Phlebotomy Procedure Performing Venipuncture

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					                              Chapter 6   Phlebotomy


Procedure 29 Performing A Venipuncture

Procedure 30 Collecting A Blood Specimen Using The Vacuum-Tube System

Procedure 31 Collecting A Blood Specimen Using A Needle And Syringe

Procedure 32 Collecting A Blood Specimen Using A Butterfly Needle And Syringe

Procedure 33 Collecting A Blood Culture

Procedure 34 Drawing Blood Using A Lancet For A Microdraw Or Infant Heel Stick

Procedure 35 Measuring Bleeding Time
                                       PERFORMANCE REVIEW CHECKLIST
Procedure 29
Performing A Venipuncture
Name of Patient Care Technician ________________________ Date of Program ______ to ______
Social Security Number or Identification Number _______________________________
Program Code Number (if any) _________________
S=Satisfactory Performance
U=Unsatisfactory Performance
Place a full signature to correspond with each set of initials appearing below.

         Initials           Corresponding Signature of Instructor                           Title




Supplies needed:
•        Disposable exam gloves
•        2 x 2 gauze pads
•        Alcohol or povidone-iodine sponges
•        Tourniquet
•        Puncture-resistant needle disposal container
•        Syringe method:
         — 10-mL syringe
         — Sterile needles: 20–21 gauge for adults, or 23-gauge butterfly
•        Vacuum-tube method:
         — Vacuum tube with needle holder
         — Sterile double-needles: 20–21 gauge for adults, 23–25 gauge for children
•        Plastic bag for used supplies
•        Adhesive bandage

                    Procedure Guidelines                   S/U      Date   Initials   S/U       Date   Initials

    1.       Perform your beginning procedure
             actions.

    2.       Apply a tourniquet and locate a vein.
             Select the largest, most stable vein in the
             area. When palpated, the site will feel
             firm and rebound slightly.

    3.       Release the tourniquet.
             Procedure Guidelines                 S/U   Date   Initials   S/U   Date   Initials

4.    Cleanse the site with alcohol. Wipe in a
      circular motion. Begin in the center of
      the venipuncture site and extend the
      circle out 2 inches in diameter.

5.    Allow the alcohol or other skin prep to
      dry thoroughly.

6.    Reapply the tourniquet, taking care not
      to bump or touch the prepped skin area.

7.    Remove the needle cover, holding the
      needle bevel facing up in your dominant
      hand.

8.    Stabilize the vein by holding it with
      your nondominant thumb,
      approximately 1 inch below the
      puncture site. Warn the patient that he
      or she will feel a stick.

9.    With the needle at a 15-degree angle,
      slowly enter the patient’s vein. You will
      feel a change of pressure when it enters
      the vein. Slowly advance the needle 1⁄4
      inch.

10.   Release the tourniquet by pulling the
      upper end downward, before removing
      the needle. If you are releasing the
      tourniquet while filling tubes, hold the
      collection device securely. Avoid pulling
      upward, as this may cause the needle to
      come out of the patient’s arm.

11.   Continue the procedure by obtaining
      the blood specimen with the syringe or
      vacuum method or starting the
      intravenous infusion.

12.   Place a 2 x 2 gauze pad over the
      insertion site. Avoid using cotton balls.
      Cotton balls tend to stick to the
      venipuncture site and, when removed,
      remove the platelet plug, causing
      bleeding.
13.   Quickly withdraw the needle.
      Immediately apply pressure on the
      insertion site. Maintain the pressure for
      2 to 3 minutes, or longer, until bleeding
      stops.

14.   Cover the puncture site with an
      adhesive bandage.
             Procedure Guidelines                 S/U     Date   Initials   S/U   Date   Initials

 15.   Discard the needle in the puncture-
       resistant container.

 16.   Perform your procedure completion
       actions.




__________________________________           _______________
        Instructor Signature                      Date


__________________________________           _______________
         Student Signature                        Date
                                    PERFORMANCE REVIEW CHECKLIST
Procedure 30
Collecting A Blood Specimen Using The Vacuum-Tube System
Name of Patient Care Technician ________________________ Date of Program ______ to ______
Social Security Number or Identification Number _______________________________
Program Code Number (if any) _________________
S=Satisfactory Performance
U=Unsatisfactory Performance
Place a full signature to correspond with each set of initials appearing below.

         Initials          Corresponding Signature of Instructor                           Title




Supplies needed:
•        Disposable exam gloves
•        2 x 2 gauze pads
•        Alcohol or povidone-iodine sponges
•        Tourniquet
•        Blood collection tubes
•        Labels for collection tubes
•        Permanent black pen for labeling tubes
•        Laboratory requisition forms
•        Puncture-resistant needle disposal container
•        Vacuum tubes with needle holder
•        Sterile double-needles: 20–21 gauge for adults, 23–25 gauge for children
•        Plastic bag for used supplies
•        Bandage

                    Procedure Guidelines                S/U        Date   Initials   S/U       Date   Initials

    1.       Perform your beginning procedure
             actions.

    2.       Assemble the needle and tube holder.

    3.       Check the requisition slip to determine
             what test to collect. Select the proper
             tubes. Position the specimen collection
             tubes in the order in which they will be
             drawn.
             Procedure Guidelines                   S/U   Date   Initials   S/U   Date   Initials

4.    Apply a tourniquet and locate a vein.
      Select the largest, most stable vein in the
      area. When palpated, the site should feel
      firm and rebound slightly.

5.    Release the tourniquet.

6.    Cleanse the site with alcohol. Wipe in a
      circular motion. Begin in the center of
      the venipuncture site and extend the
      circle out 2 inches in diameter.

7.    Allow the alcohol or other skin prep to
      dry thoroughly.

8.    Reapply the tourniquet, taking care not
      to bump or touch the prepped skin area.

9.    Remove the needle cover, holding the
      needle bevel facing up in your dominant
      hand.

10.   Stabilize the vein by holding it with
      your nondominant thumb,
      approximately 1 inch below the
      puncture site. Warn the patient that he
      or she will feel a stick.

11.   With the needle at a 15-degree angle,
      slowly enter the patient’s vein. You will
      feel a change of pressure when the
      needle enters the vein. Slowly advance
      the needle 1⁄4 inch.

12.   Rest your dominant hand on the
      patient’s arm. Gently insert the first
      collection tube into the holder, and
      push forward gently to pierce the rubber
      stopper. Make sure that the needle does
      not move. Blood should begin to flow.

13.   Release the tourniquet as soon as blood
      begins to flow. Hold the collection
      device securely, then pull the upper end
      of the tourniquet downward. Avoid
      pulling upward, as this may cause the
      needle to come out of the patient’s arm.

14.   When the tube has finished filling, grasp
      the end of the tube, pushing off the
      flange with your thumb.

15.   Gently invert additive tubes 10 to 12
      times, then insert the next tube. Repeat
      until all tubes are filled with blood.
              Procedure Guidelines                  S/U     Date   Initials   S/U   Date   Initials

 16.   Remove the last tube drawn from the
       holder.

 17.   Place a 2 x 2 gauze pad over the
       insertion site. Avoid using cotton balls.
       Cotton balls tend to stick to the
       venipuncture site and, when removed,
       remove the platelet plug, causing
       bleeding.

 18.   Quickly withdraw the needle.
       Immediately apply pressure on the
       insertion site. Maintain the pressure for
       2 to 3 minutes, or longer, until bleeding
       stops.

 19.   Cover the puncture site with a bandage.

 20.   Discard the needle in the puncture-
       resistant container.

 21.   Label the tubes according to facility
       policy.

 22.   Perform your procedure completion
       actions.




__________________________________             _______________
        Instructor Signature                        Date


__________________________________             _______________
         Student Signature                          Date
                                    PERFORMANCE REVIEW CHECKLIST
Procedure 31
Collecting A Blood Specimen Using A Needle And Syringe
Name of Patient Care Technician ________________________ Date of Program ______ to ______
Social Security Number or Identification Number _______________________________
Program Code Number (if any) _________________
S=Satisfactory Performance
U=Unsatisfactory Performance
Place a full signature to correspond with each set of initials appearing below.

         Initials          Corresponding Signature of Instructor                           Title




Supplies needed:
•        Disposable exam gloves, 2 pairs
•        Face shield or goggles
•        Surgical mask
•        Fluid-resistant gown or lab coat
•        2 x 2 gauze pads
•        Alcohol or povidone-iodine sponges
•        Tourniquet
•        10-mL syringe
•        Sterile needles, 20–22 gauge
•        Kelly clamp
•        Blood collection tubes
•        Labels for collection tubes
•        Permanent black pen for labeling tubes
•        Laboratory requisition forms
•        Puncture-resistant needle disposal container
•        Plastic bag for used supplies
•        Bandage

                    Procedure Guidelines                S/U        Date   Initials   S/U       Date   Initials

    1.       Perform your beginning procedure
             actions.

    2.       Check the requisition slip to determine
             what specimen to collect. Select the
             proper tubes.
             Procedure Guidelines                   S/U   Date   Initials   S/U   Date   Initials

3.    Assemble the needle and syringe. Move
      the plunger back and forth to break the
      seal.

4.    Apply a tourniquet and locate a vein.
      Select the largest, most stable vein in the
      area. When palpated, the site should feel
      firm and rebound slightly.

5.    Release the tourniquet.

6.    Cleanse the site with alcohol. Wipe in a
      circular motion. Begin in the center of
      the venipuncture site and extend the
      circle out 2 inches in diameter.

7.    Allow the alcohol or other skin prep to
      dry thoroughly.

8.    Reapply the tourniquet, taking care not
      to bump or touch the prepped skin area.

9.    Remove the needle cover, holding the
      needle bevel facing up in your dominant
      hand.

10.   Stabilize the vein by holding it with
      your nondominant thumb,
      approximately 1 inch below the
      puncture site. Warn the patient that he
      or she will feel a stick.

11.   With the needle at a 15-degree angle,
      slowly enter the patient’s vein. You will
      feel a change of pressure when the
      needle enters the vein. Slowly advance
      the needle 1⁄4 inch.

12.   Rest your dominant hand on the
      patient’s arm. Make sure that the needle
      does not move. Blood should begin to
      flow into the hub of the needle.

13.   Release the tourniquet as soon as blood
      begins to flow. Hold the collection
      device securely, then pull the upper end
      of the tourniquet downward. Avoid
      pulling upward, as this may cause the
      needle to come out of the patient’s arm.

14.   Holding the syringe with the dominant
      hand, slowly pull back on the plunger
      with the nondominant hand, filling the
      syringe with blood.
              Procedure Guidelines                     S/U     Date   Initials   S/U   Date   Initials

 15.   Place a 2 x 2 gauze pad over the
       insertion site. Avoid using cotton balls.
       Cotton balls tend to stick to the
       venipuncture site and, when removed,
       remove the platelet plug, causing
       bleeding.

 16.   Quickly withdraw the needle. Immediately
       apply pressure on the insertion site.
       Maintain the pressure for 2 to 3 minutes,
       or longer until bleeding stops.
 17.   Cover the puncture site with a bandage.
 18.   Remove the needle using the Kelly
       clamp, if this is your facility policy.
       Discard the needle in the puncture-
       resistant container. (This is not necessary
       if you will transfer the blood in the
       patient’s room.)

 19.   Open the 20-gauge needle and attach it
       to the syringe.

 20.   Perform your procedure completion
       actions.

 21.   After leaving the room, apply full
       personal protective equipment.

 22.   Transfer the blood to the vacuum tubes
       in a rack by inserting the needle through
       the rubber stopper, allowing the tube to
       fill. Allow the rack to support the tube
       when the needle is inserted. Avoid
       holding it with your hand.

 23.   Fill the tubes in the order of the draw.

 24.   Gently invert the tube several times to
       mix the sample. Avoid shaking.

 25.   Discard the needle and syringe in the
       puncture-resistant container.

 26.   Label the tubes according to facility policy.

 27.   Transport the blood to the lab, following
       facility policy.



__________________________________                _______________
        Instructor Signature                           Date

__________________________________                _______________
         Student Signature                             Date
                                    PERFORMANCE REVIEW CHECKLIST
Procedure 32
Collecting A Blood Specimen Using A Butterfly Needle And Syringe
Name of Patient Care Technician ________________________ Date of Program ______ to ______
Social Security Number or Identification Number _______________________________
Program Code Number (if any) _________________
S=Satisfactory Performance
U=Unsatisfactory Performance
Place a full signature to correspond with each set of initials appearing below.

         Initials          Corresponding Signature of Instructor                           Title




Supplies needed:
•        Disposable exam gloves, 2 pairs
•        Face shield or goggles
•        Surgical mask
•        Fluid-resistant gown or lab coat
•        2 x 2 gauze pads
•        Alcohol or povidone-iodine sponges
•        Tourniquet
•        10-mL syringe
•        Sterile 23-gauge butterfly needle
•        Sterile 20-gauge needle
•        Bandage tape to secure the butterfly in place
•        Blood collection tubes
•        Labels for collection tubes
•        Permanent black pen for labeling tubes
•        Laboratory requisition forms
•        Puncture-resistant needle disposal container
•        Plastic bag for used supplies
•        Bandage

                    Procedure Guidelines                S/U        Date   Initials   S/U       Date   Initials

    1.       Perform your beginning procedure
             actions.

    2.       Check the requisition slip to determine
             what specimen to collect. Select the
             proper tubes.
             Procedure Guidelines                   S/U   Date   Initials   S/U   Date   Initials

3.    Assemble the needle and syringe. Uncoil
      the butterfly tubing. Move the plunger
      back and forth to break the seal.

4.    Apply a tourniquet and locate a vein.
      Select the largest, most stable vein in the
      area. When palpated, the site should feel
      firm and rebound slightly.

5.    Release the tourniquet.

6.    Cleanse the site with alcohol. Wipe in a
      circular motion. Begin in the center of
      the venipuncture site and extend the
      circle out 2 inches in diameter.

7.    Allow the alcohol or other skin prep to
      dry thoroughly.

8.    Reapply the tourniquet, taking care not
      to bump or touch the prepped skin area.

9.    Remove the needle cover, holding the
      needle by the wings, with the bevel
      facing up, in your dominant hand.

10.   Stabilize the vein by holding it with
      your nondominant thumb,
      approximately 1 inch below the
      puncture site. Warn the patient that he
      or she will feel a stick.

11.   With the needle at a 15-degree angle,
      slowly enter the patient’s vein. You will
      feel a change of pressure when the
      needle enters the vein. Slowly advance
      the needle 1⁄4 inch.

12.   Rest your dominant hand on the
      patient’s arm. Make sure that the needle
      does not move. Blood should begin to
      flow into the attached tubing.

13.   Gently tape the butterfly wings against
      the skin to hold the needle in place.

14.   Release the tourniquet as soon as blood
      is obtained. Pull the upper end of the
      tourniquet downward. Avoid pulling
      upward, as this may cause the needle to
      come out of the patient’s arm.

15.   Holding the syringe with the dominant
      hand, slowly pull back on the plunger,
      filling the syringe with blood.
              Procedure Guidelines                     S/U     Date   Initials   S/U   Date   Initials

 16.   Place a 2 x 2 gauze pad over the
       insertion site. Avoid using cotton balls.
       Cotton balls tend to stick to the
       venipuncture site and, when removed,
       remove the platelet plug, causing
       bleeding.

 17.   Quickly withdraw the needle.
       Immediately apply pressure on the
       insertion site. Maintain the pressure for
       2 to 3 minutes, or longer until bleeding
       stops.

 18.   Cover the puncture site with a bandage.

 19.   Remove the butterfly and tubing from
       the syringe. Carefully discard them in
       the puncture-resistant container.

 20.   Open the package for the 20-gauge
       needle and attach the needle to the
       syringe.

 21.   Perform your procedure completion
       actions.

 22.   After leaving the room, apply full
       personal protective equipment.

 23.   Transfer the blood to the vacuum tubes
       in a rack by inserting the needle through
       the rubber stopper, allowing the tube to
       fill. Allow the rack to support the tube
       when the needle is inserted. Avoid
       holding it with your hand.

 24.   Fill the tubes in the order of the draw.

 25.   Gently invert the tubes several times to
       mix the samples. Avoid shaking.

 26.   Discard the needle and syringe in the
       puncture-resistant container.

 27.   Label the tubes according to facility
       policy.

 28.   Transport the blood to the lab, following
       facility policy.



__________________________________                _______________
        Instructor Signature                           Date

__________________________________                _______________
         Student Signature                             Date
                                    PERFORMANCE REVIEW CHECKLIST
Procedure 33
Collecting A Blood Culture
Name of Patient Care Technician ________________________ Date of Program ______ to ______
Social Security Number or Identification Number _______________________________
Program Code Number (if any) _________________
S=Satisfactory Performance
U=Unsatisfactory Performance
Place a full signature to correspond with each set of initials appearing below.

         Initials          Corresponding Signature of Instructor                           Title




Supplies needed:
•        Sterile gloves
•        Disposable exam gloves
•        Face shield or goggles
•        Surgical mask
•        Fluid-resistant gown or lab coat
•        2 x 2 gauze pads
•        Alcohol sponges or blood culture prep kit
•        Tourniquet
•        20-mL syringe
•        Sterile needles: 20–22 gauge or 23–25 gauge butterfly
•        Blood culture collection bottles
•        Labels for collection bottles
•        Permanent black pen for labeling bottles
•        Laboratory requisition forms
•        Puncture-resistant needle disposal container
•        Plastic bag for used supplies
•        Bandage

                    Procedure Guidelines                S/U        Date   Initials   S/U       Date   Initials

    1.       Perform your beginning procedure
             actions.

    2.       Check the requisition slip to determine
             what specimen to collect. Select the
             proper supplies.
             Procedure Guidelines                   S/U   Date   Initials   S/U   Date   Initials

3.    Assemble the needle and syringe. Move
      the plunger back and forth to break the
      seal.

4.    Apply a tourniquet and locate a vein.
      Select the largest, most stable vein in the
      area. When palpated, the site should feel
      firm and rebound slightly.

5.    Release the tourniquet.

6.    Cleanse the site with alcohol. Wipe in a
      circular motion. Begin in the center of
      the venipuncture site and extend the
      circle out 3 inches in diameter. Repeat
      the cleansing procedure twice. Use a
      clean swab each time you cleanse the
      skin.

7.    Allow the alcohol to dry thoroughly.

8.    Reapply the tourniquet, taking care not
      to bump or touch the prepped skin area.

9.    Remove the needle cover, holding the
      needle bevel facing up in your dominant
      hand.

10.   Stabilize the vein by holding it with
      your nondominant thumb,
      approximately 1 inch below the
      puncture site. Warn the patient that he
      or she will feel a stick.

11.   With the needle at a 15-degree angle,
      slowly enter the patient’s vein. You will
      feel a change of pressure when the
      needle enters the vein. Slowly advance
      the needle 1⁄4 inch.

12.   Rest your dominant hand on the
      patient’s arm. Make sure that the needle
      does not move. Blood should begin to
      flow into the hub of the needle.

13.   Release the tourniquet as soon as blood
      is obtained. Hold the collection device
      securely, then pull the upper end of the
      tourniquet downward. Avoid pulling
      upward, as this may cause the needle to
      come out of the patient’s arm.

14.   Holding the syringe with the dominant
      hand, slowly pull back on the plunger
      with the nondominant hand,
      withdrawing the required amount of
      blood.
              Procedure Guidelines                    S/U     Date   Initials   S/U   Date   Initials

 15.   Place a 2 x 2 gauze pad over the insertion
       site. Avoid using cotton balls. Cotton
       balls tend to stick to the venipuncture
       site and, when removed, remove the
       platelet plug, causing bleeding.

 16.   Quickly withdraw the needle. Immedi-
       ately apply pressure on the insertion
       site. Maintain the pressure for 2 to 3
       minutes, or longer until bleeding stops.

 17.   Cover the puncture site with a bandage.
 18.   Using a Kelly or other instrument,
       carefully remove the needle from the
       syringe, and discard the needle in the
       puncture-resistant container. Apply a
       sterile needle.

 19.   Apply full protective equipment, includ-
       ing gown, face shield, mask, and gloves.

 20.   Snap the caps off the culture bottles.

 21.   Cleanse the rubber stoppers well, using
       alcohol. Wipe in a circular motion. Use a
       new sponge for each bottle. Allow to dry
       thoroughly.

 22.   Remove the cap from the sterile needle
       and pierce the rubber stopper of the
       anaerobic bottle. Slowly depress the
       plunger, filling the bottle with the
       appropriate amount of blood. Withdraw
       the needle and repeat with the aerobic
       bottle. Inject slowly, and exercise care to
       avoid injecting air into either bottle.

 23.   Discard the needle and syringe in the
       puncture-resistant container.

 24.   Label the bottles according to facility
       policy.

 25.   Perform your procedure completion
       actions.

 26.   Transport the samples to the laboratory
       immediately in a plastic transport bag,
       or according to facility policy.


__________________________________               _______________
        Instructor Signature                          Date
__________________________________               _______________
         Student Signature                            Date
                                     PERFORMANCE REVIEW CHECKLIST
Procedure 34
Drawing Blood Using A Lancet For A Microdraw Or Infant Heel Stick
Name of Patient Care Technician ________________________ Date of Program ______ to ______
Social Security Number or Identification Number _______________________________
Program Code Number (if any) _________________
S=Satisfactory Performance
U=Unsatisfactory Performance
Place a full signature to correspond with each set of initials appearing below.

         Initials          Corresponding Signature of Instructor                           Title




Supplies needed:
•        Disposable exam gloves
•        Alcohol or povidone-iodine sponges
•        Lancets
•        Microvette collection devices
•        2 3 2 gauze pads
•        Labels for collection devices
•        Permanent black pen for labels
•        Laboratory requisition forms
•        Puncture-resistant needle disposal container
•        Plastic bag for used supplies
•        Bandage or spot adhesive bandage

                    Procedure Guidelines                S/U        Date   Initials   S/U       Date   Initials

    1.       Perform your beginning procedure
             actions. Check the requisition slip to
             determine what specimen to collect.
             Select the proper supplies.

    2.       Identify the specimen collection site.

    3.       Cleanse the site with alcohol. Wipe in a
             circular motion. Begin in the center of
             the puncture site and extend the circle
             out 2 inches in diameter.

    4.       Allow the alcohol or other skin prep to
             dry.
             Procedure Guidelines                    S/U   Date   Initials   S/U   Date   Initials

5.    Hold the plastic end of the lancet in
      your dominant hand. With your
      nondominant hand, break the plastic
      cover off the end to expose the needle.

6.    Hold the lancet at a 45-degree angle.
      With the sharp end of the lancet, pierce
      the skin. For an adult fingerstick, make
      the stick perpendicular to the lines in
      the fingerprints. Follow the directions
      for the type of lancet you are using. If
      the lancet has a plunger, depress it to
      pierce the skin while holding pressure
      on the site.

7.    Remove the lancet. Discard it in the
      puncture-resistant sharps container.

8.    Wipe the first drop of blood away with a
      sterile 2 x 2 sponge. You will need the
      rest to fill the containers.

9.    Hold the collection tube near the
      puncture site. Position the tube almost
      horizontally, with the end slightly
      down. Squeeze the skin slightly, allowing
      blood to flow into the tube. Do not
      squeeze hard, as this forces tissue fluid
      into the sample, diluting it. If blood
      does not flow freely, create suction by
      placing your gloved finger over the end
      of the capillary tube, or by squeezing the
      small bulb. Fill the tube approximately
      2⁄3 to 3⁄4 full. Usually, two or three tubes
      are filled.

10.   Apply gentle pressure with the 2 x 2
      gauze to the skin to prevent painful
      bleeding inside the tissues. The patient
      can hold the gauze sponge in place until
      the bleeding stops. Avoid using cotton
      balls. Cotton balls tend to stick to the
      puncture site and, when removed,
      remove the platelet plug, causing
      bleeding.

11.   Wipe any remaining blood from the
      skin, and cover with an adhesive
      bandage.

12.   Label the sample while in the patient’s
      room.

13.   Perform your procedure completion
      actions.
__________________________________   _______________
       Instructor Signature               Date


__________________________________   _______________
        Student Signature                 Date
                                     PERFORMANCE REVIEW CHECKLIST
Procedure 35
Measuring Bleeding Time
Name of Patient Care Technician ________________________ Date of Program ______ to ______
Social Security Number or Identification Number _______________________________
Program Code Number (if any) _________________
S=Satisfactory Performance
U=Unsatisfactory Performance
Place a full signature to correspond with each set of initials appearing below.

         Initials            Corresponding Signature of Instructor                           Title




Supplies needed:
•        Disposable exam gloves
•        Alcohol or povidone-iodine sponges
•        Surgicutt®, template, spring-loaded blade, or similar device
•        Tourniquet
•        Blood pressure cuff
•        Watch with second hand
•        Filter paper
•        2 x 2 gauze pads
•        Puncture-resistant sharps container
•        Plastic bag for used supplies
•        Steri-strips, butterfly bandage, or other bandage

                    Procedure Guidelines                  S/U        Date   Initials   S/U       Date   Initials

    1.       Perform your beginning procedure
             actions. Double-check the requisition
             slip.

    2.       Support the patient’s arm on the bed or
             other surface, palm up. Make sure the
             patient is comfortable and can maintain
             this position for the duration of the
             procedure.

    3.       Apply the blood pressure cuff to the
             upper arm. Do not inflate it.

    4.       Apply gloves.
             Procedure Guidelines                   S/U   Date   Initials   S/U   Date   Initials

5.    You will perform the test approximately
      4 inches below the antecubital space.
      Cleanse the site with alcohol or
      povidone-iodine. Wipe in a circular
      motion. Begin in the center of the
      puncture site and extend the circle out 3
      inches in diameter.

6.    Allow the alcohol or other skin prep to
      dry.

7.    Remove the Surgicutt®, template, or
      other product from the package. Twist
      off the tab on the side, taking care not to
      touch the blade or activate the trigger.

8.    Inflate the blood pressure cuff until the
      gauge reads 40mm Hg. You must start
      the test within 60 seconds of inflating
      the cuff.

9.    Apply the Surgicutt® or other device to
      the prepared skin, approximately 4
      inches below the antecubital space.
      Position the device so the blade is
      parallel to the bend in the elbow.

10.   Depress the trigger while monitoring the
      second hand on your watch. Remove the
      blade from the skin within 1 second of
      depressing the trigger. Record the time.
      Discard the device containing the blade
      in the puncture-resistant container.

11.   Absorb the blood with the edge of the
      filter paper. Position the paper near the
      incision, without touching the wound
      directly. Placing the paper directly on
      the incision will interfere with the
      results of the test.

12.   With the filter paper, blot the bleeding
      every 30 seconds. When the blood no
      longer stains the paper, stop timing.
      Discard the filter paper in the plastic
      bag. Record the time the test ended.

13.   Deflate the blood pressure cuff.

14.   Wipe remaining blood from the skin.

15.   Apply a steri-strip, butterfly bandage, or
      dressing to the incision.

16.   Remove the gloves and discard in the
      plastic bag.
             Procedure Guidelines               S/U     Date   Initials   S/U   Date   Initials

 17.   Remove the blood pressure cuff.

 18.   Perform your procedure completion
       actions.




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        Instructor Signature                    Date


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         Student Signature                      Date

				
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