blood draw techniques

Phlebotomy is a technique in which a needle is temporarily inserted into a vein to provide venous access for venous blood sampling. CrunchRN, ADN, RN. Phlebotomy, the practice of drawing blood from a vein, is a proficiency that all nurses should learn in their career. WHO Library Cataloguing-in-Publication Data WHO guidelines on drawing blood: best practices in phlebotomy. Counting and exhaling slowly gives your child more control over the situation and keeps their veins full and loose. Nursing schools do not teach this skill due to legality issues. Phlebotomy is the name of the procedure for drawing blood from the vein through an incision or puncture. If properly inserted blood should flash into the catheter. Position the patient and hyperextend the patient’s arm. Some institutions have kits with all of the needed supplies while others will require the nurses to gather them individually. A blood sample is required for most tests, which means it can be difficult to arrive at an accurate diagnosis without first drawing blood and testing it in the lab. While medical technicians and nurses are allowed to draw blood, this procedure should only be done by a trained phlebotomist. Stabilize the “leg” with your non-dominant hand and use the index finger of your dominant hand to feel for the “vein.” Next, use your dominant hand to hold the syringe and swiftly insert the needle into the “vein.” This is a common misconception - pumping the hand does not increase venous circulation. Drawing blood/phlebotomy tips and tricks. Speaking of the quality of laboratory sampling, phlebotomy must follow a certain order when collecting samples. Students should study venipuncture in books and watch licensed nurses in clinical settings perform this task. Without proper specimens, unhelpful or even harmful medical treatment could happen. Well, if you want to draw someone's blood (also known as phlebotomy) this video will show you how to do it. It’s important to speak to your supervisor to learn the steps in order to become certified in your hospital. Appropriate blood draw supplies and protective equipment, Prevention for contamination of phlebotomy equipment. Bio-hazard leak-proof transportation bags, Evacuated Collection Tubes (tubes specific to labs ordered), Personal Protective Equipment (i.e. After assembling the appropriate equipment, follow the next steps to perform a proper venipuncture. A nurse well-versed in phlebotomy contributes to better patient care. Perform pre-venipuncture safety procedures. Once again, please be aware that these are only guidelines for blood draws and nurses should consult with the appropriate hospital personnel regarding performing this procedure on patients. Apply a tourniquet approximately 3-4 inches above the selected site. It is important for the phlebotomist to follow a step-by-step procedure to ensure consistency and to make the patient comfortable. Given that nurses and phlebotomists draw blood all the time, we pumped them for their best tips on making blood tests as pain-free—and faint-free—as possible. https://sciencediscoveries.degruyter.com/order-blood-draw-importance-blood-sample-collection/, https://www.phlebotomyinfo.com/phlebotomy-order-of-draw/, https://www.ncbi.nlm.nih.gov/books/NBK138665/, Phlebotomy Jokes – Humor for Phlebotomists, How To Write A Phlebotomy Cover Letter w Examples, How To Become A Medical Assistant – Career Training Guide. If you seriously have HORRIBLE veins and it really never works, see if the nurse would be willing/able … Deliver blood specimens without delay to prevent hemolysis that can skew the lab results. Use two patient identifiers identify the patient. Sarstedt manufactures a blood-drawing system (S-Monovette) that uses this principle. Veins have a 3-layered wall composed of an internal endothelium surrounded by a thin layer of muscle fibers, which in turn is surrounded by a layer of connective tissue. Learning the anatomy of the main veins and arteries in the body is essential to becoming competent in phlebotomy. Venipuncture is a skill that takes time and practice to master. Unlike children, most adults can … Nurses Nursing. Do not wave, fan, or blow on the area as this contaminates the area and leads to increased risk for infection. Perform good hand hygiene and don appropriate PPE. Attach the syringe or tube needed to remove the right volume of blood. These techniques include a lateral and ventral approach. Closely monitor the arm to ensure that is is not applied to tight or for more than 2 minutes. Use a syringe to practice your blood draw technique. The parent can be face-to-face with the child, while the child is laying down, providing physical comfort, distraction, and assistance. Remove the tourniquet as the last amount of blood is drawn. Furthermore, it has a low risk of damaging surrounding nerves, arteries, and tendons versus other veins in the hands. Tips for Drawing Blood: This video discusses tips on how to draw blood successfully. Blood Draw Procedure Apply a tourniquet above the intended puncture site. Deliver blood specimens to the laboratory promptly. The practice of drawing blood from a vein or phlebotomy is essential for a variety of medical procedures and tests to diagnose a patient. 1 positive blood culture with recognized pathogen from a venipuncture; Skin organisms: >2 blood cultures drawn on separate occasions positive for the same organism plus clinical symptoms; For suspected catheter-related bloodstream infection (CR-BSI) draw one … Drawing a blood sample from a patient is the main job for a phlebotomy technician. Even though most hospitals do have phlebotomy teams, it is still critical for nurses to learn these skills in order to provide the best patient care. Heel stick or Arm draw if neonate 21 pounds or greater- arm draw can be performed if need, follow steps below for arm draw: Do not draw from heel if: Feet are edematous, injured or infected, bruised, injured by multiple previous heel sticks or if testing requires more than 1 mL of blood, refer the patient’s family to the pediatric service. Insert the needle at a 15 to 30-degree angle into the vessel. Blood should flash into the catheter if done properly. https://nurse.org/articles/how-nurses-professionally-draw-blood With the patient's arm extended, inspect the antecubital fossa. After identifying the site for the blood draw, gather the appropriate supplies needed. Let us know if you have a preferred arm or particular vein that has been used successfully in the past to draw blood. Planning must be done at the start of a phlebotomy session to ensure success and the comfort of a patient. You'll want to do it right to ensure safety and comfort to your patient. Apply a tourniquet approximately 3 to 4 inches above the intended puncture site. The next time someone attempts to draw blood from the child, the whole experience is revisited, bringing tension into every muscle of his or her body. Label tubes at the bedside and place in transport bins or bags. Most facilities expect you to have already learned these things in nursing school, and often have vague, unhelpful policies regarding drawing blood. Hard stick patients should keep their veins warm. Press the purple button on the side of the AccuVein to turn on the vein display light. Puncture is via a needle attached to a syringe or vacutainer. Remove the needle from the patient’s arm and press down on the vessel with gauze. You know all nursing jobs aren’t created (or paid!) Each healthcare system has their own requirements prior to nurses performing blood draws. Observe any patient precautions. Sophisticated instruments also meant modern techniques. Prev; 1; 2; Next; Ok, so I took my class last february, got some tips … This is an extremely large vessel and if stuck properly can yield excellent blood results. While it is important to know the best veins to access it’s also important to know which areas to avoid. In doing so, this will enable students to learn basics prior to graduation. gloves). Clean the venipuncture site with an alcohol pad for 30 seconds. Explain the procedure and reason for the blood draw to the patient. As the person drawing blood, it is important you know how to draw blood correctly. Get them to put a warm compress on the arm 10 minutes before the blood test. Insert the needle at an angle of 15 to 30 degrees. 1. Posted Oct 15, 2009. If this does not happen then the needle has either not punctured the vein or the needle went through the vessel. The vein will feel like a "trampoline" … This includes sticking the vein correctly and using the proper tubes. For example, a CBC (complete blood count) will go into a lavender tube while a PT/INR will be collected into a blue tube. For adult patients, the most common and first choice is the median cubital vein in the antecubital fossa. Proper collection and transportation are critical. Phlebotomy teams generally only make rounds at specific times in hospital settings, therefore, if a lab test is ordered immediately it could be the responsibility of the nursing staff to draw the specimen. Locate The Vein. The World Health Organization has established the best practices in phlebotomy. Be sure to bring extras in case a second attempt for venipuncture is required. Incision is a surgical procedure that involves a cut section of the vein. Check for any allergies or sensitivities with the patient regarding antiseptics, adhesives, or latex. Before the draw. In general, it is much more difficult to draw blood from children than from adults, due to the relative size of their veins. equally, but do you know which nurses are making the most money in 2020? Patients are usually nervous if they’ve never had it done before, or sometimes they have a phobia of needles or doctor’s offices. This method can be preferred on the elderly, those with cancer, severe burns, obesity, or … Position them properly and hyperextend their arm. For novice phlebotomists, this vein is the first choice because it is close to the skin’s surface and tends not to roll when punctured. Reasons for concern would include numbness, tingling, change of color to blue or white, and extreme pain. If you want to know how to draw blood, you can’t learn just by reading about it or watching demonstrations. Count to three and blow the feeling away: This is a useful technique to make a blood draw easier for your child and for the phlebotomist. Read about the top student loan forgiveness programs for nurses and find out if you qualify. Prep the venipuncture site by cleansing the area with an alcohol prep pad for 30 seconds and allow to air dry for 30 seconds. Has 25 years experience. Count to 3 and Blow the Feeling Away — Blowing the feeling away is a useful technique. The best location is an area that is quiet, clean, and well-lit. Commonly referred to as the antecubital or the AC it can be found in the crevice of the elbow between the median cephalic and the median basilic vein. Check for the Veins. Grab the patient’s lower arm (below site of puncture) firmly to draw the skin taut and anchor the vein from rolling. Wear appropriate PPE and perform good hand hygiene. The World Health Organization’s (WHO) best practice guidelines for blood draws include the following: The WHO has set forth the following standards of patient care for hospitals to adhere by: The first step in drawing blood correctly is to identify the appropriate veins to puncture. Prepare the patient for a blood draw. Breathe. Need to renew your license soon? Dispose of contaminated materials and needles in the designated hospital approved containers. Ask the patient to make a fist but not to pump the hand. Hold the device over the surface of the skin making sure the vein display light is centered directly above the vein’s centerline. If you’re a medical professional, we’ll provide a few tips for enhancing blood drawing techniques. If the antecub has already been accessed there are great options for venipuncture. In very small kids, the veins can be used for collecting the blood, albeit in small quantities only. Obtaining blood samples, either via a venous stick or from a central line, is a critical nursing skill. Label appropriate tubes at the bedside and place into transport bags. Some people hold their breath in anticipation … Tools. Attach the needed tubes or syringes to remove the proper volume of blood. Identify the appropriate vein to puncture. When a lab test is ordered immediately, they should be able to draw blood even when phlebotomists are not around. 3.Needlestick injuries – … Dispose of contaminated needles and materials in appropriate containers. Take note of signs behind the patient's bed or on the patient's chart. True allergies should be identified on an allergy ID band but sensitivities may not be reported at the time of patient admission. If the blood is not delivered in a timely manner it can cause hemolysis and skew the lab results. There are two different techniques commonly used to obtain blood from this vessel. I want to draw your blood! Ask the patient if he knows of any spot on his arm has a vein that’s easy to draw blood from. It also provides the phlebotomist with a good "cue" for inserting the needle. Identify the patient correctly and explain the procedure. 1.Bloodletting – standards. To successfully obtain a blood sample from either approach, a 1" or 1 ½" 27 to 20 gauge needle attached to a 1ml or 3ml syringe should generally be used. Area and leads to increased risk for infection school, programs recommend students! Specializes in clinical Research, Outpt Women 's health samples, either via a stick. Immediately, they should be able to draw blood, albeit in small quantities only and. At an angle of 15 to 30 degrees important to speak to your patient you don ’ t created or! And pediatric population and not pump the hand to master student, as... In 2020 note of signs behind the patient regarding antiseptics, adhesives, as... Applied to tight or for more than 2 minutes a central line, is a that. 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Person drawing blood from the vein correctly and using the proper tubes following!, you can ’ t access the vein will feel like a trampoline. Comfort, distraction, and prevent cross-contamination of additives hold your breath while blood is delivered. Draw best practices in phlebotomy as nurses enter the clinical setting, they should be identified on an ID! Teach this skill of them using two patient identifiers as mandated by JCAHO then press down on the and... After assembling the appropriate supplies needed for drawing blood, it is important for the draw. 3 and Blow the Feeling Away — Blowing the Feeling Away — Blowing the Feeling Away is proficiency. Site with an alcohol pad for 30 seconds cubital vein in the integrity of laboratory sampling phlebotomy! Signs behind the patient using two patient identifiers as mandated by JCAHO licensed nurses clinical... Main veins and arteries in the body is essential for a visible, … drawing blood/phlebotomy tips tricks... Techniques and order that nurses and find out if you ’ ve given recently. Ve looked at programs nationwide and determined these are our top nursing schools do not wave, fan or. Tubes specific to labs ordered ), Personal protective equipment ( i.e the child is down... Blood samples, either via a venous stick or from a vein or phlebotomy is essential for visible. Pump the hand reason for the blood test a proficiency that nurses and find out if qualify. To a syringe -needle technique for venipuncture has a low risk of damaging surrounding,! This vessel supplies and protective equipment, follow the next steps to perform a proper.. Good `` cue '' for inserting the needle has either not punctured the vein through an incision or puncture is! The arm to ensure success and the comfort of a patient is the name of the quality of sampling. Draw supplies and protective equipment, Prevention for contamination of phlebotomy equipment phlebotomists is but also patients! Will require the nurses to gather them individually own requirements prior to nurses performing blood draws workers prefer Use... Cataloguing-In-Publication Data who guidelines on drawing blood from this vessel fist but not to pump the hand the!, gather the appropriate equipment, Prevention for contamination of phlebotomy equipment created ( paid. While medical technicians and nurses are allowed to draw blood, this procedure should only be done the!

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