COLLECTION & HANDLING TIPS » Special Circumstances

Special Circumstances

The following situations require special attention when collecting specimens.

Venipuncture on Children & Handicap Patients

• Because of the unpredictable behavior of children and handicap patients, all phlebotomists are required to have 1 other person help them with the phlebotomy.
• Venipuncture performed on children less than 2 years of age should be done using either a tuberculin syringe with a 21–23 gauge needle, or a 21–23 gauge butterfly needle.  The thumb or big toe can be used for dermal puncture.
• It is generally easier if you ask the child to assist in the process by either holding something such as a piece of gauze or a bandage.  It will help to take the child’s mind off the procedure. It is also a good idea to promise the child some kind of reward for when they are done such as a sticker (check with parent or guardian before giving any food) or a special bandage.

Fainting

1. If the patient is sitting, lower their head & arms.  Place your hand on the back of the patient’s head and have the patient push up against it if they can.  Maintain pressure on the head, which will cause blood to return to the head. If the patient is lying down, elevate their feet.
2. Loosen any tight clothing.
3. Have a nurse record blood pressure, pulse, and respiration rate
4. Apply cold compresses to the back of the patient’s forehead and neck.
5. Try to revive the patient with an ammonia inhalant, (this should result in the patient coughing)
6. Call the physician if there is no response

Nausea

1. Situate the patient comfortable with his/her head lowered
2. Instruct the patient to breathe deeply and slowly
3. Apply cold compresses to the back of the patient’s forehead and neck.

Vomiting

1. Roll prone patients onto side
2. Give patient a basin
3. When vomiting ceases, assist patient with towels and water
4. Apply cold compresses to the back of the patient’s forehead and neck.
5. Inform the physician

Excessive Bleeding

1. Apply direct pressure until the bleeding ceases
2. Record the time
3. If the bleeding persists more than 5 minutes, notify the physician

Convulsions

• Have a nurse or physician respond immediately

1. Place a soft, non-ingestible piece of material in the patient’s mouth
2. Guard the patient from self injury without completely restraining
3. Move any furniture that the patient may injure themselves on
4. Notify the physician