Venipuncture I. Indications for Venipuncture a. Obtain blood samples for analysis d. Administration of intravenous sedation (phlebotomy) e.

Administration of blood and blood b. Administration of intravenous fluids products c. Administration of intravenous medication f. Treatment of Polycythemia Contraindications to Phlebotomy a. Phlebitis- firm, hard, painful c. Lymphan itis!mastectomy b. Cellulitis d. "carrin e. #ecent $enipuncture at same location f. $enous obstruction at the proposed site of $enipuncture . %ntravenous line in place on same arm as $enipuncture Equipment necessary for phlebotomy/Venipuncture-IV placement a. Tourni&uet b. Alcohol pads or betadine s'ab c. (isposable loves d. $acutainer needle, )* au e needle for the syrin e or %$ catheter. A butterfly may be needed for small veins. (needles smaller than )) au e should be avoided because the blood tends to hemoly+e in the small bore) e. Proper tubes for specific type for lab test bein collected f. Proper labels!correct patient . "terile au+e pads- alcohol applied to fresh puncture site, "T%,-" h. .anda e!(ressin for phlebotomy, $enipuncture, or %$ site Site Selection for Phlebotomy/IV placement a. The arm- most commonly used site for phlebotomy and %$ placement. The antecubital fossa should be avoided for %$ placement if possible i. The superficial veins of the arm are more easily observable and accessible, distinct, and palpable b. $ein selection should be determined by si+e, elasticity and the distance belo' the s/in. %n eneral, the most easily palpable vein, even thou h, it may not be visible, should be chosen c. Apply the tourni&uet and observe for the optimal site, 0ave the patient open and close the fist to accentuate the vasculature d. 1ou may need to place the e2tremity in a dependent position to further accentuate the vessels e. "pecial maneuvers may include tappin over the vessel or usin 'arm soa/s f. The dorsal surface of the hand General Catheter Selection Considerations Catheter Sizes !au!e" Indications 34-35 au e Trauma or ma6or sur ery 35-37 au e .lood and blood products, administration of viscous medications )*-)) au e 8ost patient applications )4 au e Pediatric patients and neonates Procedure for Intradermal In#ection $. Prepare the s/in 'ith an alcohol 'ipe. Let the s/in dry

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9ill the syrin e 'ith the desired amount of solution, usually *.3-*.)ml 0old the s/in taut bet'een the thumb and the inde2 fin er 0old the needle .:$:L ;P and an le it about 3*-3< de rees (almost parallel to the s/in) %nsert the needle into the dermis for about )!= of its len th Aspirate and in6ect the solution. A 'heal should form immediately >ithdra' the needle. (iscard into the popper sharps container #ecord the information on the patient?s chart@ type of test done, date and time of test, e2act location of test site, (ocumentation of return date or procedure for readin test