VENI EQUIPMENT

• Phlebotomy tray


  Well-equipped blood collection tray that the phlebotomist carries into the patient's room to prevent unnecessary errors during blood collection
• Phlebotomy tray


  • Provides a convenient way for the phlebotomist to carry equipment to the patients' rooms
  • Should be placed on a solid surface, such as a nightstand, and not on the patient's bed
  • Only the needed equipment should be brought directly to the patient's bed
• Mobile phlebotomy workstations


  Versatile mobile workstations that can be configured to accommodate phlebotomy trays, hazardous waste containers, sharps containers, and storage drawers and shelves
• Mobile phlebotomy workstations


  • Designed to be wheeled around the hospital and up to the patient's bedside to eliminate placing equipment or a phlebotomy tray on the patient's bed
• Blood drawing chair


  Chair with an attached or adjacently placed stand to hold equipment, and an armrest that locks in place in front of the patient to provide arm support and protect the patient from falling out of the chair if he or she faints
• Blood drawing chair


  • A reclining chair or bed should be available for special procedures or for patients who feel faint or ill
  • Infant cradle pads or portable infant phlebotomy stations are available for collection of blood from an infant
• The duties of a phlebotomist include the cleaning, disinfecting, and restocking of the phlebotomy trays, workstations, and outpatient drawing stations
• Trays should be totally emptied and disinfected on a weekly basis
• Trays also contain equipment for performing the microcollection techniques, arterial puncture equipment, and point-of-care equipment
• Evacuated tube system (ETS)


  The most frequently used method for performing venipuncture, where blood is collected directly into the evacuated tube, eliminating the need for transfer of specimens and minimizing the risk of biohazard exposure
• Evacuated tube system


  • Consists of a double-pointed needle to puncture the stopper of the collection tube, a holder to hold the needle and blood collection tube, and color-coded evacuated tubes
• Needles


  Venipuncture needles include multisample needles, hypodermic needles, and winged blood collection needles
• All needles used in venipuncture are sterile, disposable, and are used only once
• Needle gauge


  Refers to the diameter of the needle bore, with larger numbers indicating smaller diameters
• Needles with gauges smaller than 23 are available, but they can cause hemolysis when used for drawing blood samples
• Needles


  • Needles must not be used if the seal is broken
  • Needles should be visually examined before use to determine if any structural defects are present
  • Defective needles should not be used
  • Needles should never be recapped once the shield is removed regardless of whether they have or have not been used
• Multisample needles


  Evacuated tube system needles that are threaded in the middle and have a beveled point at each end, with one end for venipuncture and the other end to puncture the rubber stopper of the evacuated blood collection tube
• Multisample needles


  • Have a rubber sheath that is pushed back when a tube is attached and returns to full needle coverage when the tube is removed, preventing leakage of blood when tubes are being changed
• Safety shields and blunting devices

  Available from different manufacturers to provide additional protection against needlestick injuries
• Safety shields and blunting devices

  • BD Vacutainer Eclipse blood collection needle, PUNCTUR-GUARD self-blunting needles
• Needle holders


  Rigid plastic holders that hold the collection tube and may be designed to act as a safety shield for the used needle
• Needle holders


  • One-Use Holder by Becton, Dickinson allows a needle to be threaded into the holder only one time
  • Venipuncture Needle-Pro holder has a plastic sheath attached by a hinge that can be engaged over the needle after the puncture is performed
  • ProGuard II and VanishPoint tube holders retract the needle into the holder
  • VACUETTE QuickShield Safety Tube Holder and BD Vacutainer Passive Shielding Blood Collection Needle have safety devices that automatically cover the needle when it is removed from the vein
• Holders are available to accommodate collection tubes of different sizes
• To protect phlebotomists from accidental needlesticks by contaminated needles, a means of safe disposal must be available whenever phlebotomy is performed
• Tube holder


  Device that the collection tube is placed into, with a stopper-puncturing needle at one end
• Blood collection procedure


  1. Tube is partially advanced onto the stopper-puncturing needle

  2. Tube is fully advanced to the end of the holder when the needle is in the vein

  3. Blood flows into the tube once the needle penetrates the stopper
• Needle holder


  • Flared ends aid the phlebotomist during the changing of tubes in multiple-sample situations
  • Tubes are removed with a slight twist to help disengage them from the needle
• Needles with safety devices activated must always be placed in rigid, puncture-resistant, leak-proof disposable "sharps" containers labeled BIOHAZARD that are easily sealed and locked when full
• Syringes with the needles attached, winged blood collection sets, and holders with needles attached are disposed of directly into puncture-resistant containers
• Under no circumstances should a needle be recapped
• Evacuated tubes


  Tubes used for blood collection that contain a premeasured amount of vacuum
• Evacuated tubes


  • Amount of blood collected ranges from 1.8 to 15 mL and is determined by the size of the tube and the amount of vacuum present
  • Available in glass and plastic
  • Sterile and many are silicone coated
  • May contain anticoagulants and additives
• Using a 23-gauge needle with a large evacuated tube can produce hemolysis, because red blood cells are damaged when the large amount of vacuum causes them to be rapidly pulled through the small lumen of the needle
• Evacuated tube stoppers


  Thick rubber stoppers with a thinner central area to allow puncture by the needle
• Hemogard closures


  Provide additional protection against blood splatter by allowing the stoppers to be easily twisted and pulled off and have a shield over the stopper
• Loss of tube vacuum is a primary cause of failure to obtain blood
• Anticoagulants


  Prevent clotting by binding calcium or inhibiting thrombin in the coagulation cascade
• Common anticoagulants


  • EDTA
  • Citrates
  • Oxalates
  • Heparin
• Lavender (purple) top tubes

  Contain the anticoagulant EDTA
• Lavender (purple) top tubes

  • Used for hematology procedures that require whole blood, such as the complete blood count (CBC)
  • Cannot be used for coagulation studies because EDTA interferes with factor V and the thrombin-fibrinogen reaction