Transcript Skin Puncture Equipment

Basic Principles of
Phlebotomy Part VI:
Capillary Draws
CLS 424 Phlebotomy
Student Lab Rotation
Skin Puncture:
• Method of choice for infants, children
under 1 year
• Adults
– Scarred
– Fragile veins
– Hardened veins
– Home glucose monitoring (POCT)
– Patients with IV
2
Capillary Blood
• Mixture of arterial, venous, capillary blood
and fluid from surrounding tissues
• Fluid from surrounding tissues may
interfere and/or contaminate the specimen
• Warming skin puncture site increases
arterial blood flow to the area
• Reference ranges often differ from venous
3
Skin Puncture Equipment:
1. PPE
2. Cleaning agent
– Alcohol pads: routine
– Soap and water: alcohol testing, allergies
– DO NOT use providone iodine
3. Cotton balls, gauze
4
Skin Puncture Equipment:
4. Bandage/tape
5. Sharps container
6. Warming device
–
–
Commercial warmer
Warm wet washcloth
5
Skin Puncture Equipment:
7. Lancet
–
Always use
standardized
equipment
–
NEVER use a
surgical blade
6
Skin Puncture Equipment:
8. Micro-specimen
containers
– Capillary tubes
– Microtainers
– Capillary blood gas
tubes
– Micropipet diluting
system
7
Skin Puncture Equipment:
9. Glass slides:
used to prepare
blood smears
8
Skin Puncture Procedure:
1.
2.
3.
4.
5.
6.
7.
8.
9.
Wash hands
Approaching the patient
Patient identification
Latex allergy?
Bedside manner
Site selection
Cleanse site: DO NOT use providone- idodine
Perform puncture: Wipe away first drop of blood
Label the specimen
9
Skin Puncture Site Selection:
10
Skin Puncture Procedure:
• Hold finger between your index finger and thumb
• Puncture the finger using a quick, smooth motion
• Wipe away the first drop of blood
11
Skin Puncture Procedure:
• Collect sample
– DO NOT touch collecting device to skin surface
– DO NOT scrape collecting device across skin surface
– DO NOT scoop blood into collecting device
12
Skin Puncture Procedure:
• Order of draw is critical: platelets accumulate at
puncture site causing clot formation
–
–
–
–
Blood smear
EDTA
Heparin
Serum
• Apply pressure to puncture site
• Label specimen in sight of patient (indelible marker)
13
14
15
16
17