Jimmy Hall, RN, BSN

Identify phlebotomy process Identify common lab tests Identify common tubes used

Verify order/requisition for tests ordered Identify any special requests (some lab

tests may need to be sent on ice, etc.) Gather supplies

Tourniquet Alcohol Needle/Syringe/butterfly Tubes Gauze Band-aid

Identify patient Get patient to state name and social security

number if possible Select a site for venipuncture

Always best to stick distal If receiving IV fluids, use opposite arm if

possible If not possible, stick below IV site or turn IV fluids

off for at least 2 minutes before sticking above IV site

Place tourniquet – tourniquet should not remain on the arm longer than ONE MINUTE

Sites to Avoid Arms in a cast Arms with IV Edematous arm Cannula Fistula Vascular graft Areas of extensive scarring Side of the body that a mastectomy was

performed

Prepare equipment, the patient, and the puncture site. Explain procedure to patient Place supplies nearby Clean site (Chloraprep, alcohol)

Cleanse site in a circular motion from the center outwards with a 70% isopropyl alcohol solution

Allow site to dry

Puncture vein with bevel edge up at a 15 degree angle

Release tourniquet once blood flow begins Fill each tube until blood flow stops flowing into the

tube Place a gauze to over puncture site and remove

needle. Invert tubes 5-10 times when tube contains additive Place bandage to site

***Place needles and all sharps in sharps container immediately.

DO NOT PLACE SHARPS ON BED!

Insert tubes into holder in the correct order of draw: Blood culture tubes Light blue top tubes Red/Gold top tubes Green top tubes Lavender top tubes Gray top tubes

**When using a butterfly collection set for venipuncture and a light blue top tube is first tube to be drawn, a discard tube should be drawn first**

Specimen label should include: Patient’s first and last name Identification number (account # or medical

record #) Date and time of collection Initials of person collecting the specimen

Light Blue PT, PTT, Fibrinogen, Fibrin D-Dimer, other

coagulation testing Invert gently 3-4 times

Red top (red/black and red/gold)

For tests requiring serum; contains clot activator Common tests:

Red/Black: type/cross match Red/Gold: CMP, BMP, drug levels

Light Green (Lithium Heparin)

Troponin, Metabolic Panels, Lipid, Liver Panels, Ammonia (on ice), HIV Rapid Anti-body

Bright Green (Sodium Heparin)

Mycobacteriology (AFB) Blood Culture, HLA-B27, Chromosome Studies

Dark Green (Lithium Heparin)

Ammonia (on ice), Ionized Calcium

Lavender tube: Hematology : CBC, Platelet, Sed. Rate Chemistry: CD4, CD8, G6PD, Hemoglobin

A1C, and Hemoglobin Variants

Gray Lactate (Lactic Acid) on ice

University of California, San Francisco. Plastic tube top color and order of draw. March, 2009. Retrieved April 2, 2010, from http://labmed.ucsf.edu/sfghlab/test/pdf/Plastic%20Tube%20Top%20Color%20and%20 Order%20of%20Draw%20Chart.pdf

University of Mississippi Medical Center. October 20, 2009. Phlebotomy procedure.

Retrieved April 2, 2010, from http://pathology.umc.edu/phlebotomy_pro cedure.html