Phlebotomy Protocol

Since I haven't gone over this in a really long time since I had this class in September I thought I would post the steps on how to draw blood off a patient. It's interesting for someone to read and it refreshes my memory!

1. Introduce yourself to the patient
2. Patient Identification *** Very Important! *** Always check the wristband because the patient could be lying. And make sure the wristband is actually on their wrist. Make sure the bar code matches the one that you were given
3. Assemble all your equipment! (Vacutainers, alcohol swab, needle, tourniquet, gloves etc.)
4. Put on your gloves
5. Place the evacuated tube into the holder (Do not push tube all the way down or else the vacuum inside will become useless)
6. Choose a site for venipuncture. The 3 veins used are the cephalic, basilic and the median cubital. The median cubital is the one that you should always try to use first.
7. Apply the tourniquet and do not leave it on for any longer than 2 minutes as it can affect the results of some analytes.
8. To make the vein stand out ask the patient to make a fist and palpate it.
9. Use an alcohol swab and cleanse the area (use a circular outward motion) and allow it to dry ( do not retouch the site after it's cleansed).
10.  Assemble the evacuated tube, position the patients arm downwards and using a finger from the opposite hand place it below the venipuncture site in order to keep the skin in place.
11.  Position the needle at an angle of 45 degrees and make sure the bevel of the needle is facing upwards.
12. Insert the needle (should be one smooth motion) and carefully push the vacutainer into the needle holder unit. (Try and stay steady). **The tourniquet can be released as soon as blood flow begins**. Multiple samples can be drawn (make sure they are done in the correct order). If there is an anticoagulant or additive in the tubes invert them the specified amount of times.
13. Remove the needle/blood collecting unit with one hand and with the other immediately apply a gauze pad on the site and apply pressure (you can get the patient to hold it in place if possible).
14. Offer them a band-aid.
15. Discard equipment in sharps container.
16. Label all test tubes and fill out the test requisition.
17. Clean work area and wash hands.
18.  Make sure patient is not feeling dizzy or ill before leaving the room.