TITLE:
LAB SPECIME COLLECTIO ISTRUCTIOS – VEIPUCTURE
BLOOD COLLECTIOS
EFFECTIVE DATE:
08/25/15
PERFORMED BY:
Resource for Specimen Collections
MANUAL:
Specimen Collection Manual
FORMULATED BY:
Lab Phlebotomy Supervisor
VEIPUCTURE - Blood Draw Instructions
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Identify the patient:
Ask the patient to state his/her name.
A Patient must have two unique identifiers. (Do not use Room # as identifier.)
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• 1 Identifier: The patient’s first and last name on the hospital armband
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• 2 Identifier: The patient’s ID # Hosp #, Med Record #,“or” the patient’s DOB is
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the 2 identifier. Use age appropriate care.
Wash /disinfect hands upon entering patient’s room & putting on gloves prior to
procedure. Wash/disinfect hands upon removal of gloves after procedure before exiting
patient’s room.
If patient is seated in chair, it is best that the chair have arms to help provide support and
prevent falls if patient becomes dizzy / faints.
Identify suitable site for venipuncture. (Apply heel warmer if needed to warm site).
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• 1 choice is the medial cubital vein -largest vein in antecubital area of arm
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• 2 choice is the cephalic vein – large vein on the thumb side of antecubital area
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• 3 choice is the basilic vein –Limit needle manipulation upon missing the basilic
vein due to the close proximity of the brachial artery and median nerves.
• Hand and wrist sites are acceptable - avoid draws to the underside of wrist & arm
Do not stick:
o If hematoma or extensive scarring
o On same side that a Mastectomy has been done
o Arm that contains a shunt, fistula, or vascular/skin graft
o Feet or legs (unless instructed by Physician/Pt’s Nurse)
o Above an IV Site or in same arm as IV (when possible)
Apply tourniquet 2-4 inches above bend of elbow for no more than 1 minute.
Do not have patient do vigorous hand pumping.
Perform venipuncture with needle bevel up (no more than 30 degree angle).
Release tourniquet when blood begins to flow from puncture site into tube.
Collect blood tubes in correct order-of-draw (below): Order of draw chart at the end of
instructions
o Blood Culture Bottles
o Plain (no-additive) Tube for discard/waste tube.
o Blue Top Tube
o Gold Top Tube
o Green Top Tube (Heparin)
o Purple Top Tube (EDTA)
o Grey Top Tube / other Tube types
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Once blood draw is complete, immediately place gauze over draw site & apply pressure
as needed.
Gently invert Blue tube tubes 4 times. Invert the other tubes 10 times.
Specimen tubes must be labeled at the time of draw.
Observe site for bleeding, hematoma, or swelling before applying bandage.
Discard sharps in sharps container. Dispose of trash appropriately.
ORDER OF DRAW
1
BLOOD CULTURE
2
WHITE (PLAIN)
3
BLUE (COAG)
4
GOLD (SSR)
5
GREEN
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PURPLE
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GREY