CAP Pro Course - Phlebotomy - Challenges of Phlebotomy: Pediatric Blood Collection, Alternate Sites, and Difficult Draws

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Author: Carol Becker, MS, MLS(ASCP)CM
Reviewer: Alexandru Casapu, MBA, MLS(ASCP)CM, PBTCM

Continuing Education Credits

Objectives

  • Review established venipuncture practices and recognize approved techniques and tools used to safely provide quality phlebotomy care for adult patients.
  • Identify adult patient conditions and circumstances that may require alternative blood collection techniques.
  • Describe the proper dermal puncture procedure used as an alternative technique in the collection of blood specimens in adult patients and those pediatric patients greater than one year of age.
  • Explain the special considerations, techniques, and potential complications that can be encountered during neonatal and pediatric blood collection.

Course Outline

  • Review established venipuncture practices and recognize approved techniques and tools used to safely provide quality phlebotomy care for adult patients.
      • Fundamental Phlebotomy Practices
      • Patient Approach and Preparation for Venipuncture
      • Patient Identification
      • Preanalytical Considerations
      • Quick Steps to Adult Venipuncture
      • Potential Patient Complications
      • Venipuncture Safety Practices and Special Considerations for Handling Specimens Associated with COVID-19
      • A patient has arrived at the outpatient center for a blood draw. This patient appears anxious and fearful of the collection procedure. What is the bes...
      • A phlebotomist assigned to the floor today is performing an identification process on a male inpatient who does not have an identification bracelet or...
      • A partially-filled blood collection tube, received in the laboratory for testing, is considered a poor specimen quality variable for which of the foll...
  • Identify adult patient conditions and circumstances that may require alternative blood collection techniques.
      • Special Situations Impacting Adult Blood Collection
      • Alternative Blood Collection Sites
      • Use of Syringes and Winged Collection Devices
      • Steps to Hand Vein Blood Collection
      • Geriatric Blood Collection
      • A phlebotomist has an order to collect blood on an elderly male patient located on the medical/surgical floor. This patient has the following advisori...
      • Which of the following alternative blood collection sites are acceptable to be accessed by the phlebotomist?
      • The use of a waste or discard tube is needed when the phlebotomist is using which of the following devices to collect a patient blood specimen for coa...
      • A female renal dialysis patient has reported to the Outpatient Center for blood collection. Her test requisition reveals she has chemistry, hematology...
  • Describe the proper dermal puncture procedure used as an alternative technique in the collection of blood specimens in adult patients and those pediatric patients greater than one year of age.
      • Dermal Puncture Technique
      • Challenges to Using Dermal Puncture Technique
      • The Fingerstick
      • The Fingerstick Procedure
      • The Order of Draw for Capillary Blood Collection
      • A young child is waiting with her mother in the Outpatient Center for some laboratory tests to be collected. The phlebotomist needs to consider all of...
      • An outpatient center phlebotomist is preparing to perform a capillary puncture on a 3-year-old for a blood test. A parent is with the child and is wil...
      • A microcollection tube containing EDTA is received in the hematology department. Laboratory policy states that all specimens containing anticoagulants...
  • Explain the special considerations, techniques, and potential complications that can be encountered during neonatal and pediatric blood collection.
      • Pediatric Blood Collection Challenges
      • Pediatric Venipuncture
      • Special Considerations for Pediatric Heelsticks
      • The Pediatric Heelstick Procedure
      • An experienced phlebotomist is selecting a needle to use with his pediatric patient who requires blood collection by venipuncture. Which of the follow...
      • A newborn has orders for a blood test and needs a heelstick before he can go home. Which steps are acceptable when identifying a newborn?
      • Warming the infant's heel prior to capillary puncture is a technique that can be used to retrieve a blood sample for testing. All of the following opt...
  • References
      • References

Additional Information

Level of Instruction: Basic
Intended Audience: This program is designed as an educational and training tool for MLS, MT, and MLT personnel, phlebotomists, medical laboratory science students and interns, pathology residents, and practicing pathologists.
Author Information: Carol Becker, MS, MLS(ASCP)CM is a retired Program Director for the Clinical Laboratory Science program and Histology program at OSF St. Francis Medical Center located in Peoria, Illinois. Carol received her Master's degree at the University of St. Francis in Joliet, Illinois, and her Bachelor's degree in Medical Laboratory Science from the University of Illinois in Champaign, IL.
Reviewer Information: Alexandru Casapu, MBA, MLS(ASCP)CM, PBTCM, has over 20 years of experience as a medical laboratory scientist, section supervisor, and laboratory manager. He is the former Director of Clinical Laboratory Technology Program at Georgia Piedmont Technical College. He is currently a Program Director at MediaLab, Inc. Alex holds BS degrees in Biology and Medical Technology from Clark Atlanta University and an MBA from the University of Georgia.

This course is part of the CAP Competency Assessment Hub.

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