Obtain and Label Blood Specimens

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Obtain and Label Blood Specimens
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Introduction

• Venipuncture is a technique that permits access
  to a vein so that a needle or catheter can be
  inserted, usually to withdraw a blood specimen or
  initiate an intravenous infusion
• Venipuncture is a sterile procedure since the
  integrity of the skin is broken

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Terms and Definitions

• Venipuncture
• Palpate
• Antecubital fossa
• Anticoagulant
• Hematoma

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Veins Used for Drawing Blood
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Venipuncture Procedure

• Universal precautions - hand wash gloves
• Strict adherence to the sharps policy
• Verify the request to obtain specimen
• Check the physician's orders
• Select the proper specimen tube/s
• Prepare label(s)
• Perform a patient care hand wash/don gloves

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Stamp Label With Patients Addresograph Plate
20 000-00-0000 DP 210-221-4450
A1401TMC GAVIN, JAMES 07DEC55 M USA AD
ENL SFC HHC 2/505th PIR TMC-OUTPATIENT RECORDS,
FBNC
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Gather Equipment

• Constricting band
• Vacutainer holder or Syringe
• Sterile disposable double-ended needle or
  Butterfly or Hypodermic needle
• Betadine or alcohol wipe or sponge
• Protective pad (chux)
• Sterile 2 x 2-inch gauze sponge(s)
• Band-Aid

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Venipuncture Equipment
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Assemble Holder Needle

• Put short end of needle into threaded hole in
  vacutainer holder
• Screw tightly using clockwise motion

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Insert the Tube into the Holder

• Insert stoppered end of the tube into holder
• Do not push tube beyond the guideline
• Inspect the needle for barbs, corrosion

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Identify Patient

• Explain the procedure and purpose
• Ask patient about allergies (i.e., iodine or
  alcohol).
• Position the patient - sitting or lying
• Never draw blood from a standing patient.
• Position protective pad

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Apply Constricting Band

• Apply with enough pressure to stop venous return
  
• A radial pulse should be felt
• Place latex tubing around limb about 2 inches
  above venipuncture site
• If a commercial band is used, wrap it around limb
  and secure by overlapping velcro ends

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Apply Constricting Band

• Instruct patient to clench and unclench his fist
  several times to trap blood and distend veins
• Avoid veins that are infected, injured,
  irritated, or have an IV running distally.

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Palpate Selected Vein

• Palpate along length of vein with index finger
• Vein should have a spongy feel
• Clean the skin
• Do not re-palpate the vein after cleansing the
  skin.

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Prepare the Puncture Site

• Cleanse area with betadine or alcohol using a
  circular motion
• Do not touch the area once cleansed

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Prepare to Puncture the Vein

• Remove protective cover from needle
• Position needle in line with vein and grasp
  patient's arm below entry point with free hand
• Place thumb of free hand 1 inch below entry site
  and pull skin taut toward hand

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Puncture the Vein

• Align needle bevel up
• Pierce skin at a 15 to 30 angle
• Decrease angle until parallel to skin surface,
  then pierce vein
• If needle is withdrawn above skin surface, do not
  attempt venipuncture again with the same needle

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Puncture Vein

• If unsuccessful
• Release the constricting band
• Place 2 x 2 gauze sponge over site
• Quickly withdraw the needle and instruct the
  patient to elevate arm slightly and keeping the
  arm fully extended apply pressure to the site for
  2 to 3 minutes.
• Notify supervisor before attempting another
  venipuncture

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Single Tube Collections

• When the tube is nearly full release the
  tourniquet
• Remove the tube from the holder
• DO NOT withdraw the needle before the
  constricting band is released

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Multiple Tube Collections

• When the Tube Stops Filling Pull It Out of the
  holder
• After the last tube stops filling remove from the
  holder
• Release the tourniquet
• DO NOT withdraw the needle before the tourniquet
  is released

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Complete the Procedure

• Place 2 x 2 sponge over venipuncture site
• Withdraw the needle smoothly and quickly
• Immediately apply pressure to the site
• Have patient elevate arm and apply pressure to
  site

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Complete the Procedure

• If tube contains an anticoagulant or other
  additive, gently invert tube several times to mix
  with blood
• Apply a Band-Aid to the venipuncture site
• DO NOT unscrew needle from sleeve with hands
• DO NOT recap needle
• Dispose of needle into sharps

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Patient Comfort and Safety

• Remove protective pad
• Roll down patient's sleeve
• If patient is in bed reposition and raise side
  rails
• Remove all the equipment from area
• Dispose of used supplies
• Store reusable equipment and dispose of needle
  IAW local sharps SOP
• Remove gloves and wash hands

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Dispose of the Needle in a Sharps Container
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Administrative Duties

• Check and complete laboratory form IAW local SOP
• Apply prepared label(s)
• Document procedure IAW local SOP

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Summary

• If venipuncture is done smoothly and properly,
  there should be little pain for the patient and
  little risk to medical personnel
• The procedural steps are designed to ensure a
  properly drawn specimen
• With practice, obtaining a blood specimen can
  become a smooth routine