WHO Guidelines on Drawing Blood: Best Practices in Phlebotomy

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2.3 Illustrations for best practices in phlebotomy Figure 2. 1 Venepuncture in adults 1. Assemble equipment and include needle and syringe or vacuum tube, depending on which is to be used. 2. Perform hand hygiene (if using soap and water, 3. Identify and prepare the patient. dry hands with single-use towels). Ulnar nerve Median cubital vein Ulnar artery Basilic vein 4. Select the site, preferably at the antecubital area (i.e. the bend of the elbow). Warming the arm with a hot pack, or hanging the hand down may make it easier to see the veins. Palpate the area to locate the anatomic landmarks. DO NOT touch the site once alcohol or other antiseptic has been applied. 5. Apply a tourniquet, about 4–5 finger widths above the selected venepuncture site. 18 <strong>WHO</strong> guidelines on drawing blood: best practices in phlebotomy
6. Ask the patient to form a fist so that the veins are more prominent. 7. Put on well-fitting, non-sterile gloves. 8. Disinfect the site using 70% isopropyl alcohol for 30 seconds and allow to dry completely (30 seconds). 9. Anchor the vein by holding the patient’s arm and placing a thumb BELOW the venepuncture site. 10. Enter the vein swiftly at a 30 degree angle. 11. Once sufficient blood has been collected, release the tourniquet BEFORE withdrawing the needle. 12. Withdraw the needle gently and then give the patient a clean gauze or dry cotton-wool ball to apply to the site with gentle pressure. 13. Discard the used needle and syringe or blood-sampling device into a punctureresistant container. 14. Check the label and forms for accuracy. 15. Discard sharps and broken glass into the sharps container. Place items that can drip blood or body fluids into the infectious waste. 16. Remove gloves and place them in the general waste. Perform hand hygiene. If using soap and water, dry hands with single-use towels. 2 Best practices in phlebotomy 19
Page 1 and 2: WHO guidelines on
Page 3 and 4: Contents Acknowledgements..........
Page 5: Tables Table 2.1 Elements of qualit
Page 8 and 9: External authors and reviewers Dr R
Page 10 and 11: Declaration of interests Conflict o
Page 13 and 14: Executive summary Phlebotomy - the
Page 15: Best practice in disinfection After
Page 19 and 20: 1 Introduction 1.1 Overview Phlebot
Page 21 and 22: 1.2 Purpose and scope The aim of th
Page 23: PART II ASPECTS OF PHLEBOTOMY
Page 26 and 27: Table 2.1 Elements of quality assur
Page 28 and 29: 2.2 Practical guidance on best prac
Page 30 and 31: Step 3 - Select the site General
Page 32 and 33: Table 2.3 Order of use a Recommende
Page 36 and 37: Figure 2. 2 Filling tubes 1. If the
Page 38 and 39: Some systems have a mechanism that
Page 41 and 42: 4 Venepuncture for blood donation T
Page 43 and 44: 4.2 Practical guidance on venepunct
Page 45 and 46: 4.2.3 Adverse events in blood donat
Page 47 and 48: 5 Arterial blood sampling The infor
Page 49: 8. Advance the needle into the radi
Page 52 and 53: 6.2.2 Venepuncture Preparation Vene
Page 54 and 55: 4. Immobilize the baby or child. 5.
Page 57 and 58: 7 Capillary sampling The informatio
Page 59 and 60: 7.2 Practical guidance on capillary
Page 61: 7.3 Illustrations for capillary sam
Page 65 and 66: 8 Implementing best phlebotomy prac
Page 67 and 68: 8.3 Phlebotomy training Recommendat
Page 69 and 70: • If the patient is unconscious o
Page 71: 9 Monitoring and evaluation A monit
Page 75 and 76: References 1 Lavery I, Ingram P. Bl
Page 77 and 78: 37 Rourke C, Bates C, Read R. Poor
Page 79: PART V ANNEXES
Page 82 and 83: A2 Evidence base An initial literat
Page 85 and 86:
Annex B: Infection prevention and c
Page 87 and 88:
Annex C: Devices available for draw
Page 89 and 90:
Annex D: Managing occupational expo
Page 91 and 92:
or organs for up to 6 months after
Page 93 and 94:
Annex E: Training course content fo
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Annex F: Explaining the procedure t
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Annex H: Blood spillage Blood spill
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Annex J: Cochrane review Skin prepa
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Skin preparation with alcohol versu
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Page 109 and 110:
Page 111 and 112:
Page 113 and 114:
Page 115 and 116:
Page 117:
Page 121 and 122:
Glossary Acquired immunodeficiency
Page 123 and 124:
Human immunodeficiency virus (HIV)
Page 125:
Safe injection An injection that do
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WHO Guidelines on Drawing Blood: Best Practices in Phlebotomy

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