Question

1. A 2-year-old child is being held in the parent’s lap to have his blood drawn by venipuncture. Every time you get close to the child, he pulls away from you. He watches you carefully as you get your equipment ready. The receptionist is willing to help, but she cannot draw blood. What would be a good way to make this a successful venipuncture?

2. A 12-year-old boy is sitting in the phlebotomy chair and starts screaming that he does not want his blood drawn. The parents are in the room with you and observe the child’s behavior. There are many patients in the waiting room who can hear the child screaming. Luckily, you have several other phlebotomists at this location. How do you handle the situation?

3. A GTT is being conducted on a patient. One phlebotomist collects the samples using a finger puncture, and the other phlebotomist collects the samples with a venipuncture. How will this cause a problem with the sequential results?

4. A phlebotomist is to collect a post-dose level on a patient at 10:30. The phlebotomist is delayed in the collection and collects the sample at 11:00. To hide the fact that he was late for the collection, the phlebotomist enters 10:30 as the collection time. How will this affect the treatment of the patient?

5. A patient arrives to submit a sample for a chain of custody urine test. Upon entering the restroom, the patient says her 10-year-old daughter must go into the restroom with her because the child is afraid to be left alone. How should you handle this situation?

Answer 1

1. you can ask for receptionist help. First discuss with the parent, the problem you are facing with the child. Repeated withdrawl of the hand can sometimes causes needle stick injuries for both the child and phlebotomist. hence to avoid that particualr risk, ask the parents to change the childs mood and focus by giving some of his favourite toys. Later, ask the receptionist to hold the babys particular area, from where you are planning to collect the blood straight, following all the aseptic techniques. Better use butterfly needles in case of peiatric population, As it is pain less and helps in easy blood withdrawl.Before the prick, if child allows, show him that butterfly needle, and tell him that," i am going to give you a butterfly, look how beautiful it is"...etc. try to make the baby comfort.

2. Give adequate time to the boy. Make him to watch the blood withdrawn procedure that other phlebotomist are doing for adult patients. Usually for adults, when blood is withdrawn, they wont cry. Teach and explain him that like others it wont hurt for him also. Show him the articles you are going to use. Try to win the confidence of the child and appreciate his efforts. Get the parents helps to make him comfort.

3. Usually it better to collect the blood samples of venous blood following a GTT. Here the diagnosis of DM is made by the presence of glucose in the blood. If two mecahnsim of blood collection is used, there will be variations in the blood glucose levels. Either, follow venous blood all the time for collecting blood, or follow finger prick test. Usually when finger prick sample is collected, it incudes the capillary blood. Where in venous blood withdrawl time, blood from a vein is collected. Most of the time, the sugar concentration will be high in capillary blood. Hence there are chances of occuring errors in patients results.

4. It will alter the blood results of the patient. The result become inaccurate and misleading, even it can leads to false Clinical diagnosis of a disease also.This may lead to change the entire tretment plan of the patient. Most of the time this lead to faulty diagnosis.

5. If the phleobotomy unit is free, and no other patients, the phlebotomist can take care of the child, until the mother comes from the toilet. She can get the help of the receptionist and make the child to sit comfortably at the reception.But still the child want to be with the mother, allow mother to take her.