3- Phlebotomy.pdf

Tishk International University Faculty of Nursing Nursing Department Phlebotomy Practical Biochemistry Lecture: 3 MSc. Pary Ameer 2023-2024 Outlines Previous Lecture & 2 Quizzes Medical Terms - Phlebotomy Screen for Latex Allergy Choosing a Needle Choosing a site Supplies Steps to Phlebotomy ...

Tishk International University Faculty of Nursing Nursing Department Phlebotomy Practical Biochemistry Lecture: 3 MSc. Pary Ameer 2023-2024 Outlines Previous Lecture & 2 Quizzes Medical Terms - Phlebotomy Screen for Latex Allergy Choosing a Needle Choosing a site Supplies Steps to Phlebotomy Learning Outcome Demonstrate Venipuncture Techniques: Ensuring Control and Safety Developing Patient Interaction and Communication Skills Previous Lecture What's Biochemistry? An Overview about Carbohydrates Blood Glucose Monitoring What is Diabetes? Hypoglycemia & Hyperglycemia Practical – Blood Glucose Monitoring Quizzes of st 1 and nd 2 Lecture Medical Terms - Phlebotomy phlebotomy = xwengrtn puncture = kunkrdn thrombophlebitis = hawkrdnexwenhenar ba hoe clot bwn thrombus = xwen mayen Phlebotomy means collecting blood Venipuncture is the act of puncturing a vein with a needle Thrombophlebitis is the inflammation of a vein with blood clot formation Thrombus a blood clot Medical Terms - Phlebotomy Hemolysis is the breaking of blood cells Coagulate “the act of blood clotting” Lumen is the hollow center of a structure (needle) Hematoma a blood-filled bruise caused when a blood vessel is broken; collection of blood under the skin Bevel is the slant at the end of a needle Medical Terms - Phlebotomy Vacutainer is a vacuum tube used to draw blood Butterfly smaller needle with wings on each side used to draw blood; winged infusion needle Straight needle is a straight needle used to draw blood Medical Terms - Phlebotomy Anticubital space is the area in front of the elbow Bruise = shen halgaran Ecchymosis a bruise Centrifuge is a device used in the lab to spin blood and separate the liquid and solid portions of the blood Screen for Latex Allergy Always ask patient if he/she is allergic to latex before drawing blood! Why? Many medical supplies still contain latex and could cause an allergic reaction Choosing a Needle • Size/diameter of lumen: smaller the gauge= larger the lumen. • Choice depends on amount of blood being drawn • Length: user preference, may need longer needle for obese patients • Use a 21 gauge or bigger to prevent hemolysis Which needle is larger in diameter? 16 gauge or 20 gauge gauge = geche neddle Choosing a Site Places to avoid Arm with IV Solution Infusing Infected/Swollen Areas Site with Injury, Burn, Scarring Lower Extremities Area with Rash Arm with Dialysis Graft/Mastectomy Side Inner Portion of Wrist Choosing a Site Use a tourniquet to evaluate which vein to use Apply tourniquet 2-3 inches above elbow. Evaluate vein selection Not too tight; tight enough to cause the veins to stand out but not so tight to occlude arterial flow- check pulse Remove tourniquet until ready to perform full procedure ( within 1-2 minutes) Choosing a Site • Antecubital space are most commonly used • Apply tourniquet 2-3 inches above elbow or desired blood draw site • A good vein stands our when the tourniquet is applied • Use “touch” more than “sight” • Use vein that feels “springy” Supplies Alcohol Betadine Chlorhexidine Tourniquet Needle(smaller number=bigger needle) Vacutainer Adapter Gauze bandaid Steps to Phlebotomy 1. Gather Supplies: Collect necessary items. 2. Explain Latex Allergy Screening: Inform patient about the procedure. 3. Take Standard Precautions: Wear appropriate protective gear. 4. Examine Arm: Inspect for suitable veins. 5. Apply Tourniquet; Find Vein (1-2 mins): Secure tourniquet, locate vein promptly. 6. Release Tourniquet: Allow blood flow to normalize. 7. Prepare and Clean Site: Ready supplies, sanitize venipuncture site. 8. Replace Tourniquet Carefully: Avoid contamination. 9. Stabilize the Vein: Ensure the vein is secure for puncture. 10. Insert at 15 Degree Angle: Enter the vein at a specific angle. 11. Push Vacutainer at "Flash": Advance tube upon seeing blood flash. 12. Allow Tube to Fill: Let blood collect in tubes sequentially if multiple are required. 13. Release Tourniquet Last: Remove tourniquet once last tube is filling. 14. Cover Site with Gauze: Place gauze as needle is withdrawn. 15. Apply Pressure for 2-3 Minutes: Hold to stop bleeding. 16. Apply Band-Aid if No Bleeding: Secure site if bleeding has ceased. After collection 1.Invert Blood Tubes 5-10 Times: Gently rotate or invert blood collection tubes upside down 5-10 times to ensure proper mixing of the blood with any additives present in the tubes. This step is crucial for adequate mixing of anticoagulants or preservatives. 2.Label Tubes per Facility Requirements: Accurately label each tube with patient identification details, date, time, and any other necessary information as per the facility's protocol. This ensures proper identification and traceability of samples. 3.Place in Biohazard Bag x 2: Securely place the labeled blood collection tubes in a biohazard bag, ensuring double bagging for added safety. This practice helps contain any potential spills or leaks, reducing the risk of exposure to biohazardous materials during transport to the laboratory.