Blood Specimen Collection Chapter 43 Blood Specimen Collection

Capillary Puncture Skin puncture or finger puncture Obtain blood from just under the surface of the skin Ideal for tests requiring only a small amount of blood

Sites for Capillary Puncture Ring finger Great finger Lateral sides of the heel on infants

Performing the Capillary Puncture Sterile lancet device is used Make skin puncture across the fingerprints, not parallel to them

Venipuncture Surgical puncture of a vein, also called phlebotomy

Site Selection Sites for venipuncture Swab area with alcohol Most common: the inner arm at the bend of the elbow Back of the palm (for difficult draw) Swab area with alcohol

Applying the Tourniquet Tourniquets promote palpation and sometimes visual position of the veins Apply three inches above the intended venipuncture site Do not leave on patient longer than 1 minute

Preparing the Patient Explain the procedure and answer any patient questions Patient instructions Explain that there will be minimal pain and/or discomfort, which usually subsides quickly Relaxing will help speed up the procedure

Venipuncture Methods Vacuum tube and sterile needle Most popular method of collection 21-23 gauge needle is generally used Blood specimen enter directly into test tubes

Venipuncture Methods Sterile needle and syringe Used when patient has small veins Usually a 10-20 mL syringe is used

Venipuncture Methods Butterfly Used for difficult draws A smaller gauge needle is used The tourniquet is applied just above the wrist

Collection Tubes Red-stoppered tubes Red/black stoppered tubes Range from 3 to 15 mL Used for whole blood collection and allowed to clot After clotting, blood is spun and serum poured off Red/black stoppered tubes SST separates red cells from serum

Collection Tubes Lavender-stoppered tubes Gray-stoppered tubes Contain EDTA Range from 5 to 10 mL Used in whole blood collection Gray-stoppered tubes Contains oxylate Usually 5 mL Used in blood glucose test

Collection Tubes Blue-stoppered tubes Green-stoppered tubes Usually 5 mL Used for testing prothrombin times Must be completely full Green-stoppered tubes Contains heparin Used to determine several chemical constituents

Order of Draw Yellow Blue Red/ Red Black Green Lavender Gray

Documentation for Specimen Collection Lab request form must be completed, sent with specimens, and listed in log book Date collected Patient’s full name, DOB, or records number Date sent to lab Test(s) requested Date results received Test results