1-13. PHLEBOTOMY AND COLLECTION OF SAMPLES FOR PROCESSING AND
In order to obtain a clot-free full collection of blood, it is most important to do a
clean, skillful venipuncture.
a. STEP 1: Inspect bag for any defects. Apply pressure to check for leaks. The
anticoagulant solution must be clear.
b. STEP 2: Position bag carefully. Determine and do the following:
(1) If balance system is used, be sure counterbalance is level and adjusted
for the amount to be drawn. Unless metal clips and a hand sealer are used, make a
very loose overhand knot in tubing. Hang the bag and route tubing through the pinch
(2) If balance system is not used, position bag low enough to allow gravity
collection. The bag may be hung upside down so blood flows through the
anticoagulant. There must be a means to monitor the amount of blood drawn.
(3) If a vacuum-assist device (see figure 1-3) is being used, the manufacturer's
instructions should be followed.
(4) Quality assurance--For accuracy, balance system (see figure 1-4) or
vacuum-assist devices and scales must be checked upon receipt and periodically.
c. STEP 3: Reapply tourniquet or BP cuff (40 mmHg). Have donor open and
close hand until previously selected vein is again prominent.
d. STEP 4: Uncover sterile needle and do venipuncture immediately (see
figure 1-5). Tape the tubing to hold needle in place and cover site with sterile gauze.
e. STEP 5: Open the temporary closure between the interior of the bag and the
tubing following manufacturer's instructions (see figure 1-6).
f. STEP 6: Instruct donor to open and close hand, squeeze a rubber ball or
other resilient object, slowly every 10-12 seconds during collection.
g. STEP 7: Mix the blood and anticoagulant gently and periodically
(approximately every 30 seconds) during collection. Mixing may be done manually, by
placing bag on a rotator, or by using a vacuum-assist device.