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