps
outlined below.
Introduce yourself to the patient, and ask the patient to state their
full name.
Check that the laboratory form matches the patient’s identity (i.e.
match the patient’s details with the laboratory form, to ensure
accurate identification).
Ask whether the patent has allergies, phobias or has ever fainted
during previous injections or blood draws.
If the patient is anxious or afraid, reassure the person and ask what
would make them more comfortable.
capillary method
aretial method
1. Venepuncture
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2. Venepuncture is the procedure of inserting a needle
into a vein, usually to obtain blood
In order to do this safely the student must:
1. Know the relevant anatomy and physiology
2. Understand the criteria for selection of an appropriate vein and
device
3. Appreciate potential problems that may occur
4. Have an awareness of associated Health and Safety/ risks
involved in undertaking the procedure and correct disposal of
equipment
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3. Indications
• To obtain blood for diagnostic purposes
• To establish/ monitor levels of blood components
• To establish/ monitor levels of drugs
• To monitor response to medical treatments (e.g. fluids)
• To provide a sample to cross match prior to transfusion
• To screen for infection
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4. Vein construction: 3 Layers
Tunica adventitia
Connective tissue
Surrounds, supports
Tunica media
Muscular tissue
Contracts and relaxes
Tunica intima
Smooth endothelial cells
Valves
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5. Selecting a site
Usually those found in the antecubital
fossa
1. Median cubital vein
2. Cephalic vein
3. Basilic vein
Metacarpal veins should only be
utilised for venepuncture when
the other veins are not accessible
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6. Choosing a vein
• Accessible
• Unused
• Easily detected
• Appears healthy and patent
The most prominent vein is not necessarily the most
suitable vein
-Visual inspection
-Palpation
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7. Visually scrutinise the veins in both arms, avoiding:
• Evidence of infection, bruising and phlebitis
• An oedematous limb where there is status of lymph
• Areas of previous venepuncture. Repeated trauma
causes pain
Palpate veins too:
• Distinguish vein from arteries and tendons
• Identify deeper veins and presence of valves
• Use index finger, or fore finger, not thumb
• Healthy veins are soft, bouncy and refill when depressed
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8. Other factors influencing vein selection
? Injury, disease or treatment
? Position of patient
? Age of patient
? Weight of the patient
? Dehydration or Shock
? Medication/ condition that causes excessive bleeding or
delayed clotting (anticoagulants, steroids,
thrombocytopenia)
? Fear
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9. Hazards/ Risks
• Infection- adherence to an aseptic technique (thorough hand
washing and use of alcohol gel) required. Performed with single use
equipment, non- sterile gloves may be worn.
• Accidental damage- inadvertently punctured nerve, tendon or artery.
Spend time undertaking visual inspection and palpation.
• Haematoma- Caused by poor technique, failure to remove the
tourniquet before removing the needle and inadequate pressure on
the site. Patient/ Client must not flex arm on completion of the
procedure. Identify those with relevant medical history/ drug therapy.
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10. Associated hazards
• Incorrect or lack of details on request form and/or sample-
Increases likelihood of errors occurring. Sample will be rejected by
lab, necessitating repetition of the procedure. Always check details
with patient, request form and sample correspond.
• Insufficient sample/ wrong specimen bottle- necessitating
repetition.
• Needlestick injury- correct use of Vacutainer system and Sharps
policy help reduce this.
• Infected/ ‘High risk’ samples- correctly identified as such through
labelling so all those involved with handling are aware.
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11. Equipment list…..
Sharps bin
Procedure tray
Non-sterile gloves
Apron
Vacutainer device/ needle
Tourniquet
Alcohol hand gel
Patient identification labels
Specimen request
Specimen bottle
Gauze/ swab
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12. Procedure
• Correctly identifies patient/ gains consent
• Hand washing/ use of alcohol gel
• Supports chosen limb
• Applies Tourniquet
• Selects appropriate vein
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13. Technique
• Anchor vein
• Verbally warn patient
• Insert needle smoothly at angle of 15-30 degrees with bevel upwards
• Level off needle and advance approx 1mm
• Push specimen bottle into heamguard
• Allow vacutainer to fill specimen bottle
• Gently but firmly remove bottle
• Remove tourniquet
• Cover puncture site with gauze, remove needle, dispose of needle
into sharps bin
• Apply pressure to straight arm, apply plaster
• Correctly label sample
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14. References and further reading
Nottingham City Hospital/ queens Medical Centre/ Rushcliffe PCT Nursing
Practice Guidelines (2004) Venepuncture using the Vacutainer System
(*Accessible on Hospital intranet- contains extensive further reading list)
Nottingham City Hospital/ Queens Medical Centre Nottingham ‘Working in
New Ways’ (2004) Venepuncture and Cannulation: An educational Self-
directed Package for Registered Nurses, Midwives and Non- registered
staff.
Johnson and Johnson (1997) Practical Guide to Peripheral Cannulation
R.Seeley, T Stephens, P.Tate (1988) Anatomy and Physiology
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