PMLSLAB Butterfly Veni

• consists of a 1/2 to 3/4 inch stainless steel needle permanently connected to a 5 to 12 in. length of tubing with either a Luer attachment for syringe use or a multisample Luer adapter for use with the evacuated tube system
• During use, the needle may be held from above by gripping the “wings” together between the thumb and index finger
• Plastic extensions that resemble butterfly wings are attached to the needle where it is joined to the tubing
• The first tube collected with a butterfly will underfill because of the air in the tubing
• If an additive tube is the first tube to be collected, it is important to draw a few milliliters of blood into a nonadditive tube or another additive tube of the same type and to discard it prior to collecting the first tube
• “clear” or discard tube is especially critical when one is collecting coagulation tubes using a butterfly
• most commonly used gauge for butterfly

  23 gauge needle
• this gauge is used by specially trained personel


  25 gauge needle
• this gauge is used to collect blood from scalp or other tiny veins of premature infants and other neonates.


  25 gauge needle
• Butterfly safety devices include: locking shields, blunting devices, needle retracting devices
• Using a needle smaller than 23 gauge increases the chance of hemolyzing the specimen.
• how much air space is in the plastic tubing

  1.2 inch = 0.5 air
• one type winged infusion set


  hub that can be attached to a syringe
• second type of winged infusion set

  hub with a multisample Luer adapter that can be threaded onto an ETS tube holder
• The method chosen (ETS or syringe) typically depends on the

  • size of vein
  • condition of vein
  • location of the vein
  • skill of user
  • personal preference of the user
• Verify sterility of the butterfly packaging before aseptically opening it and removing the butterfly.
• To help preserve needle sterility (a butterfly needle cover is typically an open-ended tubular sheath), It is a good idea to retain the package so you can put the needle back in it temporarily while retying the tourniquet.
• To help straighten it and keep it from coiling back up, use the thumb and index finger of one hand to grasp the tubing just beyond the point where it attaches to the needle
• Butterfly tubing may be coiled somewhat because it was coiled in the package
• The vacuum draw of largevolume tubes may collapse the vein or hemolyze the specimen
• butterfly needle is appropriate in these situations because it is less likely to collapse or “blow” (rupture) the vein
• LUER ADAPTER

  Shorter needle can be attached to:

  1. Needle holder
  2. Syringe
  3. Blood culture bottle
• Shorter needle: tube holder

  Longer needle: vein
• Palpating (areas):

  • Depth of vein
  • Direction of vein
  • Diameter of vein
• apply tourniquet: proximal to the wrist bone
• angle degrees for hand vein puncture

  10-15 degrees
• a "flash" or small amount of blood will appear in the tubing when the needle is in the vein
• "Seat" the needle by slightly threading it within the lumen of the vein to keep it from twisting back out of the vein if you let go of it
• to anchor the vein of the hand:

  • use non dominant hand to hold the patient's hand, just below the knuckles and pull the skin taut over the knuckles with the thumb while bending patient's fingers
  • have the patient make a tight fist, encircle the fist with your fingers, and use your thumb to pull the skin over the knuckles
• place a tube in the ETS holder and push it part way onto the needle with a clockwise twist
• maintain tubing and holder below the site, and positioned so that the tubes fill from the bottom up to prevent reflux
• immediately apply pressure to the site with your free hand while simultaneously activating the needle safety device with the other to prevent the chance of a needlestick
• what is the other term for needle in winged infusion set

  cannula
• Winged infusion blood collection set


  Also called a butterfly

  
• Winged infusion set


  • Indispensable tool for collecting blood from small or difficult veins
  • Allows much more flexibility and precision than a needle and syringe
  • Consists of a ½ to ¾ inch stainless steel needle permanently connected to a 5 to 12 in. length of tubing with either a Luer attachment for syringe use or a multisample Luer adapter for use with the evacuated tube system

  
• Multisample Luer adapter


  Available separately
• Plastic extensions


  • Resemble butterfly wings (thus the name butterfly)
  • During use, the needle may be held from above by gripping the "wings" together between the thumb and index finger to achieve the shallow angle of needle insertion required to access small veins
• The first tube collected with a butterfly will underfill because of the air in the tubing. If the tube contains an additive, the blood-to-additive ratio will be affected. If an additive tube is the first tube to be collected, it is important to draw a few milliliters of blood into a nonadditive tube or another additive tube of the same type and to discard it prior to collecting the first tube. This is referred to as collecting a "clear" or discard tube and is especially critical when one is collecting coagulation tubes using a butterfly
• Butterfly safety devices

  • Locking shields
  • Blunting devices
  • Needle retracting devices
• Using a needle smaller than 23 gauge increases the chance of hemolyzing the specimen