Venipuncture

Venipuncture is usually done in the antecubital fossa . You can harvest the veins on the dorsal forearm , dorsal hand or foot , or other accessible location depending on the situation . Inner wrist of the hand is not used only rarely as area harvested due to high risk of damage to anatomical structures in that area . The most common places are the venipuncture from the forearm ( median vein , basilica and cephalic ) followed by the hand ( metacarpal venous plexus , dorsal veins ) .

Materials needed:

gloves tourniquet special syringe or tube -specific additives required analysis or attached needle holder needle holder and label holder with alcohol pads application form for laboratory analysis container for collecting and transporting laboratory samples adhesive bandage puncture site
Preparation of materials :

application form must be completed correctly and clear analysis of patient data , analyzes required , time of harvest, indicating the name of the doctor analyzes . Specimens are carefully selected based on analyzes that are required and the additives they contain each tube must be completed accurately and clearly with patient data
Harvesting:

 Wash hands thoroughly and put gloves
 confirm the identity of the patient ( to avoid confusion and to never take another patient analyzes )
 be communicated to the patient what will be done , I will explain the procedure to reduce anxiety and ensure cooperation to
 give a brief history on the patient ‘s feelings and eventulele incidents where some previous harvests ( lipotimii , dizziness )

 harvesting is done with the patient lying in bed or sitting in a chair, with his hand resting on the seat support or a special meal
 evaluating the best place venipuncture
 be observed and palpate the vein for a more precise location
 install tourniquet proximal to the area chosen for the puncture . If the veins have not been properly dilated patient is asked to close and open the fist several times. ( patient must keep his fist while vein puncture and open it after inserting the needle into a vein) .
 chosen area disinfected with alcohol pads to spot it stays clean. Clean the area is from the inside out to prevent contamination of existing flora puncture area surrounding skin.
 not combined with the use of alcohol in the forest iodine as alcohol neutralize the effect of iodine-based disinfectants .
 after disinfecting the area is expected to dry before puncture
 pressing with the thumb is immobilized vein just below the place chosen for the puncture and skin stretching
 vein puncture is at an angle of 30 degrees . If the tube is used , it will automatically fill to the level that is indicated . When using the syringe , avoid sudden and rapid extraction because it will Colaba vein .
 Holder shall be maintained in a safe position to avoid going out of vein
 will remove the tourniquet as soon as blood begins to flow properly to prevent blood stasis and hemoconcentration that may affect the results of samples taken
 Avoid tourniquet to take more than 3 minutes
 changing tubes to be filled carefully to avoid accidentally remove the needle from the vein or vein pierce
 after filling each tube gently shake to mix additives with blood
 Always loosen the tourniquet before removing the needle
 put a sterile gauze over the needle at the site of puncture and gently remove the needle from the vein. Always remove the tube from the holder first and then remove the needle
 pressed puncture site for 2-3 minutes or until the bleeding stops if it takes longer than that. This prevents extravasation of blood into the surrounding tissue and hematoma formation .
 after stop bleeding apply an adhesive bandage
 avoid vigorous shaking and suddenly as this may cause haemolysis tubes .
 puncture site is recheck to see if there was hematoma . In the case in which the hematoma is to release the energy of at least 5 minutes , after which the hot compresses .
 to download materials used in special containers separated .
Special considerations :

 will not ever yield on the arm or leg that was already used for various intravenous therapies or transfusions because test results can be affected.
 Also , avoid harvesting blood from edematous areas , arteriovenous shunts , areas of hematoma or vascular injuries

 If the patient has vizbile veins , pronounced avoiding the tourniquet will harvest , thus preventing hematoma formation .
 If the patient has bleeding disorders or taking anticoagulants will press firmly puncture site at least 5 minutes to prevent hematoma formation and specify the anticoagulant treatment analysis application to be sent to the laboratory
 Avoid venipuncture foot because it can increase the risk of thrombosis

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