UNIVERSITY OF SANTO TOMAS

FACULTY OF PHARMACY

DEPARTMENT OF MEDICAL TECHNOLOGY

Principles and Strategies of Teaching in Health EducationTEACHING DEMONSTRATION

VENIPUNCTUREOBJECTIVESA. Cognitive Objectives

1. Recognize the legal and ethical importance of proper patient/sample identification.2. Describe the information that should be affixed to a patient sample for identification purposes. 3. Identify potential sites for venipuncture.4. Describe the appropriate types of equipment needed to collect various clinical laboratory blood specimens by venipuncture.5. Identify the various types of anticoagulants used in blood collection and the vacuum tube color-codes for these anticoagulants.6. Describe the appropriate order of drawing additive tubes when performing a venipuncture.B. Affective Objectives

1. Reducing pain from patients2. Considering the age of the patient.3. Tending to the needs of physically and mentally disabled patients.C. Psychomotor Objectives

1. Correctly label a tube with the information that should be affixed to a patient sample for identification purposes. 2. . Locate potential sites for venipuncture on a patient or colleague.3. Describe and perform the steps in the preparation a puncture site.4. Perform an acceptable venipuncture of a patient.VENIPUNCTUREI.OVERVIEW

Venipuncture is the process of obtaining intravenous access for the purpose of intravenous therapyor forblood samplingofvenousblood.II.PRINCIPLE

Venipuncture is an invasive procedure, which carries a small risk to the patient as well as to the phlebotomist. The following techniques and procedures are used to minimize these risks. In addition, procedures for specimen handling are followed in order to preserve specimen integrity. Venipunctureis the collection of blood from a vein, usually for laboratory testing. Most of the time, blood is drawn from a vein located the inside of the elbow or the back of the hand. The site is cleaned with germ-killing medicine (antiseptic).III.MATERIALSA. Blood collecting trays.

B. Gloves

C. Sterile Needles

D. Push Button Winged butterflies

E. Evacuated tubes

F. Tourniquet

G. Antiseptic

H. Clean Gauze

I. Antiseptic

IV.METHOD

A. Identify the patient. Outpatients are called into the phlebotomy area and asked their name and date of birth. This information must match the requisition.

B. Wash hands and put on gloves.

C. Position the patient with the arm extended to form a straight-line form shoulder to wrist.

D. Select the appropriate vein for venipuncture.

E. Apply the tourniquet 3-4 inches above the collection site.

F. Clean the puncture site by making a smooth circular pass over the site with the 70% alcohol pad.

G. Pull the skin tight with your thumb or index finger just below the puncture site.

H. Holding the needle in line with the vein, use a quick, small thrust to penetrate the skin and enter the vein in one smooth motion.

I. Holding the hub securely, insert the first vacutainer tube following proper order of draw into the large end of the hub penetrating the stopper. Blood should flow into the evacuated tube.

J. After blood starts to flow, release the tourniquet and ask the patient to open his or her hand.

K. When blood flow stops, remove the tube by holding the hub securely and pulling the tube off the needle. V.INTERPRETATION:

If a blood sample is not attainable:

A. Reposition the needle to the median cubital.

B. Ensure that the collection tube is completely pushed onto the back of the needle in the hub.

C. Use another tube as vacuum may have been lost.

D. Loosen the tourniquet.

E. Probing is not recommended. In most cases, another puncture in a site below the first site is advised.

F. A patient should never be stuck more than twice unsuccessfully by a phlebotomist.The Supervisor should be called to assess the patient.

REFERENCES

A. Books1. Brown, B. (1993). Hematology: Principles & Procedures 6th edition. Boston: Williams & Wilkins A Waverly company.2. Frankel Ph.D, S., Reitman MD, S., & Sonnenwirth PhD, A. (1970). Gradwhohl's Clinical Laboratory methods & diagnosis 7th edition. Saint Louis: The CV Mosby Company.3. Lewis, S., & Bain, B. (2006). Practical Haematology 10th edition. Philadelphia: Elsevier Ltd.4. McKenzie, S. (1996). Hematology 2nd edition. Boston: Williams & Wilkins A Waverly company.5. Sood, R. (2010). Hematology for students and practitioner 6th edition. New Delhi: Jaypee Brothers Medical Publishers (P) LTD.B. Journal Articles1. Emanuelson, J. (1997, February 14). Needle Phobia. Retrieved from http://www.phlebotomypages.com/needle_phobia.htm2. Bacon, BR et al. (2011). Diagnosis and management of hemochromatosis: 2011 practice guideline by the American Association for the Study of Liver Diseases.C. Internet Sources1. Romito, K. (2012, October 15). Phlebotomy. Retrieved from http://www.webmd.com/a-to-z- guides/phlebotomy

2. Kieche, EL., et al. (2010). Blood Collection: Routine Venipuncture and Specimen Handling. Phlebotomy. Retrieved from http://library.med.utah.edu/WebPath/TUTORIAL/PHLEB/PHLEB.html3. Joanes, N. (2010). History of Phlebotomy. Phlebotomist Certification: Guide to Phlebotomy Career. Retrieved from http://thephlebotomycertification.com/history-of-phlebotomy.htmlACTIVATED PARTIAL THROMBOPLASTIN TIMEASSESSMENT AND EVALUATION

TYPE OF EXAMArrangement Items

NUMBER OF ITEMS5

INSTRUCTION: The following items are followed in performing activated partial thromboplastin time in the laboratory. Arrange the items in sequential order by using letters A, B, C, D, or E.

__________ 1. Keep the reagent in 37 OC for 10 min

__________ 2. Add 0.1 ml of pre-warmed CaCl2 and mix the contents of the tube.__________ 3. Start the stop-watch and record the end point.__________ 4. Add 0.1 ml of plasma and incubate the mixture for 3 min at 37 OC__________ 5. Add 0.1 ml of PTT reagentTYPE OF EXAMMultiple Choice Items

NUMBER OF ITEMS5

INSTUCTION: Choose the best answer by encircling the correct letter of your choice.

1. ___________________________________________________________________

a. ____________

b. ____________

c. ____________

d. ____________6