17 Questions
What is the term for the accumulation of fluids in the tissues?
Edema
How should one handle a patient with adhesive allergy during blood collection?
Apply gauze for 15 minutes
Which situation would indicate nerve involvement during a blood collection procedure?
Extreme numbness or pain reported by the patient
What action should be taken if a patient experiences nausea and vomiting during a blood collection procedure?
Discontinue the procedure until the patient feels better
What is the term used for an iatrogenic complication associated with blood collection that involves leakage of blood from the vessels?
Hematoma
Which vascular access device is needed for infusing medication, central venous pressure readings, and blood transfusion of a patient?
Central Vascular Access Devices (CVADs)
What is a potential risk if a phlebotomist extracts more blood than required from a patient?
Increased risk of iatrogenic anemia
What is the consequence of rapid filling of the tube during a venipuncture procedure?
Greater likelihood of hemolysis
How can a phlebotomist prevent the reflux of anticoagulant during venipuncture?
Observing a downward position of the tube below the venipuncture site
What could be a reason for hemoconcentration in a blood specimen collected by a phlebotomist?
Inadequate tourniquet application
What is a potential outcome of a phlebotomist pulling a tube before reaching the required volume during blood collection?
Greater likelihood of incorrect blood-to-additive ratio
Which action by a phlebotomist can contribute to vein damage during venipuncture?
Excessive redirection of the needle and blind probing
What should be done when a patient experiences seizures or convulsions during a blood draw?
Check the mouth for any obstruction and protect the patient from self-injury
Which of the following conditions can trigger hematoma formation during a blood draw?
Leaving the tourniquet on after removing the needle
What is a potential consequence of iatrogenic anemia?
Blood loss due to blood draw
Which action can help address swelling at the draw site after a blood draw?
Holding pressure over the site immediately after discontinuing the draw
What does petechiae look like when a tourniquet is applied?
Small red or purple spots resembling rashes
Study Notes
Complications Associated with Blood Collection
- Edema: accumulation of fluids in the tissues
- Hematoma: leakage of blood from vessels during venipuncture
Vascular Access Sites and Devices
- Arterial Line
- Arteriovenous shunt or Fistula
- Blood-sampling Device
- Heparin or Saline Lock/ “hep-lock” for medicine administration or blood sampling
- IV Sites: phlebotomist should collect below IV lines
- Central Vascular Access Devices (CVADs)/ Indwelling lines: central venous catheter lines, implanted port, peripherally inserted central catheter
Handling Patient Complications
- Allergies to Equipment and Supplies:
- Adhesive allergy: apply gauze for 15 mins
- Antiseptic allergy: use a different antiseptic technique
- Latex allergy: use non-latex gloves, tourniquet, bandages
- Excessive Bleeding: apply pressure until bleeding stops
- Fainting: lie down during procedure
- Nausea and Vomiting: discontinue procedure until patient feels better
- Pain: if patient complains of extreme numbness or pain, remove needle and apply ice to site (may indicate nerve involvement)
- Phlebotomist should only extract required volume from patient, as 10% loss of blood can threaten patient
Inadvertent Complications
- Inadvertent Arterial Puncture: rapid filling of tube, rapid formation of hematoma on site
- Infection: maintain sterile conditions, keep veni site closed for 15 mins
- Nerve Injury: improper site selection, rapid needle insertion, excessive redirection of needle, blind probing
- Reflux of Anticoagulant: downward position, tube below veni site
- Vein Damage: follow proper techniques, avoid blind probing
Specimen Quality
- Hemoconcentration: decrease in fluid content or plasma volume caused by tourniquet that stagnates blood flow
- Hemolysis: rupture of RBCs, release of Hgb into surrounding fluid
- Partially-filled tube or short draw: incorrect blood-to-additive ratio
- Specimen contamination
- Wrong or Expired Collection tube
Troubleshooting Failed Venipuncture
- Needle position is critical to success
- Petechiae: small red or purple spots that resemble rashes when tourniquet is applied
- Seizures or convulsions: discontinue procedure, check mouth for obstruction, protect patient from self-injury, notify first aid personnel
Avoiding and Handling Procedural Errors and Failure to Draw Blood
- Hematoma Formation:
- Hold pressure over site immediately after discontinuing draw
- Cold compress or ice pack may help address swelling
- Conditions that trigger hematoma include: excessive or blind probing, inadvertent arterial puncture, small vein size, needle penetration through vein, incomplete needle insertion, tourniquet still on when needle removed, inadequate pressure
- Iatrogenic Anemia: blood loss due to blood draw
Learn about how to avoid and handle procedural error risks in blood draws, specifically focusing on preventing hematoma formation. Discover techniques for mitigating swelling and addressing complications during the blood draw process.
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