Patients must be properly identified for the blood collection procedure, including their name and another form identifier such as their birth date or medical record number. If one letter or number is different in either identifier, the blood should not be drawn unless proper identification is obtained.
Prepare patients for blood collection by explaining the procedure, letting them know they can expect to experience pain from the needlestick. Position them in a supported seated or lying position.
Tourniquets slow the blood to the site but if left on more than one minute can cause pain to the patient and hemoconcentration of the blood specimen.
The venipuncture and dermal puncture sites are selected based upon their location and appearance. Venipuncture is typically performed in the antecubital area of the arm and dermal puncture is typically performed on the heel of an infant or third or fourth finger of an adult.
Cleaning the site for dermal puncture most often requires the use of an alcohol prep pad, wiping in a circular motion from the center out. The site must dry thoroughly before the collection of blood.
The specimen label includes the patient's full name, the patient record/identification number or birth date, date and time of the collection, and the phlebotomist's initials.
The maximum number of times a phlebotomist should attempt blood collection is two.
When you are unable to obtain blood during venipuncture, first change tubes in case the vacuum is lost from the first tube, then reposition the needle by pulling back slightly. Lastly you may want to loosen the tourniquet.
A butterfly needle set should be the last resort when attempting blood collection; however it may become necessary in certain circumstances.
Dermal puncture and venipuncture are similar procedures with the exception of the site of puncture and type of equipment used.
