CEBU DOCTORS’ UNIVERSITY

College of Allied Medical Sciences

Principles of Medical Laboratory Science 2
A.Y 2018-2019

ACTIVITY 5:
EVACUATED TUBE SYSTEM (SINGLE DRAW)

Introduction:

Venipuncture is defined as the process of collecting or “drawing’ blood from a vein. It is the
most common way to collect blood specimens for laboratory testing. There are two ways by
which blood can be collected by venipuncture. These are by the use of the needle and syringe
which is referred to as the “open system”, and by the use of the evacuated tube system
referred to as the “closed system”. In this activity, venipuncture by evacuated tube system
(single draw) will be performed.

Objectives:

At the end of the activity, the students shall be able to perform proper venipuncture by the
evacuated tube system (single draw).

Materials:

1. Alcohol prep pads

2. Povidone-iodine swabs for blood cultures
3. Nonalcohol-based sanitizers for blood alcohol collections
4. Gauze pads or cotton balls
5. Adhesive bandage
6. Gloves
7. Tourniquet
8. Blood collection evacuated tubes
9. Multisampling needle
10. Standard tube holder
11. Sharps container
12. Permanent marker or pen

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Procedure:

To properly execute this activity, the students should work by pair. Each pair should be given
time to discuss the procedure and organize the materials needed for the activity.
Conversations should be audibly heard by the instructor.

1. Obtain and accession the test request.

a. Requisitions are the form on which tests orders are entered and sent to the lab
i. Manual requisitions
ii. Computer generated requisitions
iii. Barcode labels
2. Identify the patient
a. The most important step in specimen collection
b. Ask the patient to state name and date of birth
c. Check the patient’s identification bracelet
i. Name
ii. Identifying number
a. Medical record number
b. Visit number
3. Verify diet restrictions
4. Prepare the patient for testing
a. Bedside manner
b. Explain the procedure
c. Obtain consent
5. Assemble the equipment and supplies
6. Wash hands and put on gloves
7. Reassure patient
8. Position patient
a. Seated patients
i. Patient arm should be supported firmly
ii. Arm should not be bent at the elbow
b. Supine patients
i. Arm extended
ii. Not bend at elbow
9. Apply tourniquet
10. Ask the patient to make a fist
11. Select the venipuncture site
a. Dominant arm will generally have the most prominent veins
b. Veins have a bounce or resilience
c. Use the tip of the index finger to palpate (feel) veins to determine suitability or located
veins which cannot be seen
i. Helps determine size, depth and direction of vein
d. Do not select a vein that feels hard and cord-like or lacks resilience
i. Tendons are hard and lack resilience
e. Do not draw from above an IV
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 i. if necessary, have IV turned off for a minimum of 2 minutes
f. Avoid burned, scarred or tattooed areas
g. Edematous areas should be avoided
h. Avoid drawing in the area of a hematoma
i. draw below the site is no alternative
i. Mastectomy patients
i. Draw from the side opposite of the mastectomy whenever possible
ii. Application of tourniquet may cause injury on mastectomy side
iii. If patient has double mastectomy, physician should be consulted
12. Release tourniquet
13. Clean the site
a. Clean with antiseptic in circular motion
b. Do not contaminate the site after cleaning
14. Verify equipment and tube selection
15. Reapply tourniquet
16. Pick up and position blood collection equipment
17. Remove the cover and inspect the needle
18. Anchor the vein
19. Insert the needle into the vein
20. Fill the tube
a. Advance the tube onto the needle
b. As soon as blood flows into the tube, release the tourniquet and have the patient
release his or her fist
c. Mix tube with additives immediately by gentle inversions
21. Withdraw the needle
22. Engage safety device
23. Dispose of sharps
24. Label the tubes
25. Observe special handling instructions
a. Putting on crushed ice (e.g. ammonia, BNP, lactic acid, blood gases)
b. Keeping it warm (e.g. cold agglutinin, cryoglobulin)
c. Protecting from light (e.g. bilirubin)
26. Check the patient’s arm and apply bandage
27. Dispose of contaminated materials
28. Thank the patients
29. Remove gloves and wash hands
30. Check specimen collection logs (if applicable)
31. Transport the specimen to the lab
a. Transport in a timely manner
b. Enter specimens into the computer system or logbook to verify collection and receipt
into the laboratory

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