By: KenToy

BLOOD COLLECTION Only use povidone iodine if:

Blood Donation
Alcohol + Betadine
PHLEBOTOMY: Blood Culture Collection
Test ordered by doctors to
The process of blood collection. evaluate patient with
Three types: Venipuncture (veins), Capillary bacteremia or septicemia (to
puncture (skin), Arterial puncture (artery; know if there are presence of
fatally invasive; only well trained should bacteria in the blood).
perform; wrist, waist, heel). Bacteria in blood will result to
Arterial blood glass testing – measures O2, fever.
CO2, pH. There should be no
ROUTINE VENIPUNCTURE – pain is contamination.
comparable to a bee sting; every tube is 2 -5 Alcohol + Betadine + Alcohol
mL.
FINGERSTICK – compared to a mother MICROSAMPLING TECHNIQUE (capillary
prickling her finger with a needle or pin while puncture):
sewing
Refers to blood collection by skin/arterial
NOTE: puncture.
Micro since needed blood is only small (0.5 –
ISCH – they are fighting against blood 1 mL).
collection from the earlobe; big toes if adult, We use commonly 3CC to 5CC.
heels if baby. 10 CC for 8 mL of Blood.
Pathologist in Davao City (PSP) – Dr. It would also depend on the test requested if it
Graheda (pioneers the memorandum to can be done with microsampling.
prevent arterial puncture to be performed). Used on following patients:
QUALITIES OF A GOOD PHLEBOTOMIST: Infants (all tests requiring serum
samples are not collected using this
Skillful – MedTech knows what to do. method) (during collection use
Patient – there are patients who are scared to venipuncture to avoid hemolysis).
be punctured. Young children (toddlers)
Understanding Adults w/ poor veins
SITE STERILIZATION – use 70% isopropanol, dry NOTE:
using a sterile gauze (or air dry).
Never use another method in collection of
BETADINE (Povidone Iodine) blood that is not requested by the physician.
If ever in some cases (guitarists or those px
Not be used to routinely clean the phlebotomy
with thick callouses on the hand are advised
site since it will cause blood contamination
for capillary puncture, reach out first the nurse
which will result to false increase of
and the nurse will reach out to the doctor
potassium, uric acid, phosphorous.
regarding the concern).
Never use in chemistry collection.

1
 By: KenToy
MATERIALS:
Alcohol (70% isopranol).
Either of the following:
Tenderfoot Heel Incision Device
(automated) – incision is 1 mm deep
and 2.5 mm in length.
Tenderfoot Preemi – for small
babies: incision is 0.8 mm deep and
1.75 mm in length.
Tenderlett – automated, disposable
incision device, surgical blade
protrudes at a 30◦ angle (because it is
used for kids since veins are near the PROCEDURE:
bones).
THREE SIZES: Location of Phlebotomy Site
Tenderlett Toddler (narrowest)
➢ Incision: 0.85 mm deep
x 0.46 mm long.
➢ Used for: infants 6
months old.
Tenderlett Junior
➢ Incision: 1.25 mm deep
x 0.67 mm long.
➢ Used for: 7 – 8 years
old.
Tender let (much deeper)
➢ Incision: 1.75 mm deep
x 0.94 mm long.
➢ Used for: older
children and adults. For <1 year old: HEEL.
Inside (medial) or outside
(lateral) portion of the bottom
(plantar surface) of the foot.
NOTE:
➢ Depth of the puncture
must not be greater
than 2.4 mm.
➢ Blood vessels of the
heels are located
between 0.35 and 1.6

2
 By: KenToy
mm below the surface Excessive massaging = expression of tissue
of the skin. juice.
For >1 year old: 3rd or 4th FINGER Excessive crying = increased WBCs.
NOTE: Sites that should never be punctured: Thumb,
➢ Puncture should be Big toe, Ear lobe.
PREPENDICULAR to Blood for the following tests should be
the fingerprint. collected first: platelet count (magataas
➢ Puncture should not be madugay from supposedly 200 it will increase
deeper than 3.1 mm. to 240-250) and blood smears.
Puncture site should contain NO
NOTE:
SWELLING: do not re-puncture
punctured areas. Tissue juice – found in surrounding tissue or
cells.
NOTE:
Contamination will lead to dilution (lowers the
NBS – is taken within the first 24 hours of life. blood level components).
If crying (calm the child) and wait for 30 mins.
PREPARATION OF THE PUNCTURE SITE:
Before collecting.
Puncture site should be warm.
Disinfectant: 70% isopropanol.
Apply pressure
Hold capillary pipet in a straight or slightly
downward position.
PRESS, COMPRESS, RELEASE (to allow
blood flow).
Capillary action – refers to the capillary tube
when in contact with blood automatically
comes in.
ORDER OF DRAW:
EDTA
Other anticoagulated tubes
No additives
AFTER BLOOD COLLECTION:
Elevate the foot above the body or put the
finger in an upright position.
Apply adhesive bandage.
DISCUSSION:
Blood from your capillary puncture is a mixture
of venous, arterial, and capillary blood.