Physicians needed a way to get to the veins of their patients quickly, so several tools were fabricated over the centuries, ensuring a swift puncture; even some punctures with a measurable degree of incision. These tools consisted of lancets and scarifications, which opened the vein; then there were cupping cups and leeches, which allowed a more localized draw from the capillaries. Davis and Apel state, "in the eighteenth century, delicate mechanical spring lancets and scarifications were invented to replace the simpler thumg lancets and fleams." Lancets are surgical knives that bore the greatest amount of liquid; creating an opening approximately one-fifth of an inch. Spring-loaded lancets were the easiest to use because they made consistent cuts whose cuts varied depending on the skill of the physician. Scarificators were brass boxes with a lever on top that released a set of blades which snapped out of slits on the base; offering a consistent depth and length of an incision. Cupping cups were heated while placed on the patients skin. As the cup cooled on the skin, a vacuum type of energy
There are many ways that blood can be drawn from a patient. There are patients who may have special needs, such as the elderly and infants. These patients often have collapsible or delicate veins that often make drawing blood more difficult, than other patients. Individuals who learn what is phlebotomy will find these people work in all aspects of the medical field. They can be found in nursing homes, doctor's offices, hospitals, and various clinical-type settings.
(Hwang 2015). This is typically controlled by snare tip soft coagulation (STSC), a technique involving protruding the snare tip 2-3 mm beyond the catheter, followed by application of coagulating current while lightly touching the tip directly onto the bleeding point. Vigorous irrigation with the foot pump clears the resection field of blood and helps localize the bleeding vessel. In the minority of cases where STSC does not achieve hemostasis, coagulating forceps or through the scope (TTS) clips may be used, both of which have been associated with a low rate of re-bleeding and complications. (Ma 2016)
According to Clyman, “I put my needle sticking it through and through over and over laying the lacerated parts together as nice as I could with my hands.”
After a suitable vein has been visualized and the venipuncture site thoroughly cleansed, the needle is then placed into the patient’s vein for blood collection. Difficulties can arise if a needle is not fully inserted or if it went entirely through the vein and a hematoma will be the result. (Morgan, 2005) Hematomas are bruises due to the collection of blood from veins or arteries in the surrounding tissues. (Garza, 2010) Sticking a fragile vein, excessive probing of the needle if the vein is initially missed, and failure to remove the tourniquet before removing the needle are some other ways a hematoma can develop during a venipuncture procedure. (Garza, 2010) When needles are incorrectly inserted into a vein, blood is allowed to escape, forming a bruise. (Garza, 2010) If at any time this should happen, the phlebotomist should immediately end the procedure by first removing the tourniquet, then the needle, and apply firm pressure to cease the blood flow. (Morgan, 2005) Improper needle placement can also cause neurological damage. With deep insertion of a needle, hitting the nerve behind the vein is likely. (Garza, 2010) Radiating or shooting pain and sometimes numbness has been reported by patients in these situations. (Garza, 2010) Phlebotomist should always insert needles with care to avoid any injury to the
I interviewed Jenna Derusha a phlebotomist at the Mackinac Straits hospital in St. Ignace. Jenna has been drawing blood for 4 years. She is originally educated as a Medical Assistant, but also became a phlebotomist. Her training came from Chuck the head phlebotomist at Mackinac Straits. I asked her how she knows how many tubes is needed or how much blood she needs. She said it all comes with the training. She has been doing it for so long that it all becomes
It is important that you introduce yourself to the patient, confirm their identity and explain the procedure you are about to undertake so they have opportunity to ask any questions they may have. It is important to build a rapport with your patient so they feel comfortable around you. It is essential that they understand what is going to happen so they are able to give informed consent. When taking a patient’s BP you must advise them that they may feel discomfort in their arm but that is normal and that it does not take long. As with all clinical procedures, you must wash your hands before and after dealing with a patient. It is also important that you select the correct cuff size for your patient as an incorrect cuff size will not provide
Furthermore, a brief description of a Phlebotomist is simply someone who completes a venipuncture on another person. The basic daily functions of a Phlebotomist is to accurately collect the appropriate amount of blood for patient samples, treatment, prevention of disease, and medical laboratory testing purposes. Proper techniques include, cleaning puncture site, wearing gloves for protection agonist blood borne pathogens, applying pressure after the needle is removed. Failure to use proper technique during a venipuncture may result in bruising, inaccurate blood culture results, infection in or under the skin. Phlebotomists also preform sticks called “finger
Medical staff will clean and shave your groin or arm for the insertion of the catheter. A local numbing agent will be administered, but you will be awake during the procedure. Medicines for anxiety could be given if patient is having trouble relaxing during the exam. Next, a small catheter will be inserted into an artery. The doctor then uses x-rays to guide the catheter to the area of interest. Once the catheter is in place, dye will be inserted through tube. This allows for visualization of your blood vessels. Very minimal movement will be aloud during this exam to ensure safety and high quality images. This procedure could last one to two hours. If this is a planned procedure and not an emergency, this is normally only scheduled in the
In Note: Either I clap the tube with my hand by binning it or I use the clamp seizers that are provided and used by my department to protect the donor and stop the blood flow into the collection bag.
A is antisepsis of the skin, the skin could have microorganisms on them that can travel with the needle in to a patient’s blood stream. The use of alcohol wipes, chlorhexidine are the important to use before the needle breaks the skin barrier. Rubbing the site where the IV will be placed and letting it fully dry is the best way to keep infection out of the patient.
The steps to do a central line are as follows: Set up materials needed for the procedure, check the patients charts, lay them down with a roll under their back to expose the chest. Swab the chest with antiseptic, inject the anesthetic lidocaine, then use a syringe and puncture a hole near the clavicle. Next use the guidewire to find your way through the veins to the heart, and using that follow it in with the central line. The last step is suture it in place and clean up. (12)
An IV tube may be inserted to give you fluids and medicines throughout the procedure as needed.
An IV tube will be placed. It will be used to give your child fluids and medicine during the procedure.
Seat the patient in a chair and decide from which arm to draw the blood.