General Phlebotomy Procedures in Infants, Children, and Geriatric Patients - PDF

NB 3172 GENERAL PHLEBOTOMY PROCEDURES IN INFANTS, CHILDREN AND GERIATRIC Dr Noor Hazfalinda Hamzah the (left hand); hold the needle (right hand) people Danc...

NB 3172 GENERAL PHLEBOTOMY PROCEDURES IN INFANTS, CHILDREN AND GERIATRIC Dr Noor Hazfalinda Hamzah the (left hand); hold the needle (right hand) people Danchor veir old : for older people (excessive bleeding might happen * extra precaution Pediatric Pediatric blood collection may be by skin puncture or venipuncture. Skill in pediatric phlebotomy is gained by knowledge of special collection equipment, observation of skilled phlebotomists and practice. blood vessel is too tiny ~ because Very challenging patients due to size and emotional response to blood collection. New phlebotomists should learn skills by performing procedures on older children. Essential to recognize limitations, always request help when necessary.  Mig Age guidelines Infant: birth – 1 year Paediatric: 1 – 12 years Adolescent: 10 – 19 years Adult: 20 – 65 years Geriatric: > 65 Choice of procedure and site The choice of site and procedure (venous site, finger-prick or heel-prick – also referred to as “capillary sampling” or “skin puncture”) will depend on the volume of blood needed for the procedure and the type of laboratory test to be done Venepuncture is the method of choice for blood sampling in term neonates, however, it requires an experienced and trained phlebotomist Heel stick collection procedure Avoid bruised areas and sites of previous punctures. The size of the lancet must not exceed 2.0 mm to avoid puncturing bones, nerves or tendons. Automatic puncture devices are available for preemies (0.85mm puncture depth) and infants (1.25mm). Hold the heel gently as infants bruise easily. Avoid excessive milking or squeezing. Do not use adhesive bandages. Check site before leaving.  Practical guidance on paediatric and neonatal blood sampling Patient identification Blood collection: venepuncture - Use a winged steel needle (a butterfly) , preferably 22 or 23 gauge, with an extension tube and small collection tubes Xiet Immobilize the child move child Drawing blood – hand hygiene  Elderly Geriatric phlebotomy tips Thinner skin, muscles are smaller – veins to roll easier Less elastic veins Easily collapse during a venepuncture Easily bruise Medications that could affect their bleeding or their balance  Select a smaller size needle – 22 or use a butterfly needle Hand veins are favourable Place tourniquet over patient’s sleeve, not too tight to prevent collapse of the vein Release tourniquet slowly/ gently to prevent bruise