CLINICAL LAB SCIENEC

CHAPTER 11: PHLEBOTOMY 275
Latex and Bandage Sensitivity
The use of latex tourniquets or gloves should
be avoided for patients who indicate they have
a latex sensitivity. The phlebotomist or medical
worker should have already determined whether
he or she has a latex sensitivity. Laboratories
provide several varieties of gloves for those who
exhibit an allergic reaction to either powder or
latex. These reactions may be quite severe, so it
is incumbent on the person collecting blood to
ask if the patient has such an allergy. In some
cases, there might be a warning sticker on any
forms used for treating the patient, advising of
such a condition. Rarely, some brands of bandages
that contain latex or other synthetic materials
may cause reactions when placed over the
puncture site after the blood is drawn in patients
sensitive to certain materials.
FIGURE 11-7 Positioning of hand and holding of a lancet before
capillary puncture.
Source: Delmar/Cengage Learning.
Other Precautions
For inpatients, there are other considerations.
Bed rails may be let down on the side from
which blood will be collected but must be raised
again on leaving if they were raised when the
phlebotomist or technician entered the room. It
is best to avoid collecting blood from limbs with
IV (intravenous) lines present. IV solutions may
dilute the blood, giving erroneous results. If collecting
blood from an arm with an IV is unavoidable,
the blood should always be collected from
a site BELOW where the IV line enters the vein.
Capillary punctures (Figures 11-7, 11-8, and
11-9) are not usually affected by IV solutions
and it is possible to collect many samples such
as a complete blood count (CBC) by finger stick.
However, specimens such as coagulation tests
must be drawn from a vein.
Patients with chronic diseases or who have
been hospitalized for a period of time often have
bruises and sites where they have been stuck for
blood tests and other procedures on a number
of occasions. Repeat punctures of the skin and
subsequent drawing of blood from the same sites
may give erroneous results. Upon discontinuation
of IV fluid administration, blood should not
be drawn from the site for 1 to 2 days following
FIGURE 11-8 Well-rounded drop of free-flowing blood after
adequate puncture.
Source: Delmar/Cengage Learning.
FIGURE 11-9 Obtaining capillary tubes of blood for
procedure requiring small volume of sample.
Source: Delmar/Cengage Learning.
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