chapter 7

• vein locating devices - Transillumination, inspect an organ by passing light through its wall
• examples of vein locating devices: venoscope II, neonatal transilluminator, AccuVein AV300
• tourniquet - Tied around a patient’s arm prior to venipuncture to restrict blood flow
• • Maximum allowable time a tourniquet is placed on the arm: 1 minute
• tourniquet is placed 3-4 inches above the venipuncture site
• Most common type of tourniquet: strap tourniquet
• needles - Hollow stainless steel shafts with the bevel end cut at a slant to allow ease of entry through skin and vein
• multisample needle - evacuated tubes
• hypodermic needle - syringe/open system
• butterfly needle - small/fragile veins
• bevel - beveled or cut on a slant, end that pierces the vein
• lumen - Internal space of the needle
• shaft - Long cylindrical portion
• hub - End that attaches to the blood collection device
• gauge 15-17: Collection of donor units, autologous blood donations, and therapeutic phlebotomy
• gauge 20: Sometimes used when large-volume tubes are collected or large-volume syringes are used on patients with normal-size veins
• gauge 21: Considered the standard venipuncture needle for routine venipuncture on patients with normal veins or for syringe blood culture collection
• gauge 22: Used on older children and adult patients with small veins or for syringe draws on difficult veins
• gauge 23: Used on the veins of infants and children and on difficult or hand veins of adults
• The higher the number of the gauge, the smaller the needle
• needle length:

  1. and 1.5 in. is most commonly used for venipuncture
• needle length:

  1/2 to 3/4 in. used for butterfly needles
• 2 venipuncture procedures: evacuated tube system and syringe system
• Evacuated tube system (ETS): Most common and CLSI preferred system for collecting blood
• multisample needle: Used when performing ETS
• SESIP - Sharp with Engineered Sharps Injury Protection
• evacuated tube: used with both ETS and syringe system
• various sizes and volumes of evacuated tubes: 1.6 to 15 mL
• • Vacuum = evacuated tubes fill with blood automatically due to negative pressure in them
• • Premature loss of vacuum can occur and the tube will fail to fill with blood. Can result in a “short draw” = underfilled tube
• • Additive = substance placed within tube
• Thixotropic gel separator - Gel found in the gold top, separates serum to blood cell
• Nonadditive tube: Additive free, Clear tops, red tops without additives (glass)
• purpose of nonadditive tubes: clearing and discarding
• stoppers: Other names: caps, tops, closures

  purpose:  to protect lab personnel from blood drops remain
• color coding: generally universal, there is more than one stopper color for same additive
• Expiration date

  • Until the last day printed on the label
  • Storage temperature for evacuated tubes: 4 to 25 degree C
• Syringe system

  • Used for patients with small to difficult veins
  • Components:
  • Hypodermic needle
  • Syringe with Luer lock tip
• Syringe

  • Available in various sizes and volumes
  • Common volumes in phlebotomy: 2, 5, 10 ml
• parts of syringe: barrel, plunger