Venipuncture for Blood Test: Pre-procedure (Nursing)

00:04 Welcome to the skill venipuncture for lab work.

00:08 Now, before we get started to perform our venipuncture, there's a few considerations, that we need to talk about.

00:14 The first one, is, whichever extremity that you use, you want to check for lesions, lymphedema or if it's a restricted extremity.

00:24 Now, a few reasons why you may have a restricted extremity, meaning we do not want to puncture that side, is if the patients had a diagnosis of a DVT in that arm, meaning a blood clot in that arm.

00:37 Or if maybe the patient has what we call a fistula for dialysis.

00:42 Or if the patients had any lymph nodes removed on that particular site.

00:47 Now, it's important to pause any infusion before a venipuncture and you want to use the opposite extremity for that procedure.

00:57 Now, it's a good time to select the correct needle gauge by considering about a 21 to 25 gauge.

01:04 Now, make sure you consider the collection site, which is, typically going to be what we call the, “AC” or the “Anti-cubital” region.

01:13 Also, you've got to consider with your patients, some patients, due to their disease process, may have a difficulty of their vascular availability or what we call a “Hard stick”.

01:25 Also, it's a good idea to keep in mind the specific laboratory test that you're going to be drawing.

01:31 Now, sometimes, if we collect a certain laboratory test with a needle size smaller than 22 gauge, the blood cells, when we're drawing through that needle, can do what we call lyse or hemolyze or break apart and always remember to label the blood collection tubes, at the bedside and verify client identity.

01:53 Now, when we're talking about venipuncture, it's important to use your preference, be sure to use the type of blood collection device that you are going to be most successful at using.

02:03 Now, there are some differences between the needle devices that are used, to collect blood samples, but it should be all about ensuring that you get the right labs drawn, with the least amount of harm to your patient.

02:17 Now, this is a great little acronym, such as, stop, light, red.

02:22 Stay, put, green and light, go.

02:25 That may be a little bit hard to remember, but this is a great acronym just to help you remember the order of drawing, when we have multiple labs to collect on our patient.

02:35 So, let's take a look at the type of equipment, we're going to need for a venipuncture.

02:40 So, of course we're going to need the venipuncture needle.

02:42 You may use either what's called a butterfly, like you see here in this image or a straight needle.

02:48 Then, you're going to need the blood transfer device or what we call the vacutainer and of-course the appropriate blood collection tubes for the specific lab ordered by your physician.

03:00 Then, we're going to need an alcohol swab for cleaning, gauze pads and our tourniquets.

03:06 Don't forget, one of the most important things is, the laboratory labels, this is going to have the patient information on it and we've got to make sure that we label the lab appropriately, that way they know which result, goes to which patient and the biohazard laboratory bag for transportation.

03:26 Now, before we get started with our venipuncture, we want to perform our hand hygiene and provide privacy.

03:32 It's important here to explain the procedure to the patient, because any time we're talking about a needle stick, your patient could have some apprehension.

03:41 Then, you want to raise a client bed, to an appropriate height for good body mechanics for you.

03:47 And then make sure to place the patient in a position, that allows their arm to fall in a dependent position and also, so that you are most successful in your venipuncture.

03:59 Now, we can go ahead and open and prepare all the equipment on a clean dry surface.

04:05 Then we can go ahead and attach the blood transfer device, to the tubing on the needle.

04:11 We want to go ahead perform our hand hygiene again and now we can don our gloves.

04:20 Let's look at the skill of venipuncture.

04:22 So, before we get started of course we want to perform our hand hygiene and provide privacy to the client.

04:29 Now, here's a really important step to make sure we explain the procedure to the client.

04:34 Anytime you're talking about IV’s or any sort of sticks and especially venipuncture, sometimes your client can get a little apprehensive.

04:43 So, make sure you fully educate them before the procedure.

04:46 That's a great idea to raise a client's bed to an appropriate working height for you, then you want to place the client's arm in a dependent position.

04:56 Now, we can go ahead and open and prepare all the equipment on our clean dry surface.

05:01 So, when we do this, I’ve got my gauze here, I’ve got my cleaning device, my alcohol pad, my tourniquet, my lab equipment's ready in my biohazard bag.

05:11 Now, we can go ahead and attach the device.

05:14 So, this, is what we call our wing tip or our butterfly needle and again, this is really about personal preferences, but I really like holding on the wings for the stick, so, this is what my preference is for venipuncture.

05:30 So, once we've got this, we can take this out of the package and you notice this has a great covering for the sheath, which is great, you see the butterfly needle.

05:42 This down here the yellow, is actually the activation shield, that covers the needle for safety once we're done.

05:49 Then, we've got our tubing and this is going to attach to our vacutainer device.

05:57 Okay, so now we've got this attached, I'm going to place this back in here, just to make sure we keep this clean, we're going to perform our hand hygiene and then we're going to don our gloves.