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Some institutions have kits with all of the needed supplies while others will require the nurses to gather them individually. The colored top of blood collection tubes helps identify the order of blood draw. Count to 3 and Blow the Feeling Away — Blowing the feeling away is a useful technique. Wear appropriate PPE and perform good hand hygiene. Check for the veins in the pressurized arm. A person drawing blood may choose a butterfly needle when drawing blood for the following purposes: Venipuncture A venipuncture is when a phlebotomist accesses a vein to draw blood. While medical technicians and nurses are allowed to draw blood, this procedure should only be done by a trained phlebotomist. Attach the syringe or tube needed to remove the right volume of blood. Patients are usually nervous if they’ve never had it done before, or sometimes they have a phobia of needles or doctor’s offices. There are two different techniques commonly used to obtain blood from this vessel. These techniques include a lateral and ventral approach. The first on the list is the most common and often the first choice, especially for novice phlebotomists. You know all nursing jobs aren’t created (or paid!) After identifying the site for the blood draw, gather the appropriate supplies needed. By following the order of collection tubes, the time it takes to perform phlebotomy is decreased. As nurses enter the clinical setting, they will have to know how to draw blood as part of their clinical skills experiences. Position the patient and hyperextend the patient’s arm. Look for a visible, … Nurses Nursing. Need to renew your license soon? Use a comfort position when possible. As the person drawing blood, it is important you know how to draw blood correctly. Identify the patient correctly and explain the procedure. If properly inserted blood should flash into the catheter. Breathe. https://sciencediscoveries.degruyter.com/order-blood-draw-importance-blood-sample-collection/, https://www.phlebotomyinfo.com/phlebotomy-order-of-draw/, https://www.ncbi.nlm.nih.gov/books/NBK138665/, Phlebotomy Jokes – Humor for Phlebotomists, How To Write A Phlebotomy Cover Letter w Examples, How To Become A Medical Assistant – Career Training Guide. Speaking of the quality of laboratory sampling, phlebotomy must follow a certain order when collecting samples. Label tubes at the bedside and place in transport bins or bags. Copyright © 2021 Full Beaker, Inc | 866-302-3888 | [email protected] | Do Not Sell My Personal Information, 4 Steps to Becoming a Labor and Delivery Nurse, Nursing Associations Condemn Violence in DC Capitol, Availability of appropriate supplies and protective equipment, Availability of post-exposure prophylaxis (PEP), Avoidance of contaminated phlebotomy equipment, Edematous sites (swollen sites filled with serous fluid), From an IV cannula (unless permitted by your institution), Sites above an IV cannula in the same vessel, Arm with a preexisting or current blood clot, Evacuated Collection Tubes (tubes specific to labs ordered), Personal Protective Equipment (ie gloves), Bio-hazard leak-proof transportation bags. Appropriate blood draw supplies and protective equipment, Prevention for contamination of phlebotomy equipment. Hard stick patients should keep their veins warm. Additionally, these steps only apply to the adult and pediatric population and not neonates. Get them to put a warm compress on the arm 10 minutes before the blood test. The practice of phlebotomy is not something that can strictly be learned from watching videos or reading a how-to guide but something that must be practiced repeatedly in a controlled environment with other trained professionals. For adult patients, the most common and first choice is the median cubital vein in the antecubital fossa. unlocking this expert answer. Grab the patient’s lower arm (below site of puncture) firmly to draw the skin taut and anchor the vein from rolling. Deliver blood specimens without delay to prevent hemolysis that can skew the lab results. Blood Draw Best Practices, Order of Draw, and Proper Procedure. WHO Library Cataloguing-in-Publication Data WHO guidelines on drawing blood: best practices in phlebotomy. Insert the needle at a 15 to 30-degree angle into the vessel. If the antecub has already been accessed there are great options for venipuncture. Don’t be discouraged if at first, you don’t access the vein. Learning the anatomy of the main veins and arteries in the body is essential to becoming competent in phlebotomy. Count to three and blow the feeling away: This is a useful technique to make a blood draw easier for your child and for the phlebotomist. Blood draw must be carried out in an appropriate location whether outpatient or inpatient. Label appropriate tubes at the bedside and place into transport bags. Blood draw order is not only important to phlebotomists is but also to patients. Apply a tourniquet approximately 3 to 4 inches above the intended puncture site. Once again, please be aware that these are only guidelines for blood draws and nurses should consult with the appropriate hospital personnel regarding performing this procedure on patients. Reasons for concern would include numbness, tingling, change of color to blue or white, and extreme pain. Has 25 years experience. Remove the needle and then press down on the venipuncture site with a gauze. Perform good hand hygiene and don appropriate PPE. Attach the needed tubes or syringes to remove the proper volume of blood. Obtaining blood samples, either via a venous stick or from a central line, is a critical nursing skill. This is a common misconception - pumping the hand does not increase venous circulation. Remove the tourniquet as the last amount of blood is drawn. Students should study venipuncture in books and watch licensed nurses in clinical settings perform this task. Let us know if you have a preferred arm or particular vein that has been used successfully in the past to draw blood. Each healthcare system has their own requirements prior to nurses performing blood draws. The vein will feel like a "trampoline" … Try light exercise beforehand. Observe isolation restrictions, and make sure that, if the blood test requires fasting, that the patient fasted for the appropriate amount of time. Stabilize the “leg” with your non-dominant hand and use the index finger of your dominant hand to feel for the “vein.” Next, use your dominant hand to hold the syringe and swiftly insert the needle into the “vein.” https://www.ephlebotomytraining.com/blood-draw-procedure-and-techniques There are blood draw techniques and order that nurses and phlebotomists must follow. Specializes in Clinical Research, Outpt Women's Health. It is a proficiency that nurses should learn, and phlebotomists should excel at. Most facilities expect you to have already learned these things in nursing school, and often have vague, unhelpful policies regarding drawing blood. Locate The Vein. Identify the appropriate vein to puncture. The practice of drawing blood from a vein or phlebotomy is essential for a variety of medical procedures and tests to diagnose a patient. Ask the patient to make a fist and not pump the hand. This process is not as simple or as straightforward as it seems. Be sure to bring extras in case a second attempt for venipuncture is required. Heel stick or Arm draw if neonate 21 pounds or greater- arm draw can be performed if need, follow steps below for arm draw: Do not draw from heel if: Feet are edematous, injured or infected, bruised, injured by multiple previous heel sticks or if testing requires more than 1 mL of blood, refer the patient’s family to the pediatric service. Blood should flash into the catheter if done properly. In doing so, this will enable students to learn basics prior to graduation. An important tip - take extra supplies into the patient’s room in case you need to attempt a second venipuncture. Check for any allergies or sensitivities with the patient regarding antiseptics, adhesives, or latex. Grab the patient’s lower arm, just below the puncture site, to keep the vein from rolling and to draw the skin taut and give you a clear view of the vein. Then, air dry for another 30 seconds. Even though most hospitals do have phlebotomy teams, it is still critical for nurses to learn these skills in order to provide the best patient care. Let’s have a deeper look at one of them. As the last amount of blood is drawn, remove the tourniquet. 3.Needlestick injuries – … This method can be preferred on the elderly, those with cancer, severe burns, obesity, or … A blood sample is required for most tests, which means it can be difficult to arrive at an accurate diagnosis without first drawing blood and testing it in the lab. Drawing blood/phlebotomy tips and tricks. Dispose of contaminated needles and materials in appropriate containers. It also provides the phlebotomist with a good "cue" for inserting the needle. The parent can be face-to-face with the child, while the child is laying down, providing physical comfort, distraction, and assistance. Puncture is via a needle attached to a syringe or vacutainer. The phlebotomy butterfly technique is the process of drawing blood by means of a ‘winged’ apparatus. Phlebotomy teams generally only make rounds at specific times in hospital settings, therefore, if a lab test is ordered immediately it could be the responsibility of the nursing staff to draw the specimen. Phlebotomy is essential for a variety of medical diagnoses, procedures, and tests. Remove the needle from the patient’s arm and press down on the vessel with gauze. CrunchRN, ADN, RN. Press the purple button on the side of the AccuVein to turn on the vein display light. Commonly referred to as the antecubital or the AC it can be found in the crevice of the elbow between the median cephalic and the median basilic vein. Ask the patient if he knows of any spot on his arm has a vein that’s easy to draw blood from. It also helps reduce patient discomfort, prevent misdiagnosis, avoid complications, and prevent cross-contamination of additives. When a lab test is ordered immediately, they should be able to draw blood even when phlebotomists are not around. We’ve looked at programs nationwide and determined these are our top nursing schools. https://nurse.org/articles/how-nurses-professionally-draw-blood Phlebotomy is the name of the procedure for drawing blood from the vein through an incision or puncture. Read about the top student loan forgiveness programs for nurses and find out if you qualify. Take note of signs behind the patient's bed or on the patient's chart. Prep the venipuncture site by cleansing the area with an alcohol prep pad for 30 seconds and allow to air dry for 30 seconds. While not commonly taught in nursing school, programs recommend nursing students take extra courses to hone this skill. Furthermore, it has a low risk of damaging surrounding nerves, arteries, and tendons versus other veins in the hands. Tools. Some health care settings may insert blood drawing peripheral intravenous catheters into this vessel for frequent blood draws. Veins have a 3-layered wall composed of an internal endothelium surrounded by a thin layer of muscle fibers, which in turn is surrounded by a layer of connective tissue. Incision is a surgical procedure that involves a cut section of the vein. This includes sticking the vein correctly and using the proper tubes. Proper collection and transportation are critical. In general, it is much more difficult to draw blood from children than from adults, due to the relative size of their veins. Some patient-friendly advice for getting blood drawn include the following: Drink plenty of water an hour before the draw. Position them properly and hyperextend their arm. 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