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Phlebotomy means collecting blood
Venipuncture is the act of puncturing a vein with
a needle
Thrombophlebitis is the inflammation of a vein
with blood clot formation
Thrombus a blood clot
Hemolysis is the breaking of blood cells
Coagulate “the act of blood clotting”
Hematoma a blood-filled bruise caused when a
blood vessel is broken; collection of blood under
the skin
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Lumen is the hollow center of a structure
(needle)
Bevel is the slant at the end of a needle
Vacutainer is a vacuum tube used to draw
blood
Butterfly smaller needle with wings on each
side used to draw blood; winged infusion
needle
Straight needle is a straight needle used to
draw blood
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Anticubital space is the area in front of the
elbow
Ecchymosis a bruise
Thrombus a blood clot formed in a blood
vessel
Coagulate is the medical term describing
blood clotting
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Centrifuge is a device used in the lab to spin
blood and separate the liquid and solid
portions of the blood
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Always ask pt if he/she is allergic to latex
before drawing blood!
Why?
Many medical supplies still contain latex and
could cause an allergic reaction
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Size/diameter of lumen: smaller the gauge=
larger the lumen. Choice depends on amount
of blood being drawn
Length: user preference, may need longer
needle for obese patients
Use a 21 gauge or bigger to prevent
hemolysis
Which needle is larger in diameter?
16 gauge or 20 gauge
Places to avoid:
-arm w/ IV solution infusing
-infected/swollen are
-area w/ rash
-arm w/ a dialysis graft or same side as a
mastectomy
-site w/ injury, burn, scarring
-lower extremities
-inner portion of wrist- why?
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Use a tourniquet to evaluate which vein to
use
Apply tourniquet 2-3 inches above elbow.
How? See pt 132; practice
Not too tight; tight enough to cause the veins
to stand out but not so tight to occlude
arterial flow- check pulse
Evaluate vein selection
Remove tourniquet until ready to perform full
procedure ( within 1-2 minutes)
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Antecubital space are most commonly used
Apply tourniquet 2-3 inches above elbow or
desired blood draw site
A good vein stands our when the tourniquet
is applied
Use “touch” more than “sight”
Use vein that feels “springy”
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Alcohol
Betadine
Chlorhexidine
Tourniquet
Needle(smaller number=bigger needle)
Vacutainer
Adapter
Gauze
bandaid
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Gather supplies
Explain procedure/screen for latex allergy
Standard precautions
Examine arm
Place tourniquet; find vein (1-2 min max)
Release tourniquet
ready supplies and clean site
Replace tourniquet without contaminating
Stabilize the vein
10. Enter vein at 15 degree angle
11. When you see “flash”, push vacutainer into
adapter
12. Allow tube to fill( if multiple tubes drawn;
follow correct order)
13. Release tourniquet as last tube is filling
14. Place gauze over site as needle is removed
15. Hold pressure x 2-3 minutes
16. Place bandaid if bleeding has stopped
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Invert blood tubes 5-10 times. See 137
Label tubes according to facility requirements
Send to lab in biohazard bag x 2
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Used when a doctor suspects septicemia: the
presence of pathogenic organism in the
blood stream
Blood is drawn into an aerobic/anaerobic
bottle and sent to lab to “grow”
MUST be very careful not to contaminate draw
site with bacteria while drawing blood
cultures…….. Why?
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Microdraw: is a small skin puncture (capillary
puncture) used for collecting blood
specimens.
This technique for obtaining a blood sample
provides a very small sample.
The blood is a mixture of venous, capillary,
and arterial blood
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A lancet is a tiny, sharp, sterile device used to
puncture the skin to collect small blood
samples
Discuss types of lancets………..
Smaller lancets for babies
Larger lancets for adults
Use recommendations of the facility you work
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When the blood is collected from a capillary
puncture, it is tested on a reagent strip or
microvette collection device(must be ¾ full)
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Sides of the middle
and ring fingertips
Do not use the tip/pad
of fingertip
May use earlobe (not
preferred)
Puncture perpendicular
to fingertip
Warm area if needed
Always alternate sites
Adult(1yr and up)
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Medial or lateral
heel(preferred)
Great toe
Puncture at 45 degree
angle
Always alternate sites
warm area if needed
Infant(birth to 1yr)
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Gather supplies: lancet , gloves, alcohol,
gauze, bandaid, microvette collection device,
biohazard bag, sharps box……
Check order, identify correct patient
Introduce yourself and explain procedure
Wash hands/ Standard Precautions
Choose site
Clean site w/ alcohol in circle w/ 2 inch
diameter
7. Allow alcohol to dry
8. Hold plastic end of lancet with dominant
hand and remove plastic cover
9. Pierce the skin at the appropriate angle by
holding the finger/foot with your
nondominant hand.
10. Discard lancet in sharps box
11. Wipe first drop of blood w/ gauze
12. Allow next drops of blood to fill microvette
or place on reagent strip
13. May apply gentle squeeze to area but not
too hard- allow tube to fill ¾ full
14. Hold pressure over site until the bleeding
stops and apply band aid
15. Label sample and place in biohazard bag
according to facility’s standards