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1he errors LhaL can occur durlng Lhe collecLlon and handllng of blood speclmens are
poLenLlally numerous SLandards for venlpuncLure can reduce or allevlaLe many of Lhese
errors ln much Lhe same way LhaL quallLy conLrol sLandards have reduced errors wlLhln Lhe
8educlng errors durlng blood collecLlng wlll resulL ln blologlcally represenLaLlve speclmens
LhaL are comparable from one collecLor Lo anoLher 1he followlng procedure ouLllnes Lhe
recommended meLhod for collecLlng blood by healLhcare provlders

SLep 1 Wash hands and puL on gloves
SLep 2 ldenLlfy Lhe paLlenL
(a) Ask Lhe paLlenL Lo sLaLe Lhelr name
(b) Compare name and medlcal record number on armband Lo requlslLlon
SLep 3 Assemble necessary supplles and selecL approprlaLe Lubes accordlng Lo LesL
(a) Alcohol
(b) needle/ syrlnge/ buLLerfly
(c) mlcropore
(d) Cauze
(e) 1ubes
SLep 4 oslLlon Lhe paLlenL
(a) SeaL/ poslLlon Lhe paLlenL ln a manner LhaL supporLs Lhe arm and
prevenLs poLenLlal falls
(b) 1he arm should form a sLralghL llne from Lhe shoulder Lo Lhe wrlsL (arm
should noL be slgnlflcanLly benL aL Lhe elbow)
SLep 3 Apply Lhe LournlqueL and selecL veln
(a) 1ournlqueL should noL remaln on Lhe arm longer Lhan one minute lf
Lhe LournlqueL remalns on Lhe arm longer Lhan one
mlnuLe heme concenLraLlon wlll occur 1hls wlll resulL ln hlgher values
for LesL resulL
(b) oslLlon LournlqueL 34 lnches above Lhe venlpuncLure slLe
(c) Lnsure paLlenL's hand ls closed buL avo|d pumplng Lhe flsL" umplng
Lhe flsL" wlll cause an lncrease ln concenLraLlon of analyLes
(d) SelecL a veln LhaL wlll glve Lhe greaLesL chance of success wlLhouL
rlsklng nerve or arLerlal lnvolvemenL ArLerlal puncLures should noL be
consldered as an alLernaLlve Lo venlpuncLure for dlfflculL draws
(e) lf a LournlqueL musL be applled for prellmlnary veln selecLlon lL should
be reapplled afLer two mlootes
(f) AlLernaLlve slLes such as ankles or lower exLremlLles musL noL be used
wlLhouL Lhe permlsslon of Lhe physlclan because of poLenLlal for medlcal

SLep 6 Cleanse Lhe venlpuncLure slLe

(a) Cleanse Lhe slLe ln a clrcular moLlon from Lhe cenLer Lo Lhe perlphery
wlLh a 70 lsopropyl alcohol soluLlon
(b) Allow Lhe alcohol Lo toalr dryt before performlng Lhe
venlpuncLure ln order Lo prevenL hemolysls of Lhe speclmen
(c) lf Lhe venlpuncLure slLe musL be Louched afLer cleanslng Lhe slLe
should be cleansed agaln
SLep 7 erform Lhe venlpuncLure
(a) Anchor Lhe veln by Lhe holdlng Lhe paLlenL's arm flrmly dlsLal Lo Lhe
lnLended puncLure slLe
(b) uncLure Lhe veln wlLh Lhe bevel edge up wlLh a 13 angle of
lnserLlon for a syrlnge and evacuaLed Lube sysLem or a 3 angle of
lnserLlon wlLh Lhe buLLerfly collecLlon sysLem
(c) 1he LournlqueL should be released as soon as blood beglns Lo flow buL
lL should not exceed one minute on Lhe arm
(d) Cpen Lhe paLlenL's hand
(e) Allow Lubes Lo flll unLll blood flow ceases
(f) When blood flow ceases Lo flow remove Lhe Lube from Lhe holder 1o
obLaln addlLlonal speclmens lnserL Lhe nexL Lube lnLo Lhe holder and
repeaL Lhe collecLlon procedure Always remove Lhe lasL Lube collecLed
from Lhe holder prlor Lo wlLhdrawlng Lhe needle from Lhe veln
(g) lmmedlaLely afLer drawlng each Lube LhaL conLalns an addlLlve mlx Lhe
blood genLly and Lhoroughly by lnverLlng Lhe Lube flve Lo Len Llmes uo
noL mlx vlgorously

SLep 8 Crder of draw
-ote Insert tubes |nto ho|der |n the correct order of draw
(a) 8lood culLure Lubes
(b) LlghL blue Lop Lubes
(c) 8ed/ Cold Lop Lubes
(d) Creen Lop Lubes
(e) Lavender Lop Lubes
(f) Cray Lop Lubes
*-@ Jeo osloq o bottetfly collectloo set fot veolpooctote ooJ o llqt bloe top tobe ls
fltst tobe to be Jtowo o JlscotJ tobe soolJ be Jtowo fltst

SLep 9 8elease Lhe LournlqueL
(a) 8elease Lhe LournlqueL as soon as blood beglns Lo flow lL may remaln
longer however Lhe LournlqueL should noL exceed one mlnuLe on Lhe
SLep 10 lace Lhe gauze pad
(a) lace Lhe gauze llghLly over Lhe venlpuncLure slLe
SLep 11 8emove and dlspose of Lhe needle
(a) 8emove Lhe needle from Lhe arm
(b) AcLlvaLe Lhe safeLy mechanlsm accordlng Lo Lhe manufacLurer's
SLep 12 8andage Lhe arm
(a) Apply mlld pressure Lo Lhe slLe
(b) Check LhaL bleedlng has ceased
(c) Apply an adheslve bandage over Lhe venlpuncLure slLe
SLep 13 Label blood collecLlon Lubes and record Llme of collecLlon
(a) An |nd|v|dua| label musL be attached to each spec|men tube befote
leavlng Lhe paLlenL's slde
(b) Speclmen label should conLaln
1 aLlenLt`s compleLe flrsL and lasL name
2 An ldenLlflcaLlon number (accounL number or medlcal record
3 1he daLe of collecLlon
4 1he Llme ( as requlred eg LherapeuLlc drug monlLorlng)
3 1he lnlLlals of Lhe person collecLlng Lhe speclmen

SLep 14 Send blood collecLlon Lubes Lo Lhe approprlaLe laboraLorles

lacLors LhaL wlll cause alLered LesL resulLs due Lo speclmen collecLlon resulLlng ln hemolysls
(a) 1emperaLure exLremes
(b) lorceful lnoculaLlon of Lubes
(c) Slze of Lhe needle (small)
(d) Lxcesslve force ln collecLlng speclmen wlLh syrlnge
(e) Lxcesslve froLhlng or alr leakage
(f) Alcohol lefL on Lhe venlpuncLure slLe
(g) urawlng from a hemaLoma
(h) vlgorous mlxlng of blood Lubes

SlLes Lo avold for a venlpuncLure
(a) Arms ln a casL
(b) Arms wlLh lv
(c) LdemaLous arm
(d) Cannula
(e) llsLula
(f) vascular grafL
(g) Areas of exLenslve scarrlng
(h) Slde of Lhe body LhaL a masLecLomy was performed