CLINICAL LAB SCIENEC

274
ESSENTIALS OF CLINICAL LABORATORY SCIENCE
After assembling the materials needed
and prior to beginning the procedure, it is
necessary for the phlebotomist to find the
best site. This gives confidence to the patient
and the phlebotomist and is accomplished
by visually examining the area and using the
tightened tourniquet to evaluate the vein.
The phlebotomist then loosens the tourniquet
prior to preparing to perform the venipuncture.
FIGURE 11-5 Safety syringe with sliding plastic sheath covering needle.
Source: Delmar/Cengage Learning.
Remember that sometimes, in difficult
“sticks,” it will be necessary to use a syringe
(Figure 11-5) or a “butterfly” apparatus (Figure 11-6) to puncture small veins,
such as those in young children.
Washing Hands and Gloving
For the phlebotomist’s protection, the hands must be thoroughly washed and
gloves donned before performing a venipuncture procedure. Nonsterile gloves
are used to protect the medical worker. Sterile gloves are worn to protect the
patient from infection as well as the surgical worker. Hands should be washed in
a circular scrubbing motion with hands in downward position to prevent water
and soap from running toward the shoulders. Use friction by vigorously rubbing
the hands together; in addition, the cuticles of the nails should be scrubbed
against the palms of the hands. After rinsing, dry the hands thoroughly with dry
paper towels. On sinks that do not have an automatic shut off, the faucet should
be turned off using paper towels. Note that bacteria may travel through wet
paper more easily than dry, so the faucet should be turned off with dry towels.
Positioning and Reassuring the Patient
Honestly explain to the patient that there will be slight discomfort but it will
be brief. Explain the importance of not moving the arm while blood is being
obtained. Patients should preferably be seated or lying down while blood is
drawn (it is difficult to collect blood from a standing patient). It is important to
remember that certain values are changed by a
patient’s position, so in some cases it is necessary
to place the patient in a certain position.
Inpatients in a hospital are almost always in a
supine position when blood is being collected.
Never allow the patient to stand or to sit on a
high stool as it would be difficult to avoid or to
control a fall if the patient faints. Special blooddrawing
chairs are available for positioning the
patient and arranging the supplies in an easy-toreach
fashion. Never restrain the patient or have
FIGURE 11-6 Butterfly needle for difficult sticks, such as small
veins and veins located in difficult-to-reach areas.
Source: Delmar/Cengage Learning.
someone hold a patient against his or her will
when drawing blood, as this might constitute
the crime of “battery.”
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