How can venous access be improved?
Tips and Tricks for Accessing Problem Veins
- Get warm. When the body is warm, blood flow increases, dilating the veins and making them easier to find and stick.
- Use gravity. Increase blood flow to your arm and hand by letting gravity do the work.
- Hydrate. When the body is properly hydrated, veins become more dilated.
What is the purpose of using a tourniquet during venipuncture?
Purpose: A tourniquet is a constricting or compressing device used to control venous and arterial circulation to an extremity for a period of time. Pressure is applied circumferentially to the skin and underlying tissues a limb; this pressure is transferred to the vessel wall causing a temporary occlusion.
How long can you leave a tourniquet on for venipuncture?
The tourniquet must never be left on for longer than 1 min immediately before venepuncture, and it should be removed as soon as the blood begins to flow, otherwise, hemoconcentration will occur, and local stasis is likely.
What happens when you leave a tourniquet on too long when drawing blood?
A prolonged tourniquet time may lead to blood pooling at the venipuncture site, a condition called hemoconcentration. Hemoconcentration can cause falsely elevated results for glucose, potassium, and protein-based analytes such as cholesterol.
When do you remove the tourniquet during a blood draw?
Once sufficient blood has been collected, release the tourniquet BEFORE withdrawing the needle. Some guidelines suggest removing the tourniquet as soon as blood flow is established, and always before it has been in place for two minutes or more.
What is the correct order of blood draw tubes?
The draw order for specimen tubes is as follows: Gold SST (Plain tube w/gel and clot activator additive) Green and Dark Green (Heparin, with and without gel) Lavender (EDTA) Pink – Blood Bank (EDTA)
Why are the blood collection tubes supposed to be collected following proper order?
The order of draw is recommended for both glass and plastic venous collections tubes when drawing multiple specimens for medical laboratory testing during a single venipuncture. The purpose is to avoid possible test result error due to additive carryover. All additive tubes should be filled to their stated volumes.
Does order of draw matter?
In the era of lyophilized anticoagulants, order of draw is no longer important. Contamination of serum samples with K EDTA will occur routinely if order of draw is not followed. Modern lab equipment can tell the difference between K from the EDTA tube and K from the patient, so order of draw is not important.
Why is the correct order of draw so important?
Order of draw is essential in avoiding cross contamination from additives of one tube to the next. Cross contamination, depending on the tests ordered, could cause seriously erroneous results, improper patient treatment and possibly death.
What determines the order of draw?
Who determines the order of draw? Formerly known as the National Commission of Clinical Laboratory Standards (NCCLS), the Clinical Laboratory Standards Institute (CLSI) (http://clsi.org/) approves and publishes the order of draw.
What is the order of draw using evacuated method?
The order of draw listed on the right is used for the Evacuated Tube System (ETS). A winged blood collection device (butterfly) can be used for collecting a specimen as well. If it is used for coagulation studies, a waste tube must be drawn first.
Which should be the first in order of draw for most hematology studies?
Note: When multiple specimens are drawn from a single venipuncture, the following order is recommended: (1) sterile blood culture tubes, (2) nonadditive clotting tubes (red), (3) coagulation tubes and tubes containing citrate (blue), (4) gel-barrier tubes and tubes with additives (red), (5) tubes containing heparin ( …
What is the last tube in the order of draw?
Collect citrate tube (blue top) last, after 20mL of blood has been withdrawn for other testing, or as waste. Just prior to drawing the blue top tube as the last tube, draw 1mL into a discard blue top tube to prevent cross contamination from the additive of previously drawn tubes.
What is the purple top tube used for?
The purple top tube provides blood for infectious disease tests and ascertaining important data such as ABO/Rh (blood type), as well as whether the blood is positive or negative for cytomegalovirus (CMV), HIV, hepatitis, and West Nile virus, to name a few.
What color tube should be collected for a CBC?
Lavender top tube