PMLS LAB EXAM 3 (Needle and Syringe)

• Prepare equipment and put on gloves.

  Rationale:

  Select the syringe needle according to the size and location of the vein and select the syringe and tube size according to the volume of blood required for the tests. Attach the needle to the syringe but do

  not remove the cap at this time. Hold the syringe as you would an ETS tube holder.
• Reapply tourniquet, uncap and inspect needle.

  Rationale:

  The tourniquet aids in venipuncture.

  Hold the syringe in your dominant hand as you

  would an ETS holder. Place your thumb on top near the needle end and fingers underneath. Uncap and inspect the needle for defects and discard it if flawed. Although it is rare, a needle can have defects.
• Ask patient to make a fist, anchor vein, and insert needle.

  Rationale:

  Anchor by grasping the arm just below the elbow, supporting the back of it with your fingers. Place your thumb 1–2 in. below and slightly beside

  the vein and pull the skin toward the wrist.

  Warn the patient. Line the needle up with the vein and insert it into the skin using a smooth forward motion. Stop when you feel a decrease in resistance, often described as a “pop,” and press your fingers into the arm to anchor the holder.
• Establish blood flow, release tourniquet, ask patient to open fist.

  Rationale:

  Establishment of blood flow is normally indicated by blood in the hub of the syringe. In some cases blood will not flow until the syringe plunger is pulled back.

  Releasing the tourniquet and opening the fist allows blood flow to return to normal and helps prevent hemoconcentration.

  According to CLSI Standard H3-A5, the tourniquet should be released as soon as possible after blood begins to flow and should not be left on longer than 1 minute.
• Fill syringe.

  Rationale:

  Venous blood will not automatically flow into a syringe. It must be filled by slowly pulling back on the

  plunger with your free hand. Steady the syringe as you would an ETS holder during routine venipuncture.
• Place gauze, withdraw needle, activate safety device, apply pressure.

  Rationale:

  A clean, folded gauze square is placed over the site so pressure can be applied immediately after needle removal.

  Remove the needle without lifting it up or pressing down on it. Immediately apply pressure to the site with your free hand and simultaneously activate the needle safety device with the other.
• Discard needle, fill tubes, discard syringe and transfer device.

  Rationale:

  needle must be removed and discarded in the sharps container so that a transfer device for filling the tubes can be attached to the syringe. A transfer device greatly

  An ETS tube is placed in the transfer device in the order of draw and pushed onto the internal needle until the stopper is pierced. Several tubes can be filled as long as there is enough blood in the syringe. syringe and transfer device unit is discarded in the sharps container.