Prosedur Plebotomi pada Pasien Polisitemia

VENIPUNCTURE PROCEDURE
The venipuncture procedure is complex, requiring both knowledge and skill to perform. Each phlebotomist generally establishes a routine that is comfortable for her or him. Several essential steps are required for every successful collection procedure:
1. Identify the patient.
2. Assess the patient's physical disposition (i.e. diet, exercise, stress, basal state).
3. Check the requisition form for requested tests, patient information, and any special requirements.
4. Select a suitable site for venipuncture.
5. Prepare the equipment, the patient and the puncture site.
6. Perform the venipuncture.
7. Collect the sample in the appropriate container.
8. Recognize complications associated with the phlebotomy procedure.
9. Assess the need for sample recollection and/or rejection.
10. Label the collection tubes at the bedside or drawing area.
11. Promptly send the specimens with the requisition to the laboratory.
PROCEDURE FOR VEIN SELECTION:
· Palpate and trace the path of veins with the index finger. Arteries pulsate, are most elastic, and have a thick wall. Thrombosed veins lack resilience, feel cord-like, and roll easily.
· If superficial veins are not readily apparent, you can force blood into the vein by massaging the arm from wrist to elbow, tap the site with index and second finger, apply a warm, damp washcloth to the site for 5 minutes, or lower the extremity over the bedside to allow the veins to fill.
PERFORMANCE OF A VENIPUNCTURE:
· Approach the patient in a friendly, calm manner. Provide for their comfort as much as possible, and gain the patient's cooperation.
· Identify the patient correctly.
· Properly fill out appropriate requisition forms, indicating the test(s) ordered.
· Verify the patient's condition. Fasting, dietary restrictions, medications, timing, and medical treatment are all of concern and should be noted on the lab requisition.
· Check for any allergies to antiseptics, adhesives, or latex by observing for armbands and/or by asking the patient.
· Position the patient. The patient should either sit in a chair, lie down or sit up in bed. Hyperextend the patient's arm.
· Apply the tourniquet 3-4 inches above the selected puncture site. Do not place too tightly or leave on more than 2 minutes.
· The patient should make a fist without pumping the hand.
· Select the venipuncture site.
· Prepare the patient's arm using an alcohol prep. Cleanse in a circular fashion, beginning at the site and working outward. Allow to air dry.


· Grasp the patient's arm firmly using your thumb to draw the skin taut and anchor the vein. The needle should form a 15 to 30 degree angle with the surface of the arm. Swiftly insert the needle through the skin and into the lumen of the vein. Avoid trauma and excessive probing.
· When the last tube to be drawn is filling, remove the tourniquet.
· Remove the needle from the patient's arm using a swift backward motion.
· Press down on the gauze once the needle is out of the arm, applying adequate pressure to avoid formation of a hematoma.
· Dispose of contaminated materials/supplies in designated containers.
· Mix and label all appropriate tubes at the patient bedside.
· Deliver specimens promptly to the laboratory.