What should be done to standardize blood collection? The following is what I have organized for you , I hope to help you.
Standardized blood collection process
First, the Laboratory blood collection personnel on duty must wear a good badge, hat, mask and gloves, do a good job of personal biosafety protection and aseptic operation preparation.
Second, warm reception of each patient, and master the "emergency priority" principle. Carefully review the application form, according to the application form to check the patient's name, gender, age, department, test purpose, test items. Prepare blood collection tubes according to the test items and mark the patient's information on the tubes. Preparation for blood collection
1, with 0.5? disinfectant solution soaked hands (gloved hands) or with a wet handkerchief to wipe the hands (gloved hands), to do a needle
(disposable needle), a tube (one person, one tube), a band (one person, a pulse pressure band), a (one person, a piece of paper).
3, the use of disposable vacuum negative pressure blood collection device before checking whether the packaging is complete, negative pressure tube is broken. Patients take a sitting position, arm straight, flat on the blood collection table, exposure of the puncture site, 5 cm from the blood collection site tied to stop
tourniquet, tourniquet should be appropriate tightness, about between systolic and diastolic pressure, colleagues asked the patient to tightly clenched fist, if the vein thrown is not easy to see, you can ask the patient to repeatedly clenched fist a number of times, so that the vein is easy to anger, tourniquet binding time is not easy to be too long, otherwise it will affect the test results of the accuracy. Accuracy.
4. Before puncture, patients should be asked if they have a history of iodine allergy, and if they have a history of iodine allergy, they should be sterilized with 75%. Open the disposable vacuum negative pressure blood collection needle, with the left hand to fix the patient's forearm, the thumb presses the lower end of the venous puncture site, so that
it is fixed. The right hand holds the blood collection needle, the needle beveled upward, first at an angle of about 30 degrees to puncture the skin of the vein in the first 2-3 millimeters, and then puncture the wall of the vein and enter the venous cavity, to be seen after the return of blood, the needle will follow the trend and enter a little, in order to prevent the needle from slipping out of the vein during blood collection, but not too deep, so as not to puncture the vein.
5. Insert the other end of the disposable vacuum-negative pressure blood collection needle into the vacuum-negative pressure tube with the patient's information, and then pump to the required blood volume
After the first relaxation of the tourniquet, the patient was asked to relax the fists, and then a sterile swab pressed against the wound, and then pull out the needle (anticoagulant vacuum tubes must be immediately inverted to mix 6 times).
6. After blood collection, patients should be instructed to press the wound tightly until hemostasis for 5 minutes (patients with hematologic disorders should prolong the time of hemostasis by compression). Each
The patient should change the paper and tourniquet before blood collection.
VI. Venous blood collection accidental treatment
1, local hematoma: ask the patient to press the puncture needle mouth, 24 hours after the hot compresses to make it dissipate and absorb (patients with blood disease except
).
2, bloodsickness: if the blood collection is not finished, immediately stop blood collection, let the patient lie down and unlock the collar, call the patient to wake up, and notify the Emergency Department for emergency treatment if necessary.
The patient's bloodsickness can be treated as a result of the bloodsickness.
Venous blood collection operation procedure
The operator is well dressed: clean clothes and hat, nails have been trimmed, standardized hand washing.
Prepare all the supplies. Report:? Report to the jury XX to do venous blood collection technical operation is ready, please instruct ?
1. The operator checks the doctor's orders (before the operation), and says aloud ? Three check, eight right?
2. Supplies: watch, pen, hand sanitizer, scissors, labels, test slips, specimen containers on treatment cart. Treatment tray
Inside the two disposable blood collection needles, disposable gloves, 2% iodine, 75% alcohol, cotton swabs, disposable treatment towel in the tourniquet, a small pillow, adhesive tape.
3. The operator assesses the environment: ? Clean and safe environment with good lighting?
(1) Carry the supplies to the patient, check the bedside tag.
(2) Explain: ? Teacher, hello! May I ask what your name is, how are you feeling today? I am your responsibility
Nurse XX, can I see your wristband first? The operator checks the patient's wristband. Because your blood test suggests that your white blood cells are high, we are now going to review a blood test for you, can I take venous blood for you later? Which hand would you like to use to collect blood?
(3) ? Would you like me to check your veins first? Gently lift the quilt, help the patient to untie the sleeve, choose
suitable venous vessels, take a small pillow and put it under the patient's puncture site, lay a disposable therapeutic towel, and put a tourniquet. Check the local blood vessels, skin and limb activity, there is no inflammation, scarring, whether the vein is exposed
exposed, whether there is elasticity. The patient's general condition is not abnormal, the local condition is good, please wait for a moment, I go to prepare the supplies.
4. Clean hands (with rapid hand disinfectant, six-step washing method) wear mask (plastic)
5. Wear gloves
6. Disinfect the skin: centered on the point of needle insertion, disinfect the skin with 2% iodine (8cmX8cm) and wait for it to dry (please don't move this hand for a while, so as not to contaminate it, okay?). , prepare the adhesive tape.
7. Tie a tourniquet about 6cm above the puncture site. Mr. XX please make a fist", deiodination with 75% alcohol twice
8. Check again before entering the needle, choose the type of blood collection needle. Needle insertion: Tighten the skin, needle tip beveled up. Teacher, I'm going to insert the needle, please don't be nervous. To 20 degrees into the needle, stabbing into the vein, see the return of blood to take the tape to fix the needle handle, take the specimen tube connected to the blood collection needle to draw the appropriate amount of blood, loose tourniquet, loose fist, take a dry cotton swab placed in the puncture site, and quickly pull out the needle. Ask the patient to press for 2-3min, remove the therapeutic towel and small pillow.
9. Assist the patient to organize the sleeves, bed unit and take a comfortable lying position.
10. Remove gloves, wash hands and remove mask. Recheck the patient's name, bed number and specimen. Sign the test form and record the time of blood collection.
The operator places the pager in a place convenient for the patient to use and explains to the patient: ?Mr. xx, I have collected your venous blood, please observe the skin at the puncture site closely, if there is any hematoma or bleeding, please press the pager immediately to notify our medical staff, and I will also come to see you at any time, thank you for your cooperation.?
11. Organize the use of goods
14. end processing: disposable items are classified and processed according to the classification of medical waste, and items that need to be used repeatedly are placed in 1%o chlorine-containing preparations for 30 minutes, then washed, dried and set aside. (Report to the judges No. XX to do phlebotomy technical operation is completed please instruct.)
Precautions:
1. If the patient is undergoing intravenous infusion or transfusion, it is not advisable to collect blood from the same side of the arm
2. Factors that lead to hemolysis should be avoided in the process of blood collection
3. For blood specimens that need to be anticoagulated, the blood and the anticoagulant should be mixed well and the blood should be gently rotated to prevent blood from coagulating
4. Strictly implement the checking system and the principle of aseptic operation
5. Strictly implement the checking system and the principle of aseptic operation
5. When combining blood, do one person, one needle, one tube, one single
6. Avoid shaking when removing serum specimens to prevent red blood cell rupture, resulting in hemolysis.
Venous phlebotomy procedure
Precautions
1, the choice of blood vessels: generally use the elbow vein, the back of the hand vein, the vein of the inner ankle, the femoral vein, the pediatric can be picked up the external jugular vein.
2. The order of injecting blood into the blood collection tube after blood collection: blood culture tube? The blood culture tube, the blood sedimentation tube, the blood coagulation tube and the blood culture tube. Blood coagulation tube? The order of blood collection: blood culture tube, blood sedimentation tube, blood coagulation tube, blood routine tube? The amount of blood collected: whole blood or plasma test specimens, need to be shaken in time. Such as blood culture, anaerobic culture into a chemical tube. People pumping 8-10 ml (suspected subfine should be?10 ml), pediatric pumping 1-3 ml, routine blood pumping 0.5-1 ml, glycated hemoglobin, troponin and other routine blood tube pumping 2 ml, coagulation pumping 2-3 ml, hemosiderosis pumping 1.6 ml, biochemical class pumping 2 ml.
3, the selection of test tubes
① Purple tubes: all whole blood, need to be shaken well in a timely manner. Such as routine blood, troponin,
glycated hemoglobin, reticulocytes, pre-transfusion routine, blood type, cross-compatibility, BNP
are all purple tube.
④ Red tube (biochemistry tube): serum class are used red tube, such as liver and kidney function, blood black tube: blood sedimentation, need to be shaken in time. Blue tube (blood coagulation tube): plasma class with blue tube, need to be shaken in time. Such as glucose coagulation, lipids, cardiac enzymes, hepatitis complete set, A Gong three, rheumatism, immunity.
Blood routine, D-dimer, plasma fibrin degradation products and so on.
Pickup.
4, gray tube: glucose tolerance, insulin release test, blood glucose and postprandial glucose are special classes, like cortisol to take two times blood, 8:00, 16:00, respectively, with a red blood culture for the special culture bottle, print the bar code, call the field staff to the laboratory with a gray tube. Tube pumping 2 ml. Fasting blood glucose determination need to fasting 12 hours after taking venous blood, avoid strenuous exercise before taking blood, blood collection blood vessels need to be shaken can not be excessively shocked, shun inverted shaking 8-10 can be, so as to avoid hemolysis. It is strictly prohibited to take blood specimens at the place of blood transfusion or infusion, and it is better to take blood specimens from the opposite side of the limb. If taking venous blood, should avoid compression of the jugular venous sinus, and should always observe the patient's color, between the breath preferably in the morning or morning. Suction, heart rate, where the condition is critical, cardiopulmonary insufficiency patients, should not be in the jugular vein blood collection.
5, the need for fasting blood: liver function + liver disease enzymology, lipids + coronary heart disease risk factors, fasting glucose (insulin), A Gong three, C12 and so on.
Rheumatology and immunology laboratories generally only receive specimens by 10am every day.