Specimen Collection: Blood

Specimen Collection: Blood

General Guidelines
■ Verify if Pt has allergies to latex, iodine, adhesives, etc.
■ Tourniquet should not be left in place longer than 1 minute.
■ Previous puncture site areas should be avoided for 24–48 hours.
■ Specimens should never be collected above IV site.
■ Order of draw: If multiple tubes are required, they are collected in following order: blood cultures, red or red marble-top with gel, light blue, green, lavender, and then gray.

Procedure
■ Prepare Pt: Explain procedure to Pt, offer reassurance, and assess for allergies to latex, iodine, or tape.
■ Supplies:Tourniquet, skin cleanser, sterile 2 2 gauze, evacuated collection tubes or syringes, needle and needle holder, and tape.
■ Position patient: Sitting or lying with arm extended and supported.
■ Tourniquet: 3–4 inches above intended venipuncture site.
■ Choose vein: Most common and easily accessed are median cubital, cephalic, and basilic veins located in antecubital (AC) fossa anterior to elbow. Veins of forearm, wrist, and hand may also be used but are smaller and often more painful.
■ Cleanse site: Briefly remove tourniquet. With alcohol swab, cleanse site from center outward, using a circular motion. Allow site to air dry for 30–60 seconds. For blood alcohol level and blood culture specimens, use iodine in place of alcohol.
■ Perform venipuncture: Reapply the tourniquet. If necessary, cleanse end of gloved finger for additional vein palpation. Insert needle, bevel up, at 15–30 degrees using dominant hand. With nondominant hand, push evacuated collection tube completely into needle holder or pull back on syringe plunger with slow, consistent tension.
■ Remove tourniquet: If procedure will last longer than 1 minute, remove tourniquet after blood begins to flow.
■ Remove needle: Remove tourniquet if still in place. Place sterile gauze over puncture site, remove needle, and apply pressure.
■ Equipment disposal: Per facility policy/standard precautions.
■ Prepare specimen: If using syringes, transfer specimen into proper tubes. Mix additives with gentle rolling motion. Label specimen tubes with Pt’s name, ID number, date, time, and your initials.
■ Document: Record specimen collection in medical record.