Question

1. What is the most crucial step in venipuncture procedure? What must be done by the phlebotomist or Medical Technologist in order to avoid making an error for this step?
2. What are the complications encountered during blood draw and how will the phlebotomist should handle it properly?

Answer 1

Most crucial step in Venipuncture:

Venipuncture is the collection of blood from a vein for the laboratory testing.   

Most crucial step in a Venipuncture procedure is patient identification . Proper patient identification procedures has to be used by the Phlebotomist or Medical technologist to ensure the correct patient identification.    After checking the information in the order , phlebotomist should

* Ask the patient full name , if he can respond

* Then check the bracelet or arm band to confirm identification for an inpatient. If the arm band is missing , then the Phlebotomist should not draw the blood from the patient.  

* For an outpatient , ask the patient bith date or surname , other than the name . Official identification card( like license ) also can be checked to confirm the identification.

Misidentification may lead to severe problems like wrong patient, wrong diagnosis, medication errors , wrong prescription etc.

Complications encountered during blood draw:

Very rare complications are there for the Venipuncture procedure, if it is performed according to the standards and steps. Sometimes there are chances to occur complications like hematoma (bruising at the puncture site) , laceration, arterial puncture, fainting and dizziness etc.

* Hematoma: one of the common complications of Venipuncture is hematoma. It is a swelling of blood, usually clotted, which forms as a result of broken blood vessels. As soon it is noted remove the tourniquette and needle and for a minimum 3 minutes , apply the pressure at the site.

To prevent it , remove the tourniquette before removing the needle, use to main superficial veins, pierce only the uppermost wall of the vein.

* nerve injury is rare: use only the required size of the needle. large needles may cause nerve damage, if it is used carelessly.  

* Encourage to drink plenty of fluids and eat a meal , few hours before the Venipuncture to prevent fainting and dizziness. try to distract the patient from looking to the needle, if he or she is anxious.

* Select the site properly and perform the Venipuncture procedure in a proper manner to avoid unnecessary injury and arterial puncture.   Remove the needle in case of hitting an artery and apply the pressure to the site and elevate the wound