basic principles of phlebotomy part vi: capillary draws cls 424 phlebotomy student lab rotation
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Basic Principles of Phlebotomy Part VI:
Capillary Draws
CLS 424 Phlebotomy
Student Lab Rotation
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Skin Puncture:
• Method of choice for infants, children under 1 year
• Adults– Scarred – Fragile veins– Hardened veins– Home glucose monitoring (POCT)– Patients with IV
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Capillary Blood• Mixture of arterial, venous, capillary blood
and fluid from surrounding tissues
• Fluid from surrounding tissues may interfere and/or contaminate the specimen
• Warming skin puncture site increases arterial blood flow to the area
• Reference ranges often differ from venous
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Skin Puncture Equipment:
1. PPE
2. Cleaning agent– Alcohol pads: routine– Soap and water: alcohol testing, allergies– DO NOT use providone iodine
3. Cotton balls, gauze
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Skin Puncture Equipment:
4. Bandage/tape
5. Sharps container
6. Warming device– Commercial warmer– Warm wet washcloth
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Skin Puncture Equipment:
7. Lancet – Always use
standardized equipment
– NEVER use a surgical blade
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Skin Puncture Equipment:8. Micro-specimen
containers– Capillary tubes– Microtainers– Capillary blood gas
tubes– Micropipet diluting
system
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Skin Puncture Equipment:
9. Glass slides:
used to prepare
blood smears
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Skin Puncture Procedure:1. Wash hands
2. Approaching the patient
3. Patient identification
4. Latex allergy?
5. Bedside manner
6. Site selection7. Cleanse site: DO NOT use providone- idodine
8. Perform puncture: Wipe away first drop of blood
9. Label the specimen
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Skin Puncture Site Selection:
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Skin Puncture Procedure:• Hold finger between your index finger and thumb
• Puncture the finger using a quick, smooth motion
• Wipe away the first drop of blood
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Skin Puncture Procedure:• Collect sample
– DO NOT touch collecting device to skin surface– DO NOT scrape collecting device across skin surface– DO NOT scoop blood into collecting device
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Skin Puncture Procedure:• Order of draw is critical: platelets accumulate at
puncture site causing clot formation– Blood smear– EDTA– Heparin– Serum
• Apply pressure to puncture site
• Label specimen in sight of patient (indelible marker)
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