Phlebotomy Procedures
Materials Required
  Tube Types And Order Of Draw
  Venipuncture And Skin Puncture
  Venipuncture Site Selection
  Venipuncture Sources Of Error
  Pediatric Patient Special Consideration
  Blood Culture Bottle Selection
  Blood Culture
  Adverse Patient Reaction
  Handling Considerations
  Unable to Draw
  Patient Refusal
  Not Performing a Draw
  Drawing Drug Levels
  Non-blood Collection
  Down Time Labels
Specimen Collection Phlebotomy Procedures Materials Required
The following equipment should be assembled before proceeding with the venipuncture procedure:

Blood Drawing Site: The blood drawing site should provide a chair with a wide, flat, clean surface on the arms, or the patient may be lying in bed. The area should be wide enough for the patient's arm to rest comfortably. The patient's elbow should be supported so that it remains straight.

Some outpatients may prefer lying down, in which case an examination table may be used.

Blood Collection Safety Needles: "Puncture-guard" needles by BioPlexus are available in sizes 21 gauge and 22 gauge, 1 inch to 1.5 inches. We also have available safety "winged" sets in sizes of 21 ga, 23ga, 25 ga and 27 ga.

Plastic Tube/Needle Holders: The plastic holders are used to hold the needle on one end, and the vacuum tube for collection on the other. Regular, and blood culture sizes are available.

Blood Collection Vacuum Tubes: The vacuum tubes are designed to draw a predetermined volume of blood. Regular, pediatric tubes, and Microtainer®¹ tubes are available in a variety of sizes. Tubes with different additives are used for collecting blood specimens for specific types of tests. The color of the rubber stopper capping the tube is used to identify these additives, which, in turn, dictate the function of the tube. (See the next section on tube types, and order-of-draw preferences).

Tourniquets: Tourniquets are used to help distend the veins for ease in venipuncture. Easy to use Velcro lined tourniquets are available in adult and pediatric sizes. Most commonly used type is 1"x16" non-latex band.

Antiseptics: Individually packaged 70% isopropyl alcohol wipes may be used to clean the venipuncture site for most specimens. Cepti Seal Blood Culture Prep kits must be used when collecting specimens for blood cultures. (See "Collection of Blood Cultures" section for further explanation).

Gauze: 2 x 2 inch gauze squares can be folded and taped to the puncture site to control the bleeding after the blood specimen is collected.

Sharps Disposal Container: An OSHA acceptable, puncture proof, container marked "Biohazardous" with a top for unscrewing needles must be used for needle disposal, or for partially filled capillary tubes.

Ammonia Inhalants: Ammonia inhalants may be used to revive patients who faint or become dizzy.

Cold Compress: Cold compresses may be used to revive patients who faint or become dizzy.

Disinfectant: A plastic wash bottle with an ASCEND solution should be available for cleaning up small blood spills.

Adhesive Labels: 1.0 x 2.5-inch adhesive labels and a permanent marking pen should be available for labeling the specimens.

Non-Powdered Gloves: Latex gloves may be found in various sizes. Also available are various types of non-latex gloves.

Single Use Fingerstick Devices: An auto-disabling single use device used to perform a finger or heel puncture for the purpose of blood collection for either laboratory testing or Point of Care Testing. These devices are designed to be used only once, after which the blade is retracted, capped or otherwise made unusable for further use.

¹Microtainer is a registered trademark of Becton, Dickinson and Company.

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