1. Lab Procedures Chapter 47: Venipuncture and Blood Collection Chapter 48: Hematology
Part 2
Professor Fowler

2. Functions of Blood Transportation Protection
Carries oxygen and nutrients to body and removes waste products to liver, kidneys and skin for elimination
Protection
White blood cells work with immune system to fight pathogens
Heart, arteries, veins and capillaries
Heart pumps blood
Arteries: blood away from the heart
Thick walls that allow to withstand pressure sustained when heart is pumping
Blood contains oxygen
Veins: blood towards the heart
Blood contains high carbon dioxide
Capillaries: where arteries meet veins – smallest vessels
Blood regulates body temperature
Warm: dilate to release heat
Cold: constrict to retain heat

3. Blood Specimen Collection
Blood and body fluid collection strictly regulated by OSHA regulations and CDC standard precautions
CLIA sets standards that all labs must adhere to
Always follow guidelines established by these organizations

4. Venipuncture Sites Figure 47-4 Antecubital space
(depression in front of elbow)
is the most commonly used site
Four large veins in
antecubital with easy access
making this site ideal
Most common vein used is
median cephalic vein

5. Venipuncture Methods Vacuum tube Syringe and needle Butterfly
Most common method
Use large vein as small veins can collapse
Procedure 47-3
(mannequin arm and live – practical)
Syringe and needle
Uses smaller vein and needle to get
less blood
Procedure 47-2 on mannequin arm
Butterfly
Used for small veins using smaller
needle, tubing and vacuum tube
costly

6. Venipuncture Equipment
Wear PPE(gloves and lab coat/gown)
Should be assembled and expiration dates checked before attempting use
Important to fill the tubes in the order of draw recommended by Clinical Laboratory Standards Institute (CLSI) in order to prevent contamination of the tubes with skin bacteria or additive from another blood tube
Vacuum tubes come in 5mL, 7mL, 10mL and 15mL
Invert the tube 6-8 times so the anticoagulant and blood have mixed properly – DO NOT SHAKE as this will hemolyze the blood

7. Order of Draw Order of Draw
Figure tube colors, additives, inversions, and lab uses
Some labs may use additional tubes like pink, tan-black, and royal blue

9. Venipuncture Patient preparation Challenges (Chapter 47)
Fasting (lipid, GTT, FBS)
Anxious patients
Children
Challenges (Chapter 47)
Hematoma
Patient refusal
Stress
Failure to Obtain Blood
Specimen Problems
Blood Cultures

10. Venipuncture Unexpected events Complications
Fainting – immediately withdraw needle, and request pt lower head and arms or lie down – ammonia is available to help revive pts – if does not respond, call another member
Nauseous – pt breathe deeply through mouth and provide basin
Excessive anger – remain calm and reassuring – if continues or is disruptive, stop procedure
Uncontrollable bleeding – apply pressure and call for assistance
Complications
Small veins (warm compress applied)
Rolling veins (place one finger below where needle to go)
Incomplete draw/not enough blood (may request more experienced professional)

11. Capillary Puncture
Capillary puncture (manual) – Procedure 47-1 (47-4 black WB)
Puncture sites
Adults: fingers and earlobes
Infants: heels
Equipment and supplies

12. Preparing Slides
Preparing blood slides
procedure 48-4 (47-8 black WB)