Cabradilla, Kristelle Jade A.

BSMLS 1A
APRIL 9,2020
Reaction Paper (Syringe Method)

Venipuncture is a medical procedure that involves collecting blood

from a vein. It can be done primarily by 3 methods; syringe method,
butterfly collection method and evacuated tube system. It is important to
know very well the proper procedure and execution of each collection
system for the reason that any mistake in the process can affect the
quality and validity of the blood for testing. Carrying out a proper
venipuncture can also minimize the pain that the patient may feel. The
safety and comfort of the patient must always be put in mind in order to
deliver the best quality of healthcare service possible.
In the video, venipuncture is performed through syringe method.
After checking the requisition form, the most crucial step in performing
venipuncture comes next which is patient identification. It is done before
collecting blood from the patient, and the phlebotomist have done it right
since the patient has provided enough information after asking for his
name. To ensure correct identification, the phlebotomist must ask at
least two verifiers, complete name and birthdate and use the requisition
form as the basis.
The phlebotomist then introduced herself and explained the
procedure which is a good point since it can also help the patient
establish his trust and for him to be more comfortable at the same time.
In the preparation of equipment required, all of the materials needed are
complete but it would be better if she had selected or separated the
appropriate tubes for the tests indicated in the requisition form. Tubes
must also be checked if they can be used for collection by checking its
expiry date, which is not done in the video. Hand cleansing was done in
front of the patient but I think it was done too fast, not enough to cover
all of her hand surfaces. I have also noticed how the phlebotomist's hair
was not neatly tied which is a must especially because she has a long
hair. Wearing a mask and lab gown is also good to protect herself from
any possible infection upon meeting with the patient however she should
have worn her lab gown with the buttons closed.
The application of the tourniquet was nicely done. Having the
patient to make a fist also helps in making the vein more prominent,
making it easier for the phlebotomist to select the puncture site. After the
tourniquet was released, the phlebotomist then put on well-fitting gloves
before cleansing the puncture site. It is better to put on gloves after
cleansing the puncture site and while waiting for it to dry since it saves
more time. Nonetheless, the way she sanitized the puncture site was
acceptable as she has done it with friction.
Cabradilla, Kristelle Jade A. BSMLS 1A
APRIL 9,2020
Reaction Paper (Syringe Method)

After the preparation of the gauze and application of the

tourniquet, the phlebotomist then prepared the syringe. As to what I
have noticed, the way she uncapped the needle of the syringe is unsafe
and she might get pricked. It would be safer if she has done it slowly
while pointing the needle downward and letting the sheath fall off or by
slowly pushing it downward with the use of the thumb. Also, locking the
needle and breathing the syringe before use is important to secure that
the needle would not be removed from the syringe during extraction and
for the plunger to be pulled easily and smoothly.
Warning the patient as to when will the skin be punctured is also
good to help the patient to prepare himself. The vein was also anchored
properly by stretching skin taut. The needle was ensured to be in a "bevel
up" position and was also angled suitably for a smooth blood collection.
The vein was punctured fluidly and the plunger was pulled in a manner
that is not too slow or too fast, which is good. In the release of the
tourniquet, it was only done after the blood was completely drawn but
ideally, the tourniquet should be removed as soon as possible after the
blood began to flow. The patient was also not told to open his fist.
Releasing the tourniquet and opening the fist allows blood flow to
normalize. The phlebotomist was able to maintain a steady hand while
extracting the blood, and I think it is a commendable skill. The
application of the gauze and the removal of the needle was done almost
simultaneously. Application of pressure to the puncture site was also
done.
In recapping the needle, "fishing" was done but the phlebotomist
shouldn't have used her hand to recap it completely instead, she should
have done it by pushing the cap against a wall or any stable material.
Blood was transferred to tubes correctly by order of draw and inversion
was done immediately according to how many times it should be
inverted. Appropriate tubes were also used for each test, light blue-
stoppered tube for aPTT and lavender-stoppered tube for CBC. Tubes
were also labeled correctly. However, it was not clearly shown in the
video if the tubes were filled with the exact amount of blood that should
be put in each tube. In addition, the phlebotomist did not remove her
gloves and have not performed hand hygiene after the extraction.
It is important to always thank the patient after blood collection. In
this video, the phlebotomist transported the blood immediately without
thanking the patient. Since the phlebotomist is like the image of the
Cabradilla, Kristelle Jade A. BSMLS 1A
APRIL 9,2020
Reaction Paper (Syringe Method)

whole laboratory and the one who has direct interaction with patients,
she must leave every patient a good impression.
Over all, the video has shown a step by step procedure of the
syringe method but some of the important details or steps were not
emphasized, not mentioned, skipped, or incorrectly done.