Blood Collection —Junior Lab Assistant -PSC
BLOOD COLLECTION BY CAPILLARY PUNCTURE
A Blood test is prescribed in most of the blood-related disorders, metabolic disorders and in various infections as well as for the Regular health Check-ups. Whenever a small amount of blood is required for the tests, instead of venipuncture, a capillary puncture is done to collect the sample. In Children and Adults, finger puncture is done to collect the blood sample whereas, in Infants, Heel puncture is done to obtain the specimen.
I) BLOOD COLLECTION BY FINGER PUNCTURE
REQUIREMENTS FOR THE FINGER PUNCTURE
Blood Lancet
Alcohol/Spirit Swab
Surgical Gauze
Microscope Glass Slide
Capillary tube
Glass Marking pencil
All the above-mentioned things should be ready in hand before starting the procedure.
PROCEDURE OF THE FINGER PUNCTURE
⇒ Firstly ensure that the patient should be in a comfortable position.
⇒ Find a spot on the Middle or Ring finger of the left hand (as Most peoples are Right-handed).
⇒ Clean the selected site for the puncture with a sterile cotton swab dipped in 70% Isopropyl Alcohol, to remove the Dust or Epithelial Debris (Dead Cells on Skin).
⇒ Warm up the finger chosen for piercing to increase the blood flow.
⇒ Grasp the finger tightly and do the puncture with a sterile lancet. The puncture should be 2-3 mm deep.
⇒ A quick puncture is made on the site of the finger with a sterile disposable lancet. Don’t squeeze the finger tightly because the liberation of tissue fluid will dilute the blood or hemolysis may occur.
⇒ Wipe out the first drop of blood to avoid tissue fluid contamination & apply gentle pressure to obtain a free flow of blood.
⇒ Blood drops can be taken onto the Clean & grease free glass slide for making the blood smear and for the ABO & Rh blood typing. Bleeding time, Clotting time and other various tests can also be performed using the capillary puncture.
⇒ When the desired amount of blood is obtained, a clean and dry cotton swab should be applied to the puncture site and the patient is instructed to apply the pressure until the blood ceases.
II) BLOOD COLLECTION BY HEEL PUNCTURE
REQUIREMENTS FOR THE HEEL PUNCTURE
Appropriate Blood Lancet for infants
Alcohol/Spirit Swab
Surgical Gauze
Microscope Glass Slide
Capillary tube
Glass Marking pencil
All the above-mentioned things should be ready in hand before starting the procedure.
PROCEDURE OF THE HEEL PUNCTURE
⇒ Heel puncture is in Infants is begin by selecting the appropriate lancet that depends upon the infant’s health such as:
BD microtainer Quikheel lancet, 2.5 mm for Full-term Babies (Green color)
BD microtainer Quikheel lancet, 1.75 mm for Neonatal Babies (Purple color)
Unistik 2 neonatal 18G, 1.2 mm lancet for Neonatal babies less than 1000 gm (Blue color)
⇒ Gently rub the heel to warm it, which increases the blood flow.
⇒ Clean the Lateral/Medial Plantar surface of the foot using spirit swab. Allow it to dry.
⇒ Grasp the foot and using a sterile lancet, press firmly against the heel to make a puncture.
⇒ The first drop contains excess fluid and must be wiped away. Collect the drops of blood into the capillary tube or any collection device by gently squeezing the foot.
⇒ Avoid excessive pressure that may squeeze tissue fluid into the drop of blood or causes bruising.
⇒ When the required amount of blood is collected, hold a gauze pad over the puncture site for a couple of minutes to stop the bleeding, and then tie a gauze piece around the foot.
BLOOD COLLECTION BY VENIPUNCTURE – SYRINGE AND VACUTAINER METHOD
A Blood test is prescribed in most of the blood-related disorders, metabolic disorders and in various infections as well as for the Regular health Check-ups. Whenever a Large amount of blood is required for the tests, venipuncture is done to obtain the blood sample. Venipuncture can be done by two methods:
Syringe method / Open Method
Vacutainer method / Closed method
SYRINGE METHOD OF VENIPUNCTURE
REQUIREMENTS FOR THE BLOOD COLLECTION BY SYRINGE METHOD
Needle
Syringe
Collection vials
Spirit / Alcohol Swab
Tourniquet
Cotton
Needle gauge – For Adults: 20-22 G
Children : 23-24 G
PROCEDURE OF THE BLOOD COLLECTION BY SYRINGE METHOD
⇒ Firstly ensure that the patient should be in the comfortable position.
⇒ Now decide the amount of blood required and select the appropriate vials or containers according to the tests to be done.
⇒ Now ensure the patient what is to be done.
⇒ Lay the arm of the patient on the table.
⇒ Apply the tourniquet and select the prominent vein of the patient from the antecubital fossa (The Basilic, The Cephalic or The Median Cubital Vein).
⇒ Now, Disinfect the selected site for puncture using the Alcohol swab.
⇒ Assemble needle and syringe, check that it is sharp, unblocked and moving smoothly by passing the air through the syringe. But there should not be any air present in the syringe at the time of blood collection.
⇒ With the left hand, hold the patient’s arm so that the skin over the vein gets tightened and more prominent. Ask the patient to make the fist.
⇒ Take the syringe in right hand, holding with the index finger against the base of the needle, keeping the bevel of the needle to the upper side and push firmly & steadily without any hesitation into the center of the vein.
⇒ The angle between the skin and the needle should not be more than 15°-30°. The moment needle enters the vein, blood flows back into the syringe.
⇒ With your left hand, slightly pull back the piston till the required amount of blood is obtained into the syringe.
⇒ Now, remove the Tourniquet, ask the patient to open the fist and place the cotton swab over the needle and wound. Withdraw the needle slowly, and tell the patient to place a cotton swab over the wound until the blood ceases.
⇒ Carefully Remove the needle from the syringe and gently expel the blood into the appropriate vial or container.
⇒ If anticoagulant is used, gently shake the vials for proper mixing of the blood with the anticoagulant.
VACUTAINER METHOD OF VENIPUNCTURE
REQUIREMENTS FOR THE BLOOD COLLECTION BY VACUTAINER METHOD
Vacutainer Needle
Vacutainer Holder
Vacutainer vials/tubes
Spirit / Alcohol Swab
Tourniquet
Cotton
PROCEDURE OF BLOOD COLLECTION BY VACUTAINER METHOD
⇒ Firstly ensure that the patient should be in the comfortable position.
⇒ Now Assemble the vacutainer holder & needle by inserting short end of the vacutainer needle which is covered with the rubber coating into the threaded end of the holder. Screw it tightly using a clockwise motion.
⇒ Now ensure the patients what is to be done.
⇒ Lay the arm of the patient on the table.
⇒ Apply the tourniquet and select the prominent vein of the patient from the antecubital fossa (The Basilic, The Cephalic or The Median Cubital Vein).
⇒ Now, Disinfect the selected site for puncture using the Alcohol swab.
⇒ With the right hand, Grasp the vacutainer unit (Vacutainer holder+needle) and remove the translucent plastic cover from the needle.
⇒ With the left hand, hold the patient’s arm so that the skin over the vein gets tightened and more prominent. Ask the patient to make the fist.
⇒ Place the needle bevel up in the line with the vein, decrease the angle of the needle until it is almost parallel to the skin surface direct the needle towards the vein and pierce the skin and vein wall at approximately at 15°-30° angle.
⇒ Hold the unit & needle steady with your left hand. If the unit and needle are not held steady while pushing in the tube, the needle may slip out of the vein or puncture the opposing vein wall.
⇒ Place the tips of the index and middle fingers of the right hand behind the flange of the vacutainer holder. Push the tube all the way into the holder with your thumb until the needle completely punctures the rubber stopper of the vacutainer tube.
⇒ If the needle is in the vein, the vacuum will draw the blood into the tube.
⇒ When the required amount of the blood obtained, carefully pull the tube downwards, off the tube end of the needle and out of the holder. If more than one specimen is needed, push another tube into the holder. Continue exchanging the tubes until the required no. and amount of blood is obtained for analysis.
⇒ Now Instruct the patient to relax and unclench the fist and release the tourniquet after the required amount of blood is obtained as per the tests to be done and prepare to withdraw the needle.
⇒ Place the cotton swab over the needle and wound, Withdraw the needle smoothly & quickly and immediately apply firm manual pressure over the venipuncture site with the cotton swab, keeping the patient’s arm extended. This aid in the prevention of bruising and edema formation.
⇒ Instruct the patient to apply the pressure over the wound until the blood ceases.
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