PRINCIPLES OF MEDICAL LABORATORY SCIENCE 2

College of Allied Health Sciences

Bachelor of Science in Medical Laboratory Science
Second Semester, A.Y. 2022-2023

[TRANS] PMLS UNIT 5: VENIPUNCTURE USING SYRINGE

a. Fasting
OUTLINE 4. Prepare the patient for testing.
a. Observe proper bedside manner.
I Introduction b. Explain the procedure.
II Materials c. Obtain consent.
III Procedure 5. Assemble equipment and supplies.
6. Wash hands and put on gloves.
7. Reassure the patient.
INTRODUCTION 8. Position the patient.
 Venipuncture – The process of collecting or “drawing” a. Seated Patient
blood from a vein. i. Patient’s arm should be supported firmly
o It is the most common way to collect blood ii. Arm should not be bent at the elbow.
specimens for laboratory testing b. Supine Patient
 There are two ways by which blood can be collected by i. Arm extended
venipuncture ii. Not bent at elbow.
o Open System – Using the needle and syringe 9. Apply the tourniquet.
 May be used if the patient has small, fragile, 10. Ask the patient to make a fist.
or weak veins that collapse easily. The a. Veins become more prominent
vacuum pressure of the evacuated tube may b. Do not allow patient to pump (open and close) fist
be too great for such veins. When a syringe is as this causes hemoconcentration and leads to
used, the pressure can be controlled by erroneous results.
pulling the syringe plunger slowly 11. Select the venipuncture site.
o Closed System – Evacuated Tube System (ETS) a. Dominant arm will generally have the most
OBJECTIVE prominent veins.
 At the end of this activity, students should be able to b. Veins have a bounce or resilience.
perform proper venipuncture by syringe procedure. c. Use the tip of the index finger to palpate (feel)
MATERIALS veins to determine suitability or to locate veins which
 Alcohol prep pads cannot be seen.
 Povidone-iodine swabs for blood cultures i. This helps determine size, depth, and
direction of vein
 Non-alcohol-based antiseptic for blood alcohol collection
d. Do not select a vein that feels hard and cord-like or
 Gauze pads or cotton balls
lacks resilience.
 Adhesive bandages or other bandaging materials i. Tendons are hard and lack resilience.
 Gloves e. Do not draw from above an IV.
 Tourniquet i. If necessary, have IV turned off for a
 Blood collection tubes minimum of 2 minutes
 Syringe needle f. Avoid burned, scarred and tattooed areas.
 Syringe g. Avoid edematous areas.
 Transfer device h. Avoid drawing in the area of a hematoma.
 Sharps container i. Draw from below site if there is no other
 Permanent marker or pen alternative
PROCEDURE i. Mastectomy patients
 To properly execute this activity, the students should work i. Draw from the side opposite of mastectomy
in pairs. Each pair should be given time to discuss the whenever possible.
procedure and organize the materials for the activity. ii. Application of tourniquet may cause injury on
Conversations should be audibly heard by the instructor. the mastectomy side.
1. Obtain and accession the test request iii. If patient has double mastectomy, the
a. Requisitions are the forms on which test orders are physician should be consulted – usually to
entered and sent to the laboratory. avoid the side of the most recent mastectomy.
i. Manual Requisitions j. Check antecubital region on both arms to find a
ii. Computer-generated Requisitions suitable vein.
iii. Barcode Labels k. Check hand or wrist veins.
2. Identify the patient. l. Use leg, ankle, or foot veins except as a last resort
a. Make this the most important step in specimen and after obtaining permission from the patient’s
collection. physician
b. Ask patient to state his/her name and date of birth i. Blood flow to the extremities may not be
(DOB). representative of general circulation, thus
c. Check patient’s identification bracelet. producing erroneous results.
i. Name ii. Lower extremity venipuncture may cause
ii. Identifying Number blood clot formation.
iii. Medical record number 12. Release the tourniquet.
iv. Visit number 13. Clean the site.
3. Verify diet restrictions. a. Clean with antiseptic – 70% isopropyl alcohol

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 TRANS: PMLS 2 Unit 5
b. Use circular motion in cleaning. 25. Label the tubes.
c. Do not contaminate the site by drying the alcohol a. Patient’s name
with unsterilized gauze. b. Identifying number
d. Do not introduce airborne contaminants by fanning c. Date of collection
or blowing on the site. d. Time of collection
e. Do not touch the site after cleaning. e. Phlebotomist’s initials
14. Verify equipment and tube selection. 26. Observe special handling instructions.
a. Remove syringe from the package. a. Putting on crushed ice (e,g,. ammonia, BNP, lactic
b. Advance the plunger to the end of the syringe. acid, blood gases)
c. Securely attach the needle to the system. b. Keeping it warm (e,g,. cold agglutinin, cryoglobulin)
15. Reapply the tourniquet. c. Protecting from light (e,g,. bilirubin)
a. Do not touch the cleansed area. 27. Check the patient’s arm and apply bandage.
16. Pick up and position the blood collection equipment. 28. Dispose of the contaminated materials.
17. Remove the cover and inspect the needle. 29. Thank the patient.
a. Visually inspect the needle tip for obstructions, 30. Remove gloves and wash hands.
imperfections, or barbs. 31. Check specimen collection logs (if applicable).
18. Anchor the vein. 32. Transport the specimens to the lab
a. Place your thumb 1-2 inches below the intended a. Transport specimens in a timely manner.
venipuncture site. b. Enter specimens into the computer system or
b. Pull the skin toward the wrist. logbook to verify collection and receipt by the
c. Use the fingers of your anchoring hand to support laboratory.
the back of the arm.
19. Insert the needle into the vein.
a. Insert the needle bevel up.
b. A flash or small amount of blood will appear in the
hub of the needle while the needle is in the vein
c. Release the tourniquet (Backflow)
20. Fill the syringe.
a. Slowly pull back on the plunger of the syringe and
allow the barrel of the syringe to fill with blood.
21. Withdraw the needle.
a. Place gauze over the site.
b. Do not press down on the gauze while the needle is
in the vein.
c. Withdraw the needle in one smooth motion.
d. Apply the pressure on the site with the gauze pad
e. Do not bend arm up – keep it extended or raised.
22. Engage safety device.
23. Dispose of sharps.
24. Transfer blood to evacuated tubes.
a. Syringe transfer device.
i. Attach the transfer device to the syringe
ii. Hold the syringe vertically, with the tip down
and the transfer device at the bottom.
iii. Following the proper order of draw for
syringes, push the evacuated tube onto the
needle within the transfer device.
iv. Keep the tube vertical so it fills from the
bottom up – let the tube fill using the vacuum
draw.
v. If you do not want to fill the tube completely,
pull back on the plunger to stop the flow
before removing the tube.
vi. Dispose of the transfer device into a
sharps container.
b. Transferring without a transfer device.
i. If a transfer device is not available, place the
required tubes in the proper order of draw in
a rack or slot in the phlebotomy tray.
ii. Never hold the tubes in your hand.
iii. Penetrate the stopper of the tube with the
syringe needle and allow the vacuum draw of
the blood to fill the tube.
iv. Slant the needle to the side of the tube so
the blood runs down the side of the tube to
prevent hemolysis
v. When the last tube is filled, withdraw the
needle; activate the safety device; and
dispose of the sharps.

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