The most common double-ended needle is the multisample needle which has a retractable rubber sleeve that covers the second tip when it is not inserted into a tube.
A multisample needle remains in place in the patient's vein while one tube is replaced with another. The sleeve keeps blood from leaking onto or into the adapter or tube holder while you are changing tubes.
Winged Infusion Set (butterfly):
Effective for small or difficult veins (elderly & pediatric)
-Allows more flexibility & precision than a needle & syringe
Consists of:
1/2 inch to one inch stainless steel needle ,23 or 25 gauge with 5in length of tubing
Plastic extensions (wings) allow easier manipulation for shallow angle of needle insertion
Safety devices required to prevent accidental needle sticks
Gauze pads/cotton Balls:
Clean 2 x 2 inch gauze pass folded in fourths are used to hold pressure over site following blood collection.
Avoid using cotton balls, as they tend to stick
Bandages:
Used over blood collection site once bleeding has stopped
Can also use paper, cloth, or knitted tape over folded gauze
standards advise against the use of adhesive bandages on infants and children under 2yrs of age.
Evacuated tube System (ETS):
Closed system in which blood flows through a needle inserted into a vein & then directly into a collection tube.
Prevents exposure to air or outside contaminants.
Allows numerous tubes to be collected with a single venipuncture.
Components
Multisample needle
Tube Holder
Evacuated tubes
Vacuum:
Negative pressure artificially created by pulling air from tube
Designated to draw an exact volume of blood into tube
TUBE ADDITIVES
Except for the glass red-topped tube, which has no additives, all tubes contain one or more additives. Additives include anticoagulants to prevent clotting, or clot activators to promote it.
Any tube containing an additive must be inverted and mixed well. Turning the tube over, and then back upright again, equals one inversion.
The exact number of inversions needed varies with tube type; most need five to eight inversions.
Stoppers:
rubber or rubber with plastic covering
Blood Collection Additives:
-Anticoagulants
Substances that prevent blood from clotting
Types:
Ethylenediaminetetraacetic Acid (EDTA)
Citrates
Heparin
Oxalates
Clot Activators:
Substances that provide more surface for platelet activation
Types:
Glass (silica) Particles
Inert Clays (Celite)
Clotting Factors (thrombin)
Color coding:
color of stopper usually indicates type of additive
EQUIPMENT:
Phlebotomy equipment is designed and manufactured to be free of defects and minimize variability. Nonetheless, errors do occur, and it is up to the phleotomist to identify and eliminate them before they interfere with patient care.
Quality Control procedures include the following:
• Tubes should be checked for expiration date. Never use an expired tube.
• Stoppers should be checked for cracks or improper seating. Reject any tube with a defective stopper.
• Tubes may loose vacuum without any visible sign of defect. When filling a tube, be aware of incomplete filling because of loss of vacuum.
• Needles should always be inspected for defects,
including blunted points. Never use a defective needle or one from a package with a broken seal.