Venipuncture Techniques
What is the most commonly used vein for venipuncture?
the median cubital vein
What color tube is used first in the order of draw for most collections?
the blood culture bottle or yellow tube
What additive is in the lavender (purple) top tube?
EDTA
What is the first step in ensuring patient safety before venipuncture?
proper patient identification
What should you do if you can’t find a vein?
try the other arm, lower the arm below the heart, or use warm compresses
What angle should the needle be inserted during venipuncture?
15 to 30 degrees?
What is the correct order of draw using the CLSI system?
blood culture, light blue, red, gold or tiger-top, green, lavender, gray
What test is typically performed using a gray top tube?
glucose testing or lactic acid
What must be obtained before performing any phlebotomy procedure?
informed consent
What might cause a hematoma during a blood draw?
improper needle angle or failure to remove the tourniquet before removing the needle
What antiseptic is typically used to cleanse the skin before a routine blood draw?
70% isopropyl alcohol
Why is the order of draw important?
to prevent cross-contamination of additives between tubes
What does the gold or tiger-top tube contain?
a clot activator and gel for serum separation
Name one legal consequence of drawing blood without patient consent.
battery or lawsuit
How should blood draws be handled for patients with a known fainting history
perform the draw lying down or with safety precautions
Name one reason a tourniquet should not be left on for more than 1 minute.
hemoconcentration or inaccurate lab results
Which tube must be filled completely to ensure correct test results?
the light blue tube
What additive is found in the green top tube?
heparin
What is the protocol if a patient refuses a blood draw?
document and inform the supervising clinician
What is the correct action if you hit an artery instead of a vein?
remove the needle, apply pressure for at least 5 minutes, notify supervisor
What is the term for a blood draw performed through the back of the hand?
dorsal venipuncture
What tube comes after a serum separator tube in the order of draw?
the green (heparin) tube
What is the primary purpose of sodium citrate in light blue tubes?
to bind calcium and prevent coagulation for coagulation studies
What is HIPAA, and how does it relate to phlebotomy
the Health Insurance Portability and Accountability Act; it protects patient health information
What special considerations apply when collecting blood from a patient with an IV in both arms?
collect below the IV site if possible or consult provider for alternate site