required when a venipuncture cannot be performed or may be the option of choice for some point-of-care test procedures.
SKIN PUNCTURE
A dermal puncture may be a ..... or, in the case of small infants, may be a ....
finger stick, heel stick
-is deoxygenated blood that flows from tiny capillary blood vessels within the tissues into progressively larger veins
-to the right side of the heart
Venous Blood
the specimen of choice for most routine laboratory tests.
Venous Blood
-The now oxygenated blood is pumped through
-the left side of the heart via arteries.
Arterial Blood
The most common reason for collection of arterial blood is
evaluation of arterial blood gases
is obtained from capillary beds that consist of the smallest veins (venules) and arteries (arterioles) of the circulatory system.
Capillary Blood
Capillary blood is often the specimen of choice for
infants
very young children
elderly patients with fragile veins
severely burned patients.
SITES OF PUNCTURE
1.Margin of earlobe
2.Palmar surface of the finger
3.Plantar surface of heel and big toe
SURFACE TO AVOID (puncture/skin puncture)
1.Inflamed and pallor areas
2.Cold and cyanotic areas
3.Congested and edematous areas
4.Scarred and heavily calloused areas
The collection of blood from a vein
VENIPUNCTURE
Easiest and most convenient method of obtaining enough volume of venous blood suitable for a variety of tests.
VENIPUNCTURE
Sites of venipuncture
In newborn infants to 18 months old
1.External jugular vein
2.Temporal vein (scalp vein)
3.Superior longitudinal sinus
Sites of venipuncture
In older children 18 months to 3 years old
1.Femoral vein
2.Long saphenous vein
3.Popliteal vein
4.Ankle vein
Sites of venipuncture
In children 3 years old to adult
1.Wrist vein
2.Veins on dorsal of hand and fingers
3.Veins on the antecubital fossa
Most blood collection tubes contain a type of ...... or chemical that, when mixed will yield a specimen acceptable for testing.
additive
Most blood collection tubes contain an additive that either accelerates clotting of the blood (.....) or prevents the blood from clotting (.....)
clot activator, anti coagulant
A tube that contains a clot activator will produce a..... sample when the blood is separated by centrifugation
serum sample
a tube that contains an anticoagulant will produce a ..... sample after centrifugation.
plasma sample
The primary choice for routine venipuncture that will be performed on an adult or an older child.
EVACUATED TUBE SYSTEM (ETS)
This blood collection system consists of: (ETS)
a) holder/adapter
b) needle (pointed on both ends)
c) evacuated blood collection tubes
This may be chosen for pediatric venipuncture small delicate veins on adults (particularly geriatric patients or hand veins)
- The device can be used with a needle holder and evacuated tube or a syringe.
WINGED DEVICE (Butterfly)
WINGED DEVICE (Butterfly)
A ....... is incorporated into the design of the winged device to prevent needle stick injury.
needle safety device
-The...... combination should be the last equipment option that is considered;
-it is not a safe choice as the self-contained blood collection systems because it involves more manipulation.
syringe and needle
However, the phlebotomist may choose to use a ..... to prevent the vein from collapsing if the phlebotomist thinks that the vein is too fragile to withstand the pressure exerted by the vacuum as it pulls blood into the collection tube.