LESSON 5: VENIPUNCTURE PROCEDURE PMLS 2

VENIPUNCTURE STEPS:

1 REVIEW AND ACCESSION THE TEST REQUEST

2 APPROACH, IDENTIFY, AND PREPARE THE PATIENT
3 VERIFY THE PATIENT’S DIET RESTRICTIONS AND LATEX SENSITIVITY
4 SANITIZE HANDS
5 POSITION THE PATIENT, APPLY THE TOURNIQUET, AND ASK PATIENT TO MAKE A FIST
6 SELECT VEIN, RELEASE TOURNIQUET, AND ASK PATIENT TO OPEN FIST
7 CLEAN AND AIR-DRY THE SITE
8 PREPARE THE EQUIPMENT AND PUT ON GLOVES
9 REAPPLY THE TOURNIQUET, UNCAP, AND INSPECT THE NEEDLE
10 ASK THE PATIENT TO REMAKE A FIST, ANCHOR TO VEIN, AND INSERT NEEDLE
11 ESTABLISH THE BLOOD FLOW, RELEASE THE TOURNIQUET, AND ASK THE PATIENT TO OPEN FIST
12 FILL, REMOVE, AND MIX THE TUBES IN ORDER OF DRAW OR FILL THE SYRINGE
13 PLACE GAUZE, REMOVE THE NEEDLE, ACTIVATE THE SAFETY FEATURE, AND APPLY PRESSURE
14 DISCARD THE COLLECTION UNIT, SYRINGE NEEDLE, OR TRANSFER DEVICE
15 LABEL THE TUBES
16 OBSERVE SPECIAL HANDLING INSTRUCTIONS
17 CHECK PATIENT’S ARM AND APPLY BANDAGE
18 DISPOSE OF CONTAMINATED MATERIALS
19 THANK THE PATIENT, REMOVE GLOVES, AND SANITIZE HANDS
20 TRANSPORT THE SPECIMENS TO THE LAB

Thea :)
LESSON 5: VENIPUNCTURE PROCEDURE PMLS 2
STEP 2: The following practices of phlebotomists show proper BEDSIDE MANNER:
 Knock on the door gently before entering the room.
 Make a good impression by greeting the patient warmly.
 Stay organized and have all the supplies available and approach the patient in a professional manner that goes
well with having a neat appearance.
 Maintain a calm expression as most patient are afraid of blood collection.
 Introduce yourself and explain the procedure. Obtain the verbal or expressed consent of the patient before
proceeding with the test.
 Remain compassionate and professional during the procedure.
 Thank the patient for his/her cooperation before leaving.

STEP 6: TOURNIQUET APPLICATION

1. Place the tourniquet 3 to 4 inches or about 4 to 5 finger widths from the intended puncture site.
2. Hold one side of the tourniquet in each hand. It should be a few inches from the end.
3. Apply a little tension so that it will be snug when tied.
4. Bring the two sides together. Hold both ends between the thumb and forefinger of the right hand.
5. Reach over the right hand and grasp the right side of the tourniquet between the thumb and forefinger of the
left hand and release it from the grip of the right hand.
6. Near the left index finger, cross the left end over the right. Hold both sides together between the thumb and the
forefinger of the left hand, close to the patient’s arm.
7. While securely holding both sides, use either the left middle finger or the right index finger to tuck a portion of
the left side under the right side and pull into a loop.
8. Toe the tourniquet properly with its ends pointing toward the shoulder.

If the tourniquet is applied, release it and the patient should be asked o open his/her fist.

STEP 7: Steps in equipment preparation for different venipuncture procedure.

 Evacuated Tube System
1. Select the appropriate tube for ETS and tap to dislodge any additive in the stopper.
2. Select and inspect the needle for defects.
3. Twist needle to expose the back of the needle.
4. Screw this end to the threaded hub of the tube holder.
5. Place the first tube in the holder.
6. Position the tube in the holder.

Thea :)
LESSON 5: VENIPUNCTURE PROCEDURE PMLS 2
 Winged Infusion Set (Butterfly)
1. Use a 23-gauge butterfly gauge with a safety feature.
2. Inspect the package before aseptically opening and removing the butterfly.
3. Attach the butterfly to an ETS holder or syringe.
4. Select the appropriate small-volume tube for the test.

 Syringe System
1. Select the appropriate syringe and needle.
2. Test the plunger before opening the sterile package.
3. Open the package aseptically.
4. Securely attach the needle to the syringe.

STEP 15: Necessary Information in the Specimen Tube Labeling.

a. Patient’s complete name (first and last name)
b. Date of birth
c. ID number (if applicable)
d. Date and time of collection
e. Initials of the phlebotomist
f. Additional information such as “fasting”

The following procedure should be followed when doing venipuncture on an ELDERLY PATIENT:
a. Identify the patient properly and confirm the patient information. Ask the attendant or relative if necessary.
b. Carefully select which needle to use (short draw or butterfly needle).
c. Apply the tourniquet properly to make sure that the skin will not be damaged.
d. Make sure that the present site is not the site from a previous venipuncture.
e. Avoid rubbing the site vigorously during cleaning.
f. Prevent the vein from rolling by anchoring it firmly during the venipuncture.
g. Hold the pressure over the site and take note that the bleeding in the elderly patients can take a longer time
to stop than in younger patients.

Thea :)