Venipuncture Procedure Overview

Introduction

• Presenter: Stephen
• Context: Tutorial for medical assistants on how to perform venipuncture (also known as phlebotomy).
• Objective: Understand principles and procedures for drawing and collecting blood samples using a multi-sample needle and evacuated tube system.

Key Considerations

1. Safety: Ensure the safety of everyone involved.
2. Patient Experience: Aim to provide a comfortable and supportive experience for the patient.
3. Specimen Viability: Properly handle and process samples to ensure accurate test results.

Preparation Steps

1. Receive and Verify Order: Confirm the lab order with the licensed provider.
2. Gather Supplies:
   • Tourniquet
   • 70% Isopropyl alcohol wipes
   • Cotton or gauze
   • Tape
   • Required vacutainer tubes
   • Multi-sample straight needles (21, 22, or 23 gauge)
   • Tube holders (adapters) with needle safety guard
   • Biohazardous sharps container
   • Lab order
   • Specimen transport bag
   • Hand sanitizer
   • Disinfectant wipes
   • PPE: Non-sterile, non-latex gloves, face mask, face shield, gown with full-length sleeves

Initial Steps with the Patient

1. Self-Introduction: Greet patient warmly, provide name and pronouns, explain the procedure.
2. Verify Patient Information: Confirm patient's full name and date of birth with lab order.
3. Cleanse Area: Don gloves, clean the surface where the patient's arm will rest with a disinfectant wipe, ask patient about blood draw history and preferences.

Venipuncture Procedure

1. Tie the Tourniquet: Tie 3-4 inches above the elbow; must be snug but not uncomfortable. Ensure placement allows for easy release.
2. Select Vein: Assess veins in the antecubital space in this order:
   • Median cubital vein (most preferred)
   • Cephalic vein (second preferred)
   • Basilic vein (third preferred)
   • Use palpation techniques to locate veins
3. Assess Veins: Use the three D's:
   • Depth: How deep is the vein?
   • Diameter: How wide is the vein?
   • Direction: Which way is the vein traveling?
4. Cleanse Draw Site: Use 70% isopropyl alcohol wipe, start at center and circle outward.
5. Stage Supplies: Assemble needle and tube holder, place supplies strategically for ease of use.
6. Perform Blood Draw:
   • Ensure alcohol is dry, re-tie tourniquet
   • Anchor vein, insert needle bevel up at 15-30 degree angle
   • Collect blood into tubes, follow order of draw
   • Release tourniquet when last tube begins to fill
   • Remove needle, apply cotton immediately, activate needle safety guard
7. Post-Draw: Invert and label tubes, ensure bleeding has stopped, apply cotton and tape, excuse and thank patient.

Post-Procedure

• Clean Area: Cleanse entire area with disinfectant wipes.
• Process Specimens: Prepare specimens for processing, remove gloves, wash hands.
• Document Procedure: Record details in patient's medical record.

Conclusion

• Demonstration reflects training at Portland Community College but can vary by healthcare setting.
• Emphasis on maintaining safety, patient comfort, and specimen integrity throughout the procedure.