Blood Collection Venipuncture & Skin Puncture PDF

Blood Collection Venipuncture & Skin Puncture Composition of Blood Approx. 45% of the blood is composed of formed elements: red blood cells, white blood cells, and platelets. RBCs contain hemoglobin, which binds oxygen; WBCs defend the body against foreign substances, such as infections; a...

Blood Collection Venipuncture & Skin Puncture Composition of Blood Approx. 45% of the blood is composed of formed elements: red blood cells, white blood cells, and platelets. RBCs contain hemoglobin, which binds oxygen; WBCs defend the body against foreign substances, such as infections; and Platelets primarily function in the stoppage of bleeding.  The remaining 55% of the blood is the fluid portion, of which approx. 90% is water and 10% is composed of proteins (albumin, globulin, and fibrinogen), carbohydrates, vitamins, hormones, enzymes, lipids, and salts.  When coagulation is prevented by the use of an anticoagulant, the liquid portion of the blood is termed plasma and contains the protein fibrinogen. If a blood specimen is allowed to clot, the liquid portion released from the clot is called serum and does not contain any fibrinogen due to the fact that the fibrinogen was utilized to form the fibrin threads of the blood clot. Common Techniques in Phlebotomy The correct patient identification is critical. › For hospital patients this is accomplished by checking the identification wrist band for the correct name and hospital identification number. The procedure for outpatients is not easy. The phlebotomist should ask the patients of his/ her full name and other info specific for that patient that can be verified by the requisition slip.  The correct specimen identification is equally as important as patient identification. › Each blood specimen obtained should be labeled with the patient’s first and last name, the hospital identification number, patient location, time, date, and the phlebotomist’s initials.  To be consistent with laboratory safety guidelines and universal precautions, gloves must be worn at all times while performing phlebotomy techniques to protect the technologist from acquiring blood-borne infections such as HBV/ HIV. › In addition, the phlebotomist’s hands should be washed between each patient when removing gloves.  The puncture site should be cleaned by rubbing vigorously with a pad thoroughly moistened with 70% alcohol. The area is then dried using sterile gauze. Once the phlebotomy site has been cleaned the decontaminated area should not be touched. › Betadine should not be routinely used to clean the phlebotomy area because contamination with this substance will cause some erroneous test results  All sharp objects such as lancets and needles must be disposed of in special puncture-resistant disposable needle containers labeled as biohazardous. Needles should not be bent, broken, or recap before disposal. › All other objects such as gauze and alcohol prep swabs should be placed in biohazardous waste containers. Skin Puncture  Microsampling refers to blood collection by skin puncture and is frequently used on the following types of patients: 1. Infants less than 6 months of age generally do not have a large blood supply, and it is dangerous to remove the volume of blood involved in venipuncture 2. In young children, if only a small amount of blood is needed, a skin puncture is performed on the finger. 3. When an adult has poor veins, when the veins cannot be used because of intravenous (IV) infusions, or in case of a severely burned patient, the finger may be used as the phlebotomy site. Reagents & Equipment 1. 70% Alcohol 2. Sterile gauze 3. Skin puncture device (sterile blood lancet) 4. Capillary tubes, Microtainers Procedure 1. Location of phlebotomy site When obtaining blood from infants (