Venipuncture Syringe Method
A. Definition
Venipuncture is the process of obtaining intravenous access for the purpose of intravenous therapy or obtaining a sample of venous blood. This procedure is performed by medical laboratory scientists, medical practitioners, some EMTs, paramedics, phlebotomists and other nursing staff. Venepuncture is one of the most routinely performed invasive procedures and is carried out for two reasons, to obtain blood for diagnostic purposes or to monitor levels of blood components (Lavery & Ingram 2005). Blood analysis is one of the most important diagnostic tools available to clinicians within healthcare. Its data is relied upon in the clinical setting for interpretation of a myriad of clinical signs and symptoms and developing skills in venepuncture can facilitate holistic and timely treatment.
Blood is most commonly obtained from the median cubital vein, which lies within the cubital fossa anterior to the elbow. This vein lies close to the surface of the skin, and there is not a large nerve supply.
Minute quantities of blood may be taken by fingersticks sampling and collected from infants by means of a heel stick or from scalp veins with a winged infusion needle.
Phlebotomy (incision into a vein) is also the treatment of certain diseases such as hemochromatosis and primary and secondary polycythemia.
B. Tools and Reagen
1. Alcohol pads ( 70% )
2. Dry, clean gauze pads ( 2 inch x 2 inch )
3. Tourniquet ( clean and in good condition )
4. Vacutainer holder-these are not reusable should be discarded after use.
5. Colletion tubes ( make sure you have correct tube for all tests ordered and comfirm that the tubes are not expired )
6. Syringe of size sufficient to draw volume of blood needed.
7. Bandage tape, gauze and or adhesive bandages.
8. Sharps diposal containes
C. Procedure
To perform venipuncture , follow the steps given bellow.
1. Explain the procedure to the patient
2. Apply tourniquet around the arm approximately 2 to 3 inches above the antecubital fossa (the depression in the anterior region of the elbow, see figure 7-4) with enough tension so that the vein is compressed, but not the artery. A BP cuff (sphygmomanometer) may be used instead of a tourniquet if a patient is difficult to draw.
3. Position the patient’s arm extenden with little or no flexion at the elbow.
4. Locate a prominent vein by palpation (feeling). If the vein is difficult to find, it may be made more prominent by massaging the arm with an upward motion to force blood into the vein.
5. Cleans the puncture site with a 70% alcohol pad or povidone-iodine solution and allow to dry. Caution : After cleaning the puncture site, omly the sterile needle should be allowed to touch it.
6. Fix or hold the vein taut. This is the best accomplished by placing the thumb under the puncture site and exerting a slight down ward pressure on the skin or placing the thumb to the side of the site and pulling the skin taut laterally (fig.7-4)
7. Using a smooth continuous motion, introduce the needle, bevel side up, into the side of the vein at about a 15-degree angle with the skin (fig.7-4)
8. Holding the vecutainer barrel with one hand, push the tube into the holder with the other hand and watch for the flow of blood into the tube until filling is completed.
9. Once all the specimens have been collected, hold the vacutainer with one hand and release the tourniquet with the other.
10.Place a sterile gauzwe over the puncture site and remove the needle with a quick, smooth motion.
11.Apply pressure to the puncture site and instruct the patient to keep the arm in a straight position. Have the patient hold pressure for at least 3 minutes.
12.Take this time to invert any tubes that need to have anticoagulant mixed with the blood.
13.Label specimens.
14.Reinspect the puncture site to make sure bleeding has stopped, and apply a bandage.
Bibliography :
PICTURE
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