Podcast
Questions and Answers
When should an additive tube be mixed?
When should an additive tube be mixed?
as soon as it is removed from the holder
What should the phlebotomist do if the patient is just finishing a big breakfast while requiring a fasting specimen?
What should the phlebotomist do if the patient is just finishing a big breakfast while requiring a fasting specimen?
check with the patient's nurse to see if the specimen should still be collected
If an elderly patient is hard of hearing, how should the phlebotomist proceed?
If an elderly patient is hard of hearing, how should the phlebotomist proceed?
speak distinctly in a normal tone of voice
What should a phlebotomist do if the patient's door is closed?
What should a phlebotomist do if the patient's door is closed?
What may happen if you mix a specimen too vigorously?
What may happen if you mix a specimen too vigorously?
What can result in specimen hemolysis?
What can result in specimen hemolysis?
Which test should the phlebotomist collect first among several ordered tests?
Which test should the phlebotomist collect first among several ordered tests?
If a venipuncture site is still bleeding after 5 minutes, what should the phlebotomist do?
If a venipuncture site is still bleeding after 5 minutes, what should the phlebotomist do?
What should the phlebotomist do if an unconscious patient does not have an ID band?
What should the phlebotomist do if an unconscious patient does not have an ID band?
When does the first step in the testing process begin?
When does the first step in the testing process begin?
What does NPO mean?
What does NPO mean?
What should the phlebotomist do if the patient is sound asleep during the blood draw?
What should the phlebotomist do if the patient is sound asleep during the blood draw?
A specimen that must be drawn immediately is called a _____
A specimen that must be drawn immediately is called a _____
What should the phlebotomist do after two unsuccessful attempts to collect a fasting specimen from an outpatient?
What should the phlebotomist do after two unsuccessful attempts to collect a fasting specimen from an outpatient?
What could be bad for the specimen during vein selection?
What could be bad for the specimen during vein selection?
A tourniquet used for venipuncture procedures should be:
A tourniquet used for venipuncture procedures should be:
When should blood collection tubes be labeled?
When should blood collection tubes be labeled?
Which communication strategy demonstrates poor technique before obtaining a blood specimen from a child?
Which communication strategy demonstrates poor technique before obtaining a blood specimen from a child?
What is the recommended angle of needle insertion for an antecubital vein and a hand vein, respectively?
What is the recommended angle of needle insertion for an antecubital vein and a hand vein, respectively?
How long should a tourniquet never be left on before collection?
How long should a tourniquet never be left on before collection?
How can you tell that you are in a vein when using a needle and a syringe?
How can you tell that you are in a vein when using a needle and a syringe?
What is the job of a student phlebotomist?
What is the job of a student phlebotomist?
What is the most critical error a phlebotomist can make?
What is the most critical error a phlebotomist can make?
What should a phlebotomist do if startled while performing a venipuncture?
What should a phlebotomist do if startled while performing a venipuncture?
How can you confirm a patient's identity for a specimen collection?
How can you confirm a patient's identity for a specimen collection?
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Study Notes
General Phlebotomy Practices
- Additive tubes must be mixed immediately after removal from the holder to ensure proper blood sample integrity.
- In case of uncertain fasting status due to a recent meal, confirm with the patient's nurse before collecting specimens.
- For patients with hearing difficulties, use a normal tone but speak distinctly for clear communication.
Patient Interaction and Safety
- Always knock softly and request permission before entering a patient's room to respect privacy.
- Excessive mixing of specimens can lead to hemolysis, damaging blood cells and affecting test results.
- A large-volume tube combined with a 23-gauge needle can also result in specimen hemolysis.
Priority in Sample Collection
- STAT electrolytes should be collected first during emergencies like those in the ER, as they are urgent tests requiring immediate attention.
- If bleeding persists beyond 5 minutes after a venipuncture, notify the patient's nurse or healthcare provider for further evaluation.
Identification and Specimen Integrity
- Draw specimens only after confirming patient identification; ID bands are crucial for safe and accurate testing.
- The testing process initiates when a healthcare provider orders the test, signifying the start of sample collection protocols.
Communication and Patient Comfort
- NPO (nil per os) indicates that the patient should consume nothing by mouth before a procedure.
- Gently waking a sleeping patient before a blood draw minimizes the risk of startling them.
Types of Specimens and Collection Techniques
- Urgent specimens drawn immediately are classified as "stat".
- After two unsuccessful attempts at collecting a specimen, consult another phlebotomist for assistance.
- Avoid having patients pump their fists during vein selection, as this can negatively impact specimen quality.
Technical Procedures
- A tourniquet must be snug but comfortable, applied 3 to 4 inches above the venipuncture site to facilitate blood flow without compromising arterial circulation.
- Blood collection tubes should be labeled right after specimen collection to ensure accuracy.
- Informing a child that a procedure will not hurt may be misleading; instead, use more honest communication strategies.
Needle Insertion Techniques
- Recommended needle angles: 30 degrees or less for antecubital veins and 10 degrees or less for hand veins.
- Do not leave a tourniquet on for more than 1 minute before specimen collection to prevent complications.
Recognizing Vein Entry and Professionalism
- Blood entering the hub of the needle indicates successful entry into a vein.
- Student phlebotomists must clearly inform patients of their status as learners to maintain transparency.
- The most critical phlebotomy error is misidentifying a patient specimen, which can lead to serious consequences.
Responding to Patient Movement
- If a patient moves during venipuncture, apologize, and carefully reinsert the needle, clean the site, and proceed with the collection.
- Confirm patient identification by cross-referencing the ID band, requisition details, and the patient’s verbal confirmation to ensure accurate testing.
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