Venipuncture Report

Although he refused to wash his hands I carried out the procedure . The patient was already sitting on a sofa. I used a single-use lancet for piercing the finger, inserted a testing strip into the meter and the

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.

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

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)

This procedure is done by making a small puncture in the groin or a small incision in the chest.

A focused assessment is an assessment that centers directly on the chief complaint that a patient presents with when they arrive to seek out care. In this case, our assessment is focused on a potential deep vein thrombosis (DVT). A DVT is a essentially a ball of blood cells that are clumped together impeding blood flow which can cause irritation to the vein and potentially more dangerous problems. If the thrombus moves, it can travel through the body and into the lungs and impeded breathing which is not good. Therefore, it is essential to catch DVT’s right away and treat them to prevent them from moving. The first thing that needs to be assessed when a patient presents with a suspected DVT is their level of consciousness and their vital signs including the heart rate, blood pressure, respirations, temperature and oxygen saturation. Next, assess the site of the expected DVT, and perform a neurovascular assessment which comparing to the same site on the opposite side of the patients body. Check for adequate circulation by assessing for pink color distal to the site. While performing this assessment, you want the area distal to the site to be pink to ensure there is adequate blood flow. If it is whitish in color, this is a sign of a DVT and needs to be documented. While assessing color, also assess the site directly for any color deviation from the clients natural skin color. If the

(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)

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.

Pt requires 20 gauge IV for _______. 20 gauge catheter inserted to the right anterior forearm, first attempt. Flushed with 10 cc normal saline. Stat lock in place, covered with transparent dressing. Pt tolerated well with no complaints of pain or irritation upon flushing, no visible swelling or bruising. Sharps placed in approved container, patient’s bed lowered as far as possible and assisted to comfortable position. Reassessed in 5 minutes for bleeding , none noted.

Giving Cleveland oxygen will help with the delivery of oxygen to the tissues, and the IV fluids help with elevating the blood pressure because of the body fluids being increased. The hospital send his blood for cross-matching so they know if it would be best for him to have a transfusion of packed red blood cells, or a whole blood.

When blood is removed from a vein, it is called venipuncture or phlebotomy. Venipuncture should be performed with care. The veins of a patient are the main source of specimens for testing, the entry point of medications, and the site for IVs and blood transfusions. Because there are only a limited number of easily accessible veins in a patient, it is important that everything be done to preserve their good condition and availability. Universal precautions should be observed at all times. Gloves should always be worn when obtaining blood specimens. BEFORE BEGINNING ANY PROCEDURE—ACCURATELY IDENTIFY THE PATIENT ! Follow the proper protocol to identify the patient make positive identification of the patient by checking hospital armband for