8.1

• You should empty the tray and disinfect it with a bleach solution once a week, or more often if necessary.
• A wheeled cart is sometimes used to transport large quantities of supplies when you are scheduled to collect samples from many patients.
• but the cart should remain in the hospital corridor to reduce the risk of spreading infection from one patient to another.
• Instead,

  place the tray on a flat, solid surface such as a nightstand
• The armrest locks to prevent the patient from falling out in the event of fainting.
• A bed may also be available for patients with a history of fainting.
• A tourniquet prevents venous blood flow out of the arm, causing the veins to bulge.
• Nonlatex tourniquets are made from synthetic rubber or nitrile
• Clinical and Laboratory Standards Institute standards indicate that once a tourniquet has been used, it should be disposed of to reduce the risk of pathogen transmission between patients.
• it should be disposed of to reduce the risk of pathogen transmission between patients, including skin pathogens such as methicillin-resistant Staphylococcus aureus.
• A blood pressure cuff may also be used as a tourniquet when veins are hard to find.
• The cuff is inflated to a pressure

  above the diastolic but below the systolic reading
• antiseptic refers to an agent used to clean living tissue.
• . Disinfectant refers to an agent used to clean a surface other than living tissue.
• Isopropyl alcohol is bacteriostatic, meaning that it inhibits the growth or reproduction of bacteria but does not kill them.
• or reproduction of bacteria but does not kill them. For maximal effectiveness, the antiseptic should be left in contact with the skin for 30 to 60 seconds.
• . Chlorhexidine gluconate or benzalkonium chloride (Zephiran Chloride) is available and is used for blood cultures and for patients sensitive to iodine.
• Chlorhexidine gluconate should not be used on infants younger than 2 months.
• This is done with a 2- 3 2-inch gauze pad, folded into quarters.
• h patients on aspirin or anticoagulant medications may require 10 to 15 minutes.
• For sensitive or fragile skin, Coban is a good alternative, since it sticks only to itself, not to skin.
• All needles used for phlebotomy are sterile, disposable, and used only once.
• The needle should be straight, sharp, beveled, and free of nicks or burrs.
• Point - A sharp needle provides smooth entry into the skin with a minimum of pain.
• The bevel, or angle, eases the shaft into the skin and prevents the needle from coring out a plug of tissue.
• Shaft is to 1 to 1½ inches long for standard needles
• Factors that influence the choice of length include location and depth of the vein, and the experience and preference of the phlebotomist
• Some phlebotomists prefer a longer needle because it is easier to manipulate.
• The gauge describes the diameter of the needle’s lumen, the hollow tube within the shaft.
• The smaller the gauge number, the larger the lumen diameter.
• The choice of gauge is not a matter of personal preference; it depends on the type of collection and the condition of the patient.
• The largest-diameter needles routinely used in phlebotomy are 21 to 22 gauge.
• The blood bank uses 16- to 18-gauge needles to collect blood from donors for transfusions
• The smallest needles commonly used are 23 gauge, for collection from small, fragile veins.
• Small needles are less damaging to tissue, but collection is slower, and the blood cells may be hemolyzed as they pass through the narrower opening.
• The needle attaches to the collecting tube or syringe at its hub.
• The most common double-ended needle is the multisample needle.
• multisample needle (Figure 8-5), which has a retractable rubber sleeve that covers the second tip when it is not inserted into a tube.
• A syringe is sometimes useful for patients with fragile or small veins, when the vacuum of the collection tube is likely to collapse the vein.
• s. A syringe needle (also called a hypodermic needle)