How To Draw Blood

Venipuncture Equipment

The following are needed for routine venipuncture:

Evacuated collection tube: The tubes are designed to fill with a predetermined Volume of blood by vacuum. The rubber stoppers are color-coded according to the Additive that the tube contains. Various sizes are available. Blood should NEVER be poured from one tube to another since the tubes can have different additives or Coatings.

Needles: The gauge number indicates the bore size: the larger the gauge number, the smaller the needle bore. Needles are available for evacuated systems and for Use with a syringe, single draw, or butterfly system.

Holder/adapter: For use with the evacuated collection system. Tourniquet: A latex or plastic strip with a Velcro closing used to cause blood to Pool in the area and to enlarge the veins, making them easier to palpate. Wipe Tourniquets off with alcohol and replace them frequently. Alcohol wipes: Wipes containing 70% isopropyl alcohol for disinfecting the skin before blood collection.

Gauze sponges: For application on the site from which the needle is withdrawn.

Adhesive bandages/tape: To protect the venipuncture site after collection.

Needle disposal unit: Needles must NEVER be broken, bent, or recapped. Needles must be placed in a proper disposal unit IMMEDIATELY after their use.

Gloves: Can be made of latex, rubber, vinyl, etc.; worn to protect the patient and the phlebotomist.

Eye protection: To protect the phlebotomist from aerosols contaminating the Eyes.

Syringes: May be used in place of the evacuated collection tube for special Circumstances.

Capillary Blood Collection Equipment

The following are needed for routine capillary blood collection:

Sterile lancet: Retractable type is preferred; tip less than 2.4 mm. The tip length will depend on the intended use. For newborns and infants under 12 months, the Device should cut or puncture no more than 0.85 mm.

Alcohol wipes: Wipes containing 70% isopropyl alcohol.

Sterile gauze pads: For removal of first free-flowing drop of blood and for Pressure application after collection.

Gloves: Can be made of latex, rubber, vinyl, etc.; worn to protect the patient and the phlebotomist.

Eye protection: To protect the phlebotomist from aerosols contaminating the Eyes.

Sharps disposal unit: Lancets must be placed in a proper disposal unit Immediately after their use

Blood collection sites

From arm from hand and foot

From leg Common capillary puncture sites

Venipuncture procedure

1. Use your index finger to find the location of the vein, and you'll know it's spongy. Do not use your thumb because you may feel your pulse.

2. The strap should rest on the arm about 10 cm above the pull.

3. Locate the vein:

Note:

1. The preferred place for retraction is the inside of the elbow; this median cubital vein is usually easy to see.

2. Avoid collecting samples from sites where veins have split or joined; this increases the chance of bleeding under the skin.

1. Clean the place: using alcohol with a concentration of 70%.

Note:

1. Alcohol is better than iodine; because if the latter is mixed with blood,

   it may change the results of the required tests. If you used iodine, follow it up with a 70% alcohol swab.

2. Let the disinfectant dry before inserting the needle, and don't blow or fan it with your hand so it doesn't re-contaminate.

1. Stabilize the vein by pulling tightly the skin below the traction site.

   • To prevent the vein from escaping. Be careful not to touch the area that has been disinfected.

   • Insert the needle at a 15-30 degree angle and hold it in this position as you draw blood

   • Fill the test tube with blood in the order and directions given by the lab

   • Loosen the compression bandage after a minute and before the needle is withdrawn.

   • If the needle is pulled before it loosens the ligament, the patient will be in pain so should

2. Apply pressure to the intake site for five minutes after removing the needle to stop the bleeding

3. Dispose of the needle in a hard-walled container designated for medical hazardous waste.

4. Double check the label on the tube to avoid a mistake

Precautions

• Steps to Prevent a Hematoma

  1. Puncture only the uppermost wall of the vein

  2. Remove the tourniquet before removing the needle

  3. Use the major superficial veins

  4. Make sure the needle fully penetrates the uppermost wall of the vein. (Partial penetration may allow blood to leak into the soft tissue surrounding the vein by way of the needle bevel)

  5. Apply pressure to the venipuncture site

• Prolonged Tourniquet Application

  1. The primary effect is hemoconcentration of nonfilterable elements such as proteins. The hydrostatic pressure causes some water and filterable elements to leave the extracellular space and enter the venous blood

  2. Leave the extracellular space and enter the venous blood.

  3. Significant increases can be found in total protein, aspartate aminotransferase (AST), total lipids, cholesterol, and iron.

  4. Affects packed cell volume and other cellular elements.

Capillary blood collection procedure

Capillary blood collection from baby

Precautions

The best locations for collecting capillary samples are the 3rd and 4th fingers of the no dominant hand and the edges of the heel (infants) .

The following precautions apply to finger sticks. He’ll stick collections for infants follow the same basic principles.

• Do not use the tip of the finger or the center of the finger.

• Avoid the side of the finger where there is less soft tissue, where vessels and nerves are located, and where the bone is closer to the surface .

• Avoid the 2nd (index) digit, which tends to have thicker, callused skin.

• Avoid the 5th digit, which tends to have less soft tissue overlying the bone.

• Avoid puncturing a finger that is cold, cyanotic, swollen, scarred, or covered with A rash

Safety and Infection Control

Because it is often impossible to know which might be infectious, all patient blood specimens are to be treated with standard precautions. Obtaining blood from subjects may involve contacts with patients with underlying infectious diseases so it is important to follow safety and infection control procedures during collection and handling of their specimens.

Protect Yourself

Practice universal precautions:

• Wear gloves and a laboratory coat or gown when handling blood/body fluids.

• Change gloves after each patient or when contaminated.

• Wash hands frequently.

• Dispose of items in appropriate containers.

• Dispose of needles immediately upon removal from the patient’s vein. To avoid

• accidental needle puncture or splashing of contents, do not bend, break, recap, or

• Re sheath needles.

• Clean up any blood spills with a disinfectant such as freshly made 10% bleach.

• If you stick yourself with a contaminated needle:

• Remove your gloves and dispose of them properly.

• Squeeze puncture site to promote bleeding.

• Wash the area well with soap and water.

• Record the patient’s name and ID number.

• Follow your institution’s guidelines regarding treatment and follow-up.

• NOTE: The use of prophylactic zidovudine following blood exposure to HIV

• Has shown effectiveness (about 79%) in preventing seroconversion.

  
  

Protect the Patient

• Place blood collection equipment away from patients, especially children.

• Practice hygiene for the patient’s protection. When wearing gloves,

  change them

• Between each patient and wash your hands frequently. Always wear a clean

• Laboratory coat or gown.

• Never reuse blood collection equipment. The proper use of disposable needles,

• Syringes, and lancets virtually eliminates transmission of blood borne disease.