Anticubital fossa
Triangular area on the anterior veiw of the elbow
Basilic vein
Vessel of the forearm that's acceptable for venipuncture
Cephalic vein
Vein of the forearm that's acceptable for venipuncture
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Non profit organization that recommended Quality and standard guidelines for clinical and lab standards
Decontaminate
Use of physical or chemical means to remove or destroy blood-borne pathogens on a surface or item so that the pathogen is no longer able to transmit disease.
Evacuated tube system
Method of blood collection using a double sided needle whereby the needle is attached to a holder or adapter
Median cubital vein
Vein in anticubital that's most commonly used for venipuncture
Dermal
Skin
Cyanotic
Blue coloration of skin
Multi sample single needle venipuncture
Allow for multiple specimen tubes to fill without spillage
Palpation
Using hands to examine the body
Specimen rejection
One or more of the test ordered can not be performed as specimen don't meet lab criteria
STAT
Emergency situation that requires immediate attention
Syringe method of blood collection
Syringe used to collect blood then to transfer blood to collection tubes
Therapeutic drug monitoring
Testing procedure used to evaluate drug levels in a pts blood
Timed specimen
Biological specimen obtained at a certain time or after a certain interval
Winged collection/butterfly collection set
Used for small or frail veins
Tourniquet
Constricting device to control circulation
Calcaneus
Heel bone
capillary Action
Free flowing movement of blood into the tube without use of suction
Dehydration
Lacking fluid or water
Differential
Lab test that enumerates and categorizes WBC and abnormalities
Feathered edge
Blood smear on microscope slide; resembles the tip of bird feather
Interstitial (tissue) fluid
Naturally occurring liquid forming between the layers of tissue; small component of capillary blood specimen
Jaundiced
Yellowing of skin
Micro sample
Lab analysis on a very small amount of blood or tissue
Osteochondritis
Inflammation of the bone and cartilage
Osteomyelitis
Inflammation of the bone due to a bacterial infection
Peripheral circulation
Near surface of body
Plantar
Sole of foot
Which vein pattern is most commonly found in 70-80% of individual's arms:
The median cubital vein intersects the cephalic and basilica veins to make an "H" pattern just below the cubital fossa.
11 basic phlebotomy procedures
1. Prepare yourself
2. Prepare patient
3. Assess patient
4. Determine procedure site
5. Prepare site
6. Collect blood sample
7. Proper site care
8. label and prepare specimen
9. Take care of patient
10. Maintain hygiene
11. Transport specimens A way to re
What is palpation? Briefly describe palpation and then list two things you should do and at least one thing you shouldn't do when palpating a patient:
Palpation means to examine by touch. You should trace the path of veins with an index finger to make sure the vessel is a vein and not an artery and you should palpate the antecubital area to get an idea of the size, angle, and depth of the vein. You shou
What is the purpose of using a tourniquet in conjunction with palpation?
It slows the flow of blood which causes the vein to engorge.
Briefly describe the proper procedure for cleansing the puncture site prior to performing a venipuncture:
Use a skin disinfectant such as an alcohol swab to rub the site in concentric circles from the inside out.
List one situation when you choose a multi-sample straight needle:
For multiple draws or large amts of blood.
List one situation when you choose a winged collection set procedure:
Multiple draw or large amts of blood. Also with patients who have fragile veins.
List one situation when you choose a syringe venipuncture:
One draw blood cultures or when the pt cannot have multiple draw or blood culture utilized.
Provide at least two reasons why you would use a dermal/capillary procedure to collect a blood sample:
If the patient has severe burns or if they have fragile veins. Also to limit the amt of blood drawn to avoid iatrogenic anemia.
Give two reasons why you would
not
use a dermal/capillary procedure to collect a blood sample:
The patient may be dehydrated and a skin puncture may not produce enough blood drops, the patient may have poor peripheral circulation, or the test may require large quantities of blood.
Describe the proper location for a dermal/capillary stick on both a finger and a heel:
Use the middle two fingers of the patients non dominant hand on the lateral side on the fleshy top of the finger. Avoid the tip of the finger where you might strike a bone.
Use the medial section of the heel (sole of the foot). Avoid the heel bone.
Briefly describe how to produce a blood film or smear, and how to achieve the necessary "feathered edge" on the slide:
The blood film is prepared using a single drop of blood drawn from an EDTA anticoagulant tube or capillary tube.
Feathered edge - Spread the blood to separate cells, use another slide to spread the blood to the edges.
List several ways a phlebotomist can reduce the amount of blood collections needed from a single patient.
Proper documentation, monitor the number of times the patient has been stuck in 24 hours, reassess orders, and notify the lab for multiple tests.
What signs and symptoms should you assess your patient for during venipuncture that would indicate a need to stop the procedure?
Fainting (syncope), feeling nauseous, seizures, or diaphoresis.
What must the phlebotomist check all equipment for before performing venipuncture?
Sterility, intact, expiration dates, and manufacture defects.
Iatrogenic anemia
Shortage of RBC resulting from drawing too much blood.
Point of care testing:
Glucose monitoring, Pt INR, urinalysis, cardiac markers, cholesterol screening, and drug screening.
PKU neonatal screening:
Performed on a newborn from 0-14 days.
Bilirubin testing
When processing, the sample is very light sensitive and the sample must be protected.
Capillary blood
Is a mix of blood from arterioles, venules, capillaries, and intracellular and interstitial (tissue) fluids. When exposed to oxygen it is bright red.
Average depth of a capillary puncture:
Infants/children - 2.0 mm
Adults - 2.0-2.5 mm
Warming a capillary puncture
Do not warm the site for more than twenty minutes.
Capillary action
Lightly touch tube tip to blood drop, it will be drawn into the tube.
Capillary puncture
Wipe away the first drop of blood prevents contamination.
Collect the specimen quickly to avoid micro clot formation, but avoid air bubbles.
Fill to appropriate amount.
Order of draw for capillary blood draw:
1. Blood gases
2. EDTA specimen for hematology
3. Other tubes with additives
4. Serum tubes
Post procedure for capillary puncture:
1. Apply gauze and pressure to site
2. Label specimen and transport containers and discard all biohazard supplies and equipment prior to disposing of gloves
3. Maintain hand hygiene after removing gloves
4. Ensure bleeding has stopped, thank patient
Blood films and smears
Used to evaluate morphology, form and structure of RBCS, or detect cell abnormalities.
Prepared using a single drop of blood.
Should be prepared within 1 hour of collection.
Use blood from EDTA anticoagulant.
Spread blood using another slide to separate c
STAT
Immediately
Veins
Return deoxygenated blood back to the heart.
Arteries
Pump oxygenated blood to the body.
During venipuncture:
Avoid valves, nerve injury, and subcutaneous bleeding. Do not leave tourniquet on for more than one minute because it can cause hemoconcentration. Do not tell the pt to pump their fists. Massage arm from wrist to elbow, warm the area, let the arm hang dow
Post procedure for venipuncture:
1. Remove needle at same angle entered.
2. Activate safety device on needle.
3. Place needle in sharps.
4. Apply gauze and pressure.
5. Invert and label tubes.
6. Check pt for bleeding and bandage site.
7. Dispose of equipment, remove gloves, and wash han