Phlebotomy Pages 
A guide dedicated to students and professionals in phlebotomy!
A guide dedicated to students and professionals in phlebotomy!
ROLL UP YOUR SLEEVES AND LEARN PHLEBOTOMY NOW....
Medical Assistant, Health Care, and Phlebotomy Training Programs! 
Begin your path to an exciting new career! See schools in your local ZIP code area, or select "Show All" to view various health career programs both ON campus AND online.
Blood Collection via Capillary Puncture Technique...
|
|
FingerstickNormally the most desirable site for obtaining a blood sample for laboratory testing is from the veins of the antecubital fossa area, i.e. the bend of the elbow of the arm. This technique is useful for adults or children when only small amounts of blood will suffice. A capillary puncture may be used when venipuncture would be too invasive or not possible because:
the patient has poor veins not suitable for a venipuncture the patient has only one good vein that must be saved for another procedure the patient is extremely apprehensive about the venipuncture procedure the patient has extensive scar tissue, bruising, obesity, or mastectomy
Blood Collection via Capillary Puncture TechniqueIn general, capillary punctures may be done on earlobes, fingertips, heels, or toes, however, heels and toes are not a site of choice, especially in adults.
Heel areas are almost exclusively used with neonates and younger infants. Heels and toes of adults tend to be extremely calloused and tough.
Earlobes have only a few capillaries and there seems to be some difference in the cell concentration between capillary blood taken from the earlobe and blood taken directly from a vein.
The site of choice in older children as well as adults is the distal lateral aspect of the fingertip; usually the second or third finger.
When obtaining a sample from the fingertip and especially a series of samples it should be from the non-dominant hand with the arm in the anatomical position and the hand below the heart.
A patient should be offered the option to return to the office on a different day for another try after two failed attempts of finding the vein. Going to the local hospital, a health care facility, or a freestanding reference laboratory where more experienced phlebotomists are drawing blood could also be discussed as an option.
REMEMBER:
After cleaning the site with alcohol, ensure the site is thoroughly dryAllow the free flowing blood to form a drop and touch the collection tube to the dropGently mix the micro-collection tubes containing anticoagulant to prevent hemolysisGeneral Guidelines For Obtaining A Blood Sample When Using A Lancet:
The middle or ring finger is best used for this sort of blood collection. If the patient's hands are cold, they may be warmed by holding them under warm running water or by briskly rubbing them. You can invite the patient to step to the lavatory and wash the hands with warm soapy water. This will not only cleanse and soften the skin but simultaneously effectively increase the blood flow to the fingers.
Massage the finger from hand to tip 5-6 times to increase the blood flow. This maneuver can be best described as gently milking the finger -- not squeezing it! However, be careful not to over-do it as it may cause erroneous results due to concentration of tissue fluids.
Cleanse the selected fingertip with 70% isopropyl alcohol to remove all dirt, sweat, lotions, and invisible microorganisms. Wipe dry with a clean, dry piece of gauze or cotton. Before piercing be sure that the finger is thoroughly dry. If the puncture site is still moist the blood will not well up but begin to run. What you want is a well rounded drop of blood sitting on the finger tip.
If you are using a lancet, remove the lancet from its container and grasp the lancet between the thumb and forefinger. If you are using a finger puncture device, you will need to refer to the instructions for the device you are using.
If using a finger grasp the patient's finger firmly between the fingers and thumb of your other hand. If using an earlobe, support it from behind with your fingers of the opposite hand and pierce the fleshy outer rim of the earlobe with a lancet.
With a quick stabbing wrist motion -- down and right back up -- make a puncture lateral to the ball of the finger. Using this area avoids the nerves of the fingertip and thus avoids unnecessary pain. The cut should be perpendicular to the lines in the fingerprint so that the blood will form a drop. Punctures made parallel to the fingerprint lines will allow blood to run down the finger.
Using the hands supporting the finger, squeeze it lightly to stimulate the flow of blood. "Milking" the finger from proximal toward the distal end will also be effective in getting a good blood flow. Be careful not to cause erroneous results due to introduction of tissue fluids. The cut should be deep enough so that hard pressure is not required. If gentle pressure is not enough to start blood flow, make another puncture starting at step #4.
Using a piece of dry, clean 2x2 cotton gauze square or similar pad, wipe off the first drop of blood, as this drop may be contaminated with tissue fluid and this may interfere with the test.
Still holding the finger lightly, fill a (heparinized) capillary pipette or other collecting device. The capillary pipette should be held in an almost horizontal position with the tip touching the drop of blood. The tube should not be allowed to touch the finger. Should more blood be needed, a small test tube or commercial micro tube may be held beneath the finger andblood dropped into it.
1. If the capillary tube is open at both ends(a) Use your gloved finger to cover the top end opening
(b) hold the capillary tube horizontally and touch the open end to the drop of blood
(c) the blood will flow into the tube by capillary action
(d) make sure the blood rises to the top line; there should be no air bubbles
2. If the capillary tube is plastic and closed at one end(a) squeeze the tube or bulb, and hold the tube horizontally while
touching the open end to the drop of blood
(b) gently release pressure on the tube or bulb to draw up the blood
(c) make sure the blood rises to the top line; without any air bubbles
When sufficient blood has been obtained, place a clean, dry gauze pad or cotton ball over the site and have the patient press with the thumb on the same hand until bleeding has stopped.
Discard used capillary tubes and lancets in a sharps bin and drop contaminated swabs and tissues and all non-sharp materials into a biohazard bag.Read more:
|
Are You Cut Out To Be A Phlebotomist?The first step when deciding on a fitting career is to take time to assess what you do well. It's also important to explore the educational, training, and career opportunities available in your particular area first. Take the MAPP Career Assessment to identify your strengths.
More Phlebotomy Chapters:
|
||||
 |
||||
Learning Phlebotomy:
|
|
Phlebotomy Skills Review:
|
|
Blood Collection Review:
|
|
|
|
|
|
Blood Collection via Capillary Puncture Technique
|
The Blood PanelThank You For Linking To Us!
Title: Plebotomy Pages For Phlebotmists
Description: Offers phlebotomy career tips, tutorials and video footage on how to draw blood.
Location: www.phlebotomypages.com
Home | What is a Phlebotomist | Phlebotomist's Duties | Job Responsibilities | Retaining Skilled Phlebotomists | Tips From The Pros | A Phlebotomist's Story | Phlebotomist Forum - My Phlebotomy Community | Helpful Links | Reciprocal Link Partners | Site Index
Disclaimer: Phlebotomy Pages at phlebotomypages.com has been voted the most comprehensive phlebotomy Website. It features tons of freely accessible phlebotomy tutorials, venipuncture reviews, blood draw videos, and jobs.Howerver, be cautioned that the resources offered may not apply to your own situation, or be totally current at any given time. Phlebotomy Pages and all of its current and past experts, sponsors, advertisers, agents, contractors and advisors disclaim all warranties with regards to anything found anywhere on this Website, quoted from, or sent from phlebotomypages.com and its related sites, publications and companies. Phlebotomy Pages also takes no responsibility for comments published by others on this site or in the Phlebotomy Forum.
Limitations: In no event shall Danni R., the owner and webmaster of Phlebotomy Pages be liable for any damages of any kind or character, including without limitation any compensatory, incidental, direct, indirect, special, punitive, or consequential damages, loss of use, loss of data, loss of income or profit, employment, claims of third parties, or other losses of any kind or character, even if Danni R. has been advised of the possibility of such damages or losses, arising out of or in connection with the use of this Website or any Website to or from which it is linked!© 2003-2008 Advanced Medical Assistant Custom Web Design, LLC. All rights reserved.