Yes, this is indeed a practice to consider, however when and how it is done requires some practice changes. The 2016 INS Standard on Phlebotomy states to consider using a peripheral catheter for blood sampling in pediatric patients, adults with difficult venous access, the presence of bleeding disorders and the need for serial tests. The issue is the point in the procedure when the sample should be obtained. The answer is after the procedure is completed. Tourniquet time is the reason for this recommendation. The length of time that a tourniquet should be on for drawing all blood samples is no more than 1 minute. Lengthy tourniquet times cause changes in the venous endothelial that produces changes in the lab values for many tests. Longer tourniquet time is usually needed for insertion of a short peripheral catheter using customary techniques of seeing and feeling the vein. Instead of drawing the sample as you insert the catheter, finish the procedure with complete securement and dressing. Then draw the sample. This allows for the tourniquet to be removed and the normal blood flow to flush away the blood containing the cellular substances that leads to alterations in lab values. Learn more about the decisions for obtaining a blood sample in our online course – Blood Sampling: Venipuncture or VAD? The focus is now on preventing hospital-acquired anemia associated with blood sampling and several other issues. 3/30/2016 04:34:34 am
Very interesting would like to know more do you recommend a once only blood draw for patients with good veins but those with poor veins can you draw more than once? Is there increased problems with occlusion or infection? Does it affect blood for coagulation tests? Is there any articles? Thank you
Lynn Hadaway
3/30/2016 05:23:28 am
Hi Sally, I am a little confused by your questions. All blood sampling should be consolidated to as few times per day as possible for all patients regardless of whether this is being done with a direct venipuncture or from a peripheral or central VAD. Our online course discusses these questions and provides all the evidence with a thorough list of references. Please click the link in the blog message to get more information about this course.
Eva
3/30/2016 02:22:20 pm
I avoid making the commitment of obtaining blood for lab sampling with the insertion of a short peripheral venous catheter. There are many unknown variables that can prevent blood from being aspirated. My primary goal is to gain venous access and maintain vein wall integrity for immediate infusion therapy. Comments are closed.
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Author: Lynn HadawayLynn Hadaway is an international thought leader in infusion therapy and vascular access, having been in this practice for more than 40 years. Her experience comes from hospital-based infusion teams, device manufacturers, and continuing education services. Her journal and textbook publications are extensive. She also maintains board certification in infusion nursing (CRNI) and nursing professional development (RN-BC). Categories
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