Venipuncture Basics
What is the first step in performing venipuncture after identifying the patient?
Wash and Sanitize hands
What is the maximum depth for a heel puncture in an infant?
2.0 mm maximum depth
How should tubes be mixed after collection if they contain additives?
gently invert as recommended per tube
What is the first tube in the standard CLSI order of draw?
BLOOD CULTURES!!! (yellow/sterile?
What organization publishes standard guidelines for phlebotomy practice?
CLSI (Clinical and Laboratory Standards Institute)
What angle should the needle enter the skin during venipuncture?
15-30 degrees
Why is the first drop of capillary blood wiped away?
removes tissue fluid contamination
Why should blood samples be allowed to clot before centrifugation in serum tubes?
to allow proper clot formation and prevent fibrin strands
Which tube is used for coagulation studies?
Light blue tube - sodium citrate
What type of precaution treats all human blood and body fluids as potentially infectious?
Standard Precautions
Which vein is most commonly used for routine venipuncture?
Median Cubital Vein
Which site should be used for a heel stick on an infant?
lateral or medial plantar surface of the heel
How should specimens for bilirubin testing be transported?
protect from light
Which tube contains Heparin and is used for chemistry tests?
Green tube - Heparin
What should never be done with a used needle?
NEVER RECAP!!! dispose of immediately in sharps container
What should be done if a hematoma begins forming during venipuncture?
Release tourniquet, withdraw needle, apply pressure
Which analyte is typically higher in capillary blood than in venous blood?
Glucose
What happens if EDTA tubes are underfilled?
alters blood-to-additive ratio --- Cell shrinkage or abnormal results
What are the last two tubes in the order of draw?
Lavender (EDTA) then Gray (sodium fluoride/potassium oxalate)
What is the term for infection acquired in a healthcare setting?
Nosocomial infection
What is the max amount of time a tourniquet can remain on a patient's arm?
One minute maximum
What is the purpose of warming the puncture site before skin puncture?
to increase blood flow and arterialize the specimen
How long should serum tubes stand before centrifugation?
30 - 60 mins at room temperature
Why is the order of draw important?
prevents additive contamination between tubes
Why is the proper patient identification critical before specimen collection?
Prevents serious misidentification and patient harm