PHLEB LAB MIDTERMS MODULE 5

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Created by
Mee Jean

Cards (32)

  • Routine Venipuncture

    Most common procedure a phlebotomist performs
  • Positive identification (ID) of the patient
    • Most important step in venipuncture
  • Routine Needle-and-Syringe Venipuncture Procedure

    1. Greet and identify the patient
    2. Position and prepare the patient
    3. Perform hand hygiene, and put on gloves
    4. Tourniquet Application
    5. Select the site
    6. Palpate the vein
    7. Clean the site
    8. Preparation of Syringe Equipment
    9. Reapply tourniquet, uncap and inspect needle
    10. Ask patient to remake a fist, anchor vein, and insert needle
    11. Establish blood flow, release tourniquet, ask patient to open fist
    12. Fill the syringe
    13. Withdraw the needle and transfer the blood to evacuated tubes
    14. Dispose of the syringe and transfer device
    15. Label Tubes
  • The Test Requisition
    The form on which test orders are entered
  • Required Requisition Information
    • Ordering physician's name
    • Patient's first and last names and middle initial
    • Patient's medical record number (if inpatient)
    • Patient's date of birth or age
    • Room number and bed (if inpatient)
    • Type of test to be performed
    • Date test is to be performed
    • Billing information and ICD-9 codes (if outpatient)
    • Test status (e.g., timed, fasting, priority)
    • Special precautions (e.g., latex sensitivity)
  • Reviewing a requisition

    1. Check to see that all required information is present and complete
    2. Verify the tests to be collected and time and date of collection
    3. Identify diet restrictions or other special circumstances that must be met prior to collection
    4. Determine test status or collection priority
  • Routine Evacuated Tube system venipuncture
    1. Greet and identify the patient
    2. Position and prepare the patient
    3. Perform hand hygiene, and put on gloves
    4. Tourniquet Application
    5. Select the site
    6. Palpate the vein
    7. Clean the site
    8. Reapply tourniquet, uncap and inspect needle
    9. Ask patient to remake a fist, anchor vein, and insert needle
    10. Establish blood flow, release tourniquet, ask patient to open fist
    11. Fill the evacuated tubes
    12. Withdraw the needle and apply pressure
    13. Dispose of the needle and transfer device
    14. Label Tubes
  • Venipuncture procedure

    1. Tilt the tube slightly so blood flows slowly down the side of the tube, rather than dropping straight down, to prevent hemolysis
    2. Allow the tube to fill without applying any pressure to the plunger. Pushing on the plunger causes hemolysis and increases the risk of causing an aerosol spray when the needle is removed
  • Dispose of the syringe and transfer device
    1. Remove the needle and discard in the syringe and transfer device sharps container
    2. Use the disposal method and container designed for the type of needle you are using
  • Label tubes

    1. Label tubes in the presence of the patient immediately after blood collection and the label must be permanently attached to the tube before leaving an inpatient's bedside or dismissing an outpatient
    2. Never label a tube before collection
    3. Any hand written labelling must be done with a permanent-ink pen
    4. Labels should include patient's first and last names, patient's identification number (inpatient) or date of birth (outpatient), date and time of collection, phlebotomist's initials, and pertinent additional information, such as "fasting"
  • Observe special handling instructions
    1. Follow applicable special handling requirements
    2. Place specimens that must be cooled (e.g.ammonia) in crushed ice slurry
    3. Put specimens that must be kept at body temperature (e.g.,cold agglutinin) in a 37°C heat block or other suitable warming device
    4. Wrap specimens that require protection from light (e.g., bilirubin) in aluminum foil or other light-blocking material or place them in a light- blocking container
  • Attend to the patient
    1. Check the puncture site to be sure bleeding has stopped
    2. If you are certain it has stopped, apply an adhesive bandage (or tape and folded gauze square) over the site
    3. Thank the patient and smile
  • Transport specimen to the lab
    1. Transport specimens to the laboratory or designated pickup site in a timely fashion. Prompt delivery to the laboratory protects specimen integrity
    2. Follow the laboratory's policy about recording your work in the computer, logbook, or other tracking system
    3. Log in the specimen arrival time in the logbook
    4. Complete all your paperwork
  • Routine evacuated tube system venipuncture
    1. Select the appropriate ETS tubes. Check the expiration date on each one to make certain that it has not expired
    2. Tap additive tubes lightly to dislodge any additive that may be adhering to the tube stopper
    3. Reapply tourniquet, uncap and inspect needle
    4. Ask patient to remake a fist, anchor vein, and insert needle
    5. Establish blood flow, release tourniquet, ask patient to open fist
    6. Fill, remove, and mix tubes in order of draw
    7. Place gauze, remove needle, activate safety feature, and apply pressure
    8. Discard collection unit
  • Venipuncture of a hand vein using a butterfly and ETS (Evacuated Tube System) holder
    1. Position hand, apply tourniquet, ask to patient to close the hand
    2. Select vein, release tourniquet, ask patient to relax hand
    3. Clean the site
    4. Preparation of a Winged Infusion Set (Butterfly)
    5. Reapply tourniquet, uncap and inspect needle
    6. Anchor vein and insert needle
    7. Establish blood flow and release tourniquet
    8. Fill, remove, and mix tubes in order of draw
    9. Place gauze, remove needle, activate safety device, and apply pressure
    10. Discard collection unit
  • Venous insufficiency occurs when the veins have trouble sending blood from the legs back to the heart.
  • Routine Venipuncture

    Most common procedure a phlebotomist performs
  • Positive identification (ID) of the patient

    • Most important step in venipuncture
  • Routine Needle-and-Syringe Venipuncture Procedure
    1. Greet and identify the patient
    2. Position and prepare the patient
    3. Perform hand hygiene, and put on gloves
    4. Tourniquet Application
    5. Select the site
    6. Palpate the vein
    7. Clean the site
    8. Preparation of Syringe Equipment
    9. Reapply tourniquet, uncap and inspect needle
    10. Ask patient to remake a fist, anchor vein, and insert needle
    11. Establish blood flow, release tourniquet, ask patient to open fist
    12. Fill the syringe
    13. Withdraw the needle and transfer the blood to evacuated tubes
    14. Dispose of the syringe and transfer device
    15. Label Tubes
  • The Test Requisition

    The form on which test orders are entered
  • Required Requisition Information

    • Ordering physician's name
    • Patient's first and last names and middle initial
    • Patient's medical record number (if inpatient)
    • Patient's date of birth or age
    • Room number and bed (if inpatient)
    • Type of test to be performed
    • Date test is to be performed
    • Billing information and ICD-9 codes (if outpatient)
    • Test status (e.g., timed, fasting, priority)
    • Special precautions (e.g., latex sensitivity)
  • Reviewing a requisition

    1. Check to see that all required information is present and complete
    2. Verify the tests to be collected and time and date of collection
    3. Identify diet restrictions or other special circumstances that must be met prior to collection
    4. Determine test status or collection priority
  • Routine Evacuated Tube system venipuncture
    1. Greet and identify the patient
    2. Position and prepare the patient
    3. Perform hand hygiene, and put on gloves
    4. Tourniquet Application
    5. Select the site
    6. Palpate the vein
    7. Clean the site
    8. Reapply tourniquet, uncap and inspect needle
    9. Ask patient to remake a fist, anchor vein, and insert needle
    10. Establish blood flow, release tourniquet, ask patient to open fist
    11. Fill the evacuated tubes
    12. Withdraw the needle and apply pressure
    13. Dispose of the needle and transfer device
    14. Label Tubes
  • Venipuncture of a hand vein using a butterfly and ETS holder
    1. Greet and identify the patient
    2. Position and prepare the patient
    3. Perform hand hygiene, and put on gloves
    4. Tourniquet Application
    5. Select the site
    6. Palpate the vein
    7. Clean the site
    8. Reapply tourniquet, uncap and inspect needle
    9. Ask patient to remake a fist, anchor vein, and insert needle
    10. Establish blood flow, release tourniquet, ask patient to open fist
    11. Fill the evacuated tubes
    12. Withdraw the needle and apply pressure
    13. Dispose of the needle and transfer device
    14. Label Tubes
  • Venipuncture procedure

    1. Tilt the tube slightly so blood flows slowly down the side of the tube, rather than dropping straight down, to prevent hemolysis
    2. Allow the tube to fill without applying any pressure to the plunger. Pushing on the plunger causes hemolysis and increases the risk of causing an aerosol spray when the needle is removed
  • Dispose of the syringe and transfer device
    1. Remove the needle and discard in the syringe and transfer device sharps container
    2. Use the disposal method and container designed for the type of needle you are using
  • Label tubes

    1. Label tubes in the presence of the patient immediately after blood collection and the label must be permanently attached to the tube before leaving an inpatient's bedside or dismissing an outpatient
    2. Never label a tube before collection
    3. Any hand written labelling must be done with a permanent-ink pen
    4. Labels should include patient's first and last names, patient's identification number (inpatient) or date of birth (outpatient), date and time of collection, phlebotomist's initials, and pertinent additional information, such as "fasting"
  • Observe special handling instructions
    1. Follow applicable special handling requirements
    2. Place specimens that must be cooled (e.g.ammonia) in crushed ice slurry
    3. Put specimens that must be kept at body temperature (e.g.,cold agglutinin) in a 37°C heat block or other suitable warming device
    4. Wrap specimens that require protection from light (e.g., bilirubin) in aluminum foil or other light-blocking material or place them in a light- blocking container
  • Attend to the patient
    1. Check the puncture site to be sure bleeding has stopped
    2. If you are certain it has stopped, apply an adhesive bandage (or tape and folded gauze square) over the site
    3. Thank the patient and smile
  • Transport specimen to the lab
    1. Transport specimens to the laboratory or designated pickup site in a timely fashion. Prompt delivery to the laboratory protects specimen integrity
    2. Follow the laboratory's policy about recording your work in the computer, logbook, or other tracking system
    3. Log in the specimen arrival time in the logbook
    4. Complete all your paperwork
  • Routine evacuated tube system venipuncture
    1. Select the appropriate ETS tubes. Check the expiration date on each one to make certain that it has not expired
    2. Tap additive tubes lightly to dislodge any additive that may be adhering to the tube stopper
    3. Reapply tourniquet, uncap and inspect needle
    4. Ask patient to remake a fist, anchor vein, and insert needle
    5. Establish blood flow, release tourniquet, ask patient to open fist
    6. Fill, remove, and mix tubes in order of draw
    7. Place gauze, remove needle, activate safety feature, and apply pressure
    8. Discard collection unit
  • Venipuncture of a hand vein using a butterfly and ETS (Evacuated Tube System) holder
    1. Position hand, apply tourniquet, ask to patient to close the hand
    2. Select vein, release tourniquet, ask patient to relax hand
    3. Clean the site
    4. Preparation of a Winged Infusion Set (Butterfly)
    5. Reapply tourniquet, uncap and inspect needle
    6. Anchor vein and insert needle
    7. Establish blood flow and release tourniquet
    8. Fill, remove, and mix tubes in order of draw
    9. Place gauze, remove needle, activate safety device, and apply pressure
    10. Discard collection unit