c. Median Cubital Vein. First choice for venipuncture (in antecubital fossa).
d. Cephalic Vein. Second choice for venipuncture (lateral portion of forearm).
e. Basilic Vein. Least desirable for venipuncture (inside of forearm).
f. Anticoagulant. A substance which prevents or reduces clotting of the blood.
Patients receiving anticoagulents tend to bleed longer than others.
g. Hematoma. A collection of blood under the skin. These are the most
common complications resulting from venipuncture attempts.
2-3.
PROCEDURE FOR OBTAINING A BLOOD SPECIMEN
a. Verify Request to Obtain Blood Specimen. The following may be used to
verify an order to obtain a blood specimen.
(1)
Therapeutic Documentation Care Plan (Non-medication), DA Form
4677.
(2)
Provider's orders.
(3)
Supervisor's directive.
b. Gather Equipment. Collect the following equipment (see figure 2-1).
(1) Blood specimen tube. Obtain the proper blood specimen tube based
upon your supervisor's directive, ward standing operating procedures (SOP), or
laboratory SOP. The type of tube needed will depend on the specific test to be
performed. Some tests require a blood specimen that has not been allowed to clot. In
this case, a blood specimen tube containing a powdered or liquid anticoagulant is used.
If coagulated (clotted) blood is acceptable, other types of tubes are used. Many
laboratories use a color code for tubes or bottles required for different tests.
(2) Vacutainer. The Vacutainer consists of a plastic holder into which a
sterile disposable double-ended needle is inserted. A vacuum tube with a rubber
stopper slips into the barrel of the holder. The needle should not penetrate the stopper
until the vein end of the double-ended needle has been inserted into the vein. After the
needle enters the vein, the tube is pushed the remaining distance into the barrel. The
vacuum in the tube will withdraw blood from the vein.
(3) Constricting band or tourniquet. Constricting bands commonly used are
made of soft, flat or round latex rubber. Commercial types of constricting bands have a
Velcro fastening device.
MD0553
2-3