Basic Principles of Phlebotomy Part III:Safety & Equipment

CLS 424 Phlebotomy

Student Lab Rotation

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Safety Practices:

For infection to spread:

1. Infectious substance: HBV, HCV, HIV

2. Mode of transmission

3. Susceptible host

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Modes of Transmission:

• Parenteral: any route other than the digestive tract– Intramuscular– Intravenous– Subcutaneous– Mucosal

• Ingestion

Non-intact skin: chapped hands, cuts, cuticles

Percutaneous: needles, sharps

Permucosal: mouth, nose, eyes

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Safety Practices:

Infection Control: stop the spread of infection

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Safety: Infection Control• Hand washing

– Primary means of preventing spread of infection (especially nosocomial)

– Minimum 15 seconds, soap, friction– Wash hands before and after each blood draw

• PPE– Lab coat– Gloves– Mask

• Standard precautions at all times

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Safety: Engineering Controls

• PPE• Sharps containers• Safer medical devices

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Safer Medical Devices:

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Equipment:

1. PPE: gloves, lab coat, mask

2. Cleaning agent– Alcohol pads: routine– Povidone iodine: blood culture collection and

blood gases– Soap and water: alcohol testing, allergies

3. Cotton balls, gauze

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Equipment: 4. Bandage, tape (use caution with children)

5. Sharps container: – Discard needles,

lancets– Biohazard marking– Puncture resistant

– NEVER recap, bendbreak needles

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Equipment:

6. Tourniquets:– Slows venous blood flow down– Causes veins to become more prominent– NEVER leave on for >1 minute – AVOID rigorous fist clenching or hand

pumping (potassium, lactic acid, LD)– Latex allergy

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Tying on the Tourniquet:

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Equipment:

7. Needles– NEVER reuse a needle– NEVER use if shield is broken– NEVER recap, cut, bend or break

– Drop immediately into sharps container after venipuncture

– Size of needle is indicated by gauge:• Larger gauge number indicates smaller needle diameter• 21, 23 gauge needles routinely used for phlebotomy

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Needles:

Used with syringe system Used with vacutainer system

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Multi-sample Needle:

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Butterfly Needle:

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Butterfly Needle:• Most often used with

syringe

• Expensive, thus not used for routine draws

• Used for small, fragile veins

• Increased risk of needle stick injury

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Equipment:

8. Tube holder/

vacutainer adapter

– Threaded– Flanges

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Equipment:

9. Syringe

10. Black

water proof

pen

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Syringe Safety Device:

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Labeling Blood Collection Tubes:

• Black indelible marker (water proof)– Never pencil– Legal document– Print legibly

• Required information: 5 items– Patient name– Identification number– Date of draw (mm,dd,yyyy)– Time of draw (military time)– Phlebotomist signature: first initial, last name

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Vacutainer or Syringe?

• Vacutainer– Most often used– Most economical– Quick– Least risk of accidental needle stick

• Syringe– More control– Reposition easily– Will see ‘flash’ of blood in syringe hub when

vein successfully entered