Structure: Blood Procedure

Casebank Combined
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Blood procedure stations are:

Blood Procedure Overview

  • Remember that in Blood Procedure stations, you are not the first line of contact with the patient (except in catheter station).
  • Your task is to do the procedure itself, so take focused history relevant to the procedure. Do not dwell on the patient’s condition itself.
  • Assume you are wearing gloves, not actually wear them. If you fail to withdraw blood, do not panic, and repeat the procedure:
    – Do not reuse the same equipment.
    – Select another part of the vein or another vein altogether
  • Touch the mannequin only after preparing your equipment
  • Tie the torniquet very late and loosen it very early. (Tie it after preparing your equipment and loosen it once you see a flashback).
  • Leave the table very tidy and the mannequin clean. The only thing that should remain in your tray once you are done is the sample you took.
    • Needles are discarded into the sharps bin. Others are discarded into the waste bin

Blood Procedure Station Structure

History Taking:

  1. Confirm the patient’s identity.
  2. Start the station well (You already know the issue. So start with that. Do not say '‘how may I help you?’’).
  3. Why? & Why? Explain why you are here and why you are taking the blood sample: (My consultant has asked me to take a blood sample from you to …).
  4. Take focused History relevant only to your procedure
  5. Red flags - relating to condition, Contraindications - relating to procedure
  6. Remember to always ask MMA as long as there is a patient involve
  7. Explain the PPECC (Procedure, Position, Exposure, Chaperone, Consent)

Patient preparation:

Patient:

  • Benefit ( I would like to take a blood sample from you in order to find out the cause of your ( complain).
  • Risk: It should not be painful, but if you feel uncomfortable at any time let me know.
  • Explain: explain exactly what you are going to do: (I will be inserting a thin needle into one of the blood vessels (veins/ arteries) of your (forearm/ wrist). It will feel like a sharp scratch, but I will be as quick and gentle as possible

Doctor:

  • Position : Can you please straighten your elbow/ wrist for me.
  • Exposure: Can you please roll up your sleeves for me.
  • Please be observant. (Notice whether the patient has short sleeves, or has rolled up the sleeves already, and comment on it accordingly).

Both:

  • Privacy: I will ensure your privacy.
  • Chaperon: Blood procedures do not require a chaperone.
  • Consent: Do I have your consent to proceed.
  • Ask about any arm soreness and any arm preference.
  • Do not forget to inform the patient that if you fail, you may need to repeat the procedure.

Procedure:

  1. Collect
  2. Open (everything you are going to use before going to the manikin)
  3. Start the procedure.
  • Collect your equipment
  • Prepare your equipment in your clean area.
    – Once the equipment is prepared, put them in your tray
  • Gloves: Assume you are wearing gloves(mostly), or if you find a gloves you should wear it.
  • Feel the vein/ Artery
  • Torniquet (above the cubital fossa)
  • Clean Prick Collect
    – Clean the area with one single stroke
    – Prick with the bevel pointing up and warn the patient about the sharp scratch.
    – Collect the blood.
  • Cotton and Label
    – Put a cotton on the prick site
    – Verbalize labeling the sample with the patient’s details and verbalize sending it to the lab.

Management :

  • Wind up everything you talked about and did
  • Sit down and discuss with the patient the management details specific to each station.
  • Safety net
    1. about the procedure itself (any bleeding, swelling or soreness)
    2. about the patient’s general condition.
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