T/F:
When a syringe is used, the amount of pressure can be reduced somewhat over that of a tube by pulling the plunger back slowly.
True
What is the complication when the syringe fills too slowly?
The specimen will begin to clot either before enough blood is collected or before it can be transferred to the appropriate tubes.
This equipment is required to safely transfer blood from the syringe into the ETS tubes.
special syringe transfer device
Enumerate the steps in performing blood collection procedure (syringe draw).
- Review and accession test request, and approach, identify, and prepare patient.
- Verify diet restrictions and latex sensitivity.
- Explain the procedure to the patient.
- Prevent the plunger from sticking by pulling it halfway out and pushing it all the way in one time.
- Select the proper tubes to transfer the blood to after collection. Place in the proper order for filling.
- Apply the tourniquet 3-4 inches above the puncture site.
- Ask the patient to close his or her hand.
- Place the patient’s arm in downward position if possible.
- Select the vein, noting the location and direction of the vein.
- Clean the venipuncture with 70% isopropyl alcohol swab.
- Put on gloves while the alcohol is drying. Do not touch the venipuncture site.
- Draw the patient’s skin taut with your thumb.
- With the bevel up, align the needle with the vein and perform venipuncture. While securely grasping the syringe with one hand, use the other hand slowly pull the plunger back until the desired amount of blood has been obtained.
- Release the tourniquet and ask the patient to release the fist as soon as the blood flows freely into the first tube or is established in the syringe.
- Lightly place gauze square or cotton ball above the venipuncture site. Gently remove the needle from the arm.
- Activate the safety shield over the needle (if applicable).
- Apply pressure to the site for 3 to 5 minutes. The patient may assist if able.
- Aliquot blood into appropriate tubes.
- Remove the needle from the syringe, and discard the needle into the sharps container.
- Dispose the syringe and transfer device into sharps
container. Do not disconnect the syringe from the transfer device or needle before disposal. - Recheck the identification bracelet with the labels or requisitions.
- Label all tubes
- Check the puncture site. Apply adhesive bandage.
- Remove gloves and wash hands.
- Thank the patient and transport the sample(s) to the laboratory.
Enumerate the steps in performing blood collection procedure (syringe draw).
- Review and accession test request, and approach, identify, and prepare patient.
- Verify diet restrictions and latex sensitivity.
- Explain the procedure to the patient.
- Prevent the plunger from sticking by pulling it halfway out and pushing it all the way in one time.
- Select the proper tubes to transfer the blood to after collection. Place in the proper order for filling.
- Apply the tourniquet 3-4 inches above the puncture site.
- Ask the patient to close his or her hand.
- Place the patient’s arm in downward position if possible.
- Select the vein, noting the location and direction of the vein.
- Clean the venipuncture with 70% isopropyl alcohol swab.
- Put on gloves while the alcohol is drying. Do not touch the venipuncture site.
- Draw the patient’s skin taut with your thumb.
- With the bevel up, align the needle with the vein and perform venipuncture. While securely grasping the syringe with one hand, use the other hand slowly pull the plunger back until the desired amount of blood has been obtained.
- Release the tourniquet and ask the patient to release the fist as soon as the blood flows freely into the first tube or is established in the syringe.
- Lightly place gauze square or cotton ball above the venipuncture site. Gently remove the needle from the arm.
- Activate the safety shield over the needle (if applicable).
- Apply pressure to the site for 3 to 5 minutes.
- Aliquot blood into appropriate tubes.
- Remove the needle from the syringe, and discard the needle into the sharps container.
- Dispose the syringe and transfer device into sharps container.
- Recheck the identification bracelet with the labels or requisitions.
- Label all tubes.
- Check the puncture site. Apply adhesive bandage.
- Remove gloves and wash hands.
- Thank the patient and transport the sample(s) to the laboratory.
How should you approach, identify, and prepare inpatients and outpatients?
Inpatient – ask the name of the patient, verify the bracelet name and hospital number/requisition information
Outpatient – ask the name of the patient, verify the bracelet name and hospital number/requisition information, and/or ask for a valid identification card
T/F:
In verifying diet restrictions, test results can be meaningless or misinterpreted and patient care compromised if diet requirements have not been met.
True
T/F:
In verifying a patient’s latex sensitivity, 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.
True
Considerations in selecting the syringe
size and location of the vein
volume of blood required for the test
Why should the patient’s arm be placed downward?
to aid in vein selection and avoid reflux as tubes are filled
Gloves must be worn during phlebotomy procedures according to what standard?
OSHA BBP standard
T/F:
If you find it necessary to reevaluate the site by palpation, directly place the finger on the site before inserting the needle.
False;
the area needs to be re-cleansed before the venipuncture is performed
In drawing the patient’s skin taut with a thumb, the thumb should be placed how many inches below the puncture site?
1 to 2 inches
Degree angle from the arm surface when performing venipuncture (syringe draw)
15- to 30-degree angle
When should you stop inserting the needle?
Stop when you feel a decrease in resistance, often described as a “pop.”
T/F (Morse type):
Establishment of blood flow is normally indicated by blood in the hub of the syringe. In some cases, blood will not flow until the syringe plunger is pulled back.
Both true
Releasing the tourniquet and opening the fist allows blood flow to return to normal and helps prevent ___________________.
hemoconcentration
Application of pressure on the site for 3-5 minutes is done to?
avoid formation of a hematoma
Ways to aliquot blood intro appropriate tubes
By puncturing the evacuated tubes
By manual transfer of the blood into the tubes
When should you label tubes?
after drawing blood
before dismissing the patient
T/F:
If the bleeding has stopped on the skin surface, it means that the site has stopped bleeding from the vein.
False;
Just because bleeding has stopped on the skin surface does not mean that the site has stopped bleeding from the vein. The site must be checked for signs of bleeding beneath the skin.
