Venipuncture Guide PDF

Chapter V Part 1: LOCATING PROPER SITE AND Sites to Avoid the Practice of Venipuncture: ANCHORING VEINS  Extensive Scarring from burns or surgery Principle: To locate the site that will give the...

Chapter V Part 1: LOCATING PROPER SITE AND Sites to Avoid the Practice of Venipuncture: ANCHORING VEINS  Extensive Scarring from burns or surgery Principle: To locate the site that will give the best blood return.  Edematous Arms Resources:  Upper extremity where a masectomy was performed 1) 70% Isopropyl Alcohol  Hematoma - venipuncture should not be performed on 2) Tourniquet a hematoma regardless of how small. If unavoidable, 3) Cotton (wet & dry) venipuncture should be distal and below the hematoma. 4) Gloves  Intravenous therapy/Blood Transfusions - if not possible Venipuncture on the opposite arm, blood should be drawn below and  is the process of obtaining intravenous access for the distal to the IV. purpose of intravenous therapy or for blood sampling of  Avoid sites with cannulas or fistulas. venous blood.  Avoid arms in casts  In healthcare, this procedure is performed by:  Avoid sites with birthmarks, moles, and tattoo a) Medical Laboratory Scientists b) Medical Practitioner Note: The tourniquet should be applied between the IV site c) Phlebotomist and the venipuncture site. d) Nursing Staff If drawing above the IV site is the only option, then the IV infusion must be turned off for at least 2 minute before Note: It is essential to follow a standard procedure for the performing venipuncture. collection of blood specimen to get the accurate laboratory results. Any kind of error in collection of blood or filing the test Procedure: tubes may lead erroneous results. 1. Wear appropriate PPE 2. Prepare the equipment Primary vein used in venipuncture is Median Cubital Vein - the 3. Select the best puncture site prominent vein in the middle arm 4. Position the patient’s arm slightly bent in a downward position Other site to venipuncture in upper arm: 5. Apply and place tourniquet 3 to 4 inches above the Basilic, Cephalic, or Median Veins selected puncture site. Note: Application of tourniquet near the puncture site may cause the vein to collapse 6. Free end of tourniquet should be away from the puncture area. Make sure there are no folds. Note: Tourniquet should only be applied not more than 1 minute; prolonged application can cause hemoconcentration and hemolysis to the specimen. 7. Ask the patient to make a fist. This makes the vein more palpable. Note: Never ask the patient to “pump” the fist because it will cause hemoconcentration. 8. Palpate the vein using the index finger or middle fingers in a vertical and horizontal direction to determine depth, direction, and size of the vein. 9. Release the tourniquet and have the patient open fist. (This is not necessary if you can locate, palpate, and extract within a minute) 10. Sanitize the area with 70% alcohol in a circular motion from the center to outside. 11. Allow the area to dry. To Keep in Mind: Note(bold mo yung note mahalaga yun): Do not blow  Median Cubital and Cephalic veins are most commonly or fan the venipuncture site. used for venipuncture.  Alternative sites are the basilic vein on the dorsum of the arm or dorsal hand veins.  Due to it close proximity to the brachial artery and median nerve, the basilic vein, should used only if there is no other prominent arm vein.  Veins in the foot and ankle should only be utilized as a last resort.  Veins o the underside of the wrist should be avoided.