Do & Don't for Blood Drawing Procedure
RELIABLE ANALYSIS of venous blood begins with accurate collecting, labeling, and handling of the specimens.
DO
- Observe standard precautions throughout the procedure.
- Assess your patient for factors that could contraindicate venipuncture or lead to complications.
- Assemble the appropriate equipment and determine whether special preparation or specimen handling is necessary.
- Wash your hands and put on clean gloves. Explain the procedure to the patient. Extend and support his arm so it's level with his heart.
- Apply the tourniquet 3 to 4 inches (7.5 to 10 cm) above the potential venipuncture site. Avoid sites above an I.V. line, infected or edematous sites, and sites of hematoma or vascular injury. Ask your patient to make a fist. Determine the best venipuncture site, clean it according to protocol, and let it air-dry.
- Follow the recommended order for drawing multiple specimens during a single venipuncture.
- Attach the needle to the blood tube holder (adapter) and slide the specimen tube inside without pushing it onto the needle.
- Slowly insert the needle into the vein with the bevel up and at a 15- to 30-degree angle. Stabilize the needle and push the collection tube forward so the back end of the needle penetrates the stopper. Release the tourniquet and have the patient relax his fist as soon as possible after blood flows freely into the tube.
- Firmly gripping the adapter, let the tube fill, then pull it out of the adapter. If the tube contains an additive, gently invert it 8 to 10 times without shaking it. Insert, remove, and invert additional tubes as needed.
- Place sterile gauze over the puncture site, then quickly withdraw the needle from the vein and activate the safety device. Apply pressure to the site for 2 to 3 minutes or until bleeding stops.
- Following facility policy, label and prepare the tubes for transport. Appropriately dispose of the needle, adapter, and other soiled devices. Wash your hands.
- Document the procedure and the patient's response in the medical record.
DON'T
- Don't use an arm with an arteriovenous fistula or one on the same side as a mastectomy or axillary node removal.
- Don't palpate the venipuncture site after you clean it.
- Don't keep the tourniquet on for more than 1 minute, to minimize discomfort and prevent hemoconcentration.
- Don't push the needle to accelerate the blood enter the tube
- Don't shake the tube which contain blood
- Don't leave the tube contain with blood without doing proper inversion
- Don't put the tube contain with blood to the centrifuge immediately after the blood draw
SELECTED REFERENCES
Altman, G., et al.: Delmar's Fundamental & Advanced Nursing Skills. Albany, N.Y., Delmar, 2000.
Garza. D.. and Becan-McBride, K. (eds): Phlebotomy Handbook: Blood Collection Essentials. Upper Saddle River, N.J., Prentice-Hall, 2002.
Smith, S., et al.: Photo Guide of Nursing Skills. Upper Saddle River, N.J., Prentice-Hall, 2002.