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Skin Puncture for Adults

Peripheral blood is obtained from the tip of the 3 rd and 4th finger or earlobe in adults.
Procedure
1. Wipe the area with a cotton ball soaked in 70% isopropyl alcohol.
2. Allow the site to air-dry or pat-dry with sterile cotton.
3. Puncture the preferred site with a sterile disposable lancet. The puncture is
ideally 2-3 mm in depth.
4. Wipe off the first drop of blood and collect the subsequent drops. Avoid
squeezing the puncture site, as this will alter the composition of the blood.
Note: Difficulty in obtaining blood can be relieved by putting warm compress on the
site.

Venipuncture
Procedure for Syringe Method
1. Apply the tourniquet 3-4 inches above the puncture site in a half-knot manner
to congest the vein. Ask the patient to open and close hand the several
times.
2. Cleanse the puncture site with 70% isopropyl alcohol. Allow the site to dry.
Puncture the vein with a sterile 20-21 gauge needle attached to a syringe at
a 15° angle and a depth of about 0.5-1 cm.
3. Loosen the tourniquet and gently aspirate the blood.
4. After obtaining the required quantity of blood, place sterile gauze or cotton
over the puncture site then withdraw the needle. Apply pressure to stop
bleeding. Never flex the arm.
Note: If bleeding is not arrested, elevate the arm and apply more pressure. Stay
with the patient until the bleeding stops.
Detach the needle from the syringe and transfer the blood along the side of
an appropriate test tube. If the tube is anticoagulated, mix the tube with blood by
gentle inversion.

Procedure for Evacuated Tube Method
1. Attach the two-way needle to the adaptor. Prepare the evacuated tubes.
2. Apply the tourniquet 3-4 inches above the site of puncture.
3. Cleanse the site with 70% isopropyl alcohol. Allow the site to dry. Puncture
the vein with the two-way needle attached to the adaptor. Push the tube into

Procedure for Two-Way Syringe Method 1. Hold the baby’s foot firmly between the thumb and the index finger of your (the phlebotomist’s) non-working hand. . Gently invert the tube several times for proper mixing if the tube is anticoagulated. taking care not to dislodge the needle from the vein. Note: For multiple blood draws. Note: The two-syringe method is recommended for whole blood clotting time technique. Remove the syringe after aspirating 3 mL of blood. 5. Perform steps 4-5 of the procedure for the syringe method. 3. Procedure 1. Place sterile gauze or cotton below the hub of the needle to prevent spillage of blood. making sure that the needle remains in position in the vein. Puncture the anterior rim of the posterior aspect of the heel or big toe only after a suitable preparation. Attach a second syringe and aspirate the required amount of blood. 5. 3. 4. 4. Note: The recommended site for skin puncture on newborns is the heel only. 2. Perform steps 1-3 of the procedure for the syringe method. Skin Puncture for Infants Peripheral blood from infants is obtained from the heel or big toe. 2. Loosen the tourniquet and withdraw the needle when blood has filled the tube tot its proper volume. remove the tube from the adaptor without withdrawing the needle and push the succeeding tubes into the adaptor.the adaptor until the other side of the needle penetrates the evacuated tube. Follow steps 1-4 for skin puncture of adults.