First, I would like to introduce myself, Hello, my name is Andrea Hernandez I am
A phlebotomy student at CWI, may I draw your blood? This is the proper way I would
Identify myself before I start the blood drawing procedure.
Patient identification is the most important part of specimen collection, after you
introduce yourself you also need to verify you have the right patient in front of you. Make
Sure name and DOB match the patient requisition. If there are any mistakes with the
name or it is spelt wrong, you may not collect specimen until this issues are resolved.
identification bracelets must match the requisitions, note: patients will never have the
same record number as others. The 3 way ID, is used so that patients are properly
identified and to make sure there are no mistakes. This means there are
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3 ways the phlebotomist has to make sure that she has the right patient, and information. The 3 way ID is the patients verbal statement, checking the ID band and visual comparison for the labeled specimen. If the patient is missing their ID or does not seem to have it on their wrist, or if it is not Visible to you,, ask if you may check their ankle just to be sure it wasn’t placed there for Medical reason. Never collect from an inpatient who is not wearing an ID band. If you have a requisition to collect a specimen from a patient who is asleep, remember the patient must be awake for you to be able to draw their blood. So, gently wake the person up to identify patient for collection. If the patient is unconscious in the ER, or ICU, ask if you have permission and the right patient identification from a relative or the patient’s nurse to Identify. You must take the person’s name who gave you Permission and or verified patient for you and write it down. Also, talk to the unconscious patient as you would to a conscious patient. General Equipment Handheld Carriers, Gloves, Antiseptics, Hand Sanitizers, Equipment Carriers, Gauze Pads, Band Aids, Sharps Container, Bio Bags, Pen, Watch, And tourniquet. Evacuated tube system (ETS) is essentially the most used procedure. The needle is Directed into vein and when the specimen tube is inserted to the other side of the needle, the vacuum of the tube creates blood flow through the needle. ETS needles are called multisampling needles, this system allows you to take multiple tubes of blood without having to poke the patient twice. ETS needles are to be used with tube holders that have a safety at the end of it. The preferred gauge of the needle for this system is 21. Despite ETS being the preferred system, a syringe system is used for small or difficult Veins. This system uses a Hypodermic needle. This needle comes packaged and sterile for immediate use. Appropriate sizes of needle’s for the syringe needle system are 21 to 23. The syringe has two parts the barrel and the plunger, using this system you will need To slowly pull plunger after you have inserted your needle. Butterfly System is used for small or difficult veins or on elderly patients and children. Needle size for this system is a 23 gauge. Using a smaller gauge for this system can cause hemolyzing the specimen. In conclusion, throughout this course I’ve learned a number of things. For instance, Check your requisition, grab your tubes that are needed, gauze, tourniquet, alcohol Pads, gloves and tape. Identify yourself, Identify your patient, Apply your tourniquet, palpate, locate the vein, clean area with alcohol pad, allow to air dry, anchor, and insert into vein. After, when last tube is full release tourniquet, remove tube, and mix properly, then Remove needle from patients arm, and apply pressure to the punctured site to prevent Bruising. Make sure you ask patient what they prefer a band aid, tape, or coban. Scenario’s 1. My name is Andrea, I am a phlebotomy student, may I take your blood? An inpatient has cirrhosis of the liver and needs an ammonia, electrolytes and CBC drawn, after you draw they ask you for a glass of water. I will first ask patient to Identify his/herself before I proceed to draw. I will be using the ETS system for this blood draw, needle gauge is 21, tubes in order of draw are; Brick Top tube (SST or corvac) or gold, Green (lithium heparin), and Lavender (EDTA). I have located the vein in the median cubital, I will begin to clean the site with alcohol pads and allow it to air dry before I enter the vein with the needle. After the area has dried, anchor vein and slide the needle in, push tube into rubberized needle as blood will flow through to let you know you have been successful. When I am on the last tube, I release the tourniquet, pull tube out of tube holder and remove needle, activate safety and apply pressure to puncture site with gauze. Last, I will need to label my tubes with patient in front of me so I don’t accidentally mix it with another patients or have the patients name wrong. Let the patient know that as soon as your done you will inform their nurse that they are wanting water, for reason being you don’t know the patients restrictions. Electrolytes must go to the Chemistry Lab Allow to clot completely Refrigerate 1 day CBC to Hematology Stored and transported refrigerated Ammonia to Chemistry Lab Must be on wet ice Must be transferred within 20 min of being collected Also draw in pre chilled tubes 2.
A 40 year old inpatient in the CCU needs the following test done stat: CBC, PTT, and a BMP. She has an IV in her right AC, and an IV in the left forearm. How do you proceed?
For this patient, I will need to draw blood from behind the right hand which would be below the IV in her right AC.
I will first identify myself as well as the patient, and make sure the patient has the right information on ID wrist band as I do on the requisition. The butterfly ETS system is what I will be using on the patient, needle size for butterfly ETS will be 23g. The tubes in order of draw will be; Red (plain) or GOLD/brick top, Blue top(buffered sodium citrate), Lavender (EDTA).
CBC to Hematology
Transported refrigerated @ room temp 24-48 hrs
PTT to Coagulation
Plasma must be removed and frozen in plastic transport tube.
BMP to Chemistry
Allow to clot completely
Transport
Refrigerated
In his book, Blood Done Sign My Name, the author Timothy Tyson tells the story of the highly combustible racial atmosphere in the American South before, during, and after the Jim Crow era. Unlike Margaret Mitchell’s account of the glory and grandeur of the Antebellum South, Tyson exposes the reader to the horrific and brutal reality that the black race experienced on a daily basis. Tyson highlights the double standard that existed during this period in history, arguing that the hypocrisy of the “white” southern judicial system allowed the murder of a young black African-American male at the hands of white racists to go unpunished (Tyson 2004, 244).
The first step is to pre-register the patient's insurance information into the computer system and making a copy of their insurance cards. The patient's insurance information would then be verified. The patient would then be seen by a medical professional to examine the patient, discuss any test results or provide a diagnosis. Once the patient is ready to check out any payment due would be collected. The medical coder would then go over the patients' medical record and assign any diagnosis codes or procedural codes and then a claim form (CMS 1500) would be completed and submitted. The payment would also receive and posted at this time and document in the patient's record. The CMS 1500 will information from the patient, including the type of
(Topic sentence) According to the Health Care, Medicine, and Science, by Deborah Porterfield (1st citation), the word phlebotomy means “obtaining blood from a vein.” (P.34) Phlebotomy came a long way, as it was one of the traditional ways of medicine. According to Jamie Cohen (2nd citation), this practice is thought to have originated from ancient Egypt. From Egypt, this practice was starting to get used in Europe. Erasistratus, a popular physician in ancient Greece, believed that illness was caused due to too much blood. A little later, the Roman Empire believed in Erasistratus’s theory and performed phlebotomy more (P.1). With these two empires rising to the top, phlebotomy was spread throughout the world, including to places like India and Arabia as well. Years later in Europe, churches were not a big fan of cutting people open and let them bleed. So, who performed this...
"Phlebotomy." EHSL - Spencer S. Eccles Health Sciences Library Home Page. N.p., n.d. Web. 1 Oct. 2013. .
If the hours are between 0800 and 1600, the provider or radiology technician calls the anti-coagulation clinic. The Lovenox protocol is then follow through via the anti-coagulation clinic. Should the diagnosis come after 1600 and before 0800, the provider much call the nursing supervisor. The provider will give an order to intiate the Lovenox protocol. It is the nursing supervisors responsibility to write the orders and enter the lab orders into the computer. A phone call to the Lead ED RN is then made by the nursing supervisor to alert that a patient will be coming to the ED for basic teaching and an injection. The nursing supervisor greets the patient in the radiology department, inquires as to which pharmacy the patient utilizes, and escorts the patient to the ED, with a patient hand-off given to the Lead ED RN. The patient has the ordered lab work drawn and waits for the results. Once the labwork is return, the first Lovenox injection is given by the Lead ED RN. The ED RN then calls the anti-coagulation clinic, leaves a voicemail with the patient information and faxes the orders received from the provider. The patient is instructed by the Lead ED RN that the clinic will call in the morning to arrange follow up lab work and appointments for injections. The anti-coagulation clinic takes over from this
The purpose of this clinical journal entry is to elaborate on the details of lab day three. On lab day three, we had check-off for blood pressure and apical pulse. In addition, we took a safety test, and learned about mobility, immobility, how to use ambulatory devices, and reposition (C#4, C#6). Since we will be going to the nursing home, it is imperative that we know how to correctly assist a client with their ambulation. To begin with, Ms. D demonstrated how to use a wheelchair, cane, and walker.
Every patient's medical records are different some contain more information due to their medical history. If a patient has alot of problems and have been treated then their file would have more information . Certain records also contain history of complaints and procedure, few records have photographs with a short summary of what is present. Medical records can be electronically stored , traditioanlly handwritten and even voice recorded. Medical records that are written on paper and kepted in folders are divivided into informative sections It contains medical terminology terms that any person in the medical field can read It should be written in either black or blue ink. Each provider should always document the evaluation and results of every visit during the visit. It is prohibited to pre-date or backdate an entry. If there is to be a mistake written in a wrong patients file it should be dated and signed by the person that is revising the file; this shows proof that it was corrected..
D- The patient arrived on time for her session as she was seen outside. The patient reports, she has to see her cardiologist for 35 days at noon to monitor her blood flow sometime next month. She is also scheduled on 05/23/2016, at night to conduct her sleep apena and also, scheduled on a Tuesday for a ultrasounds, referring to her pulse to her legs to ensure there is no blockage in her legs.
Several skills are beneficial to the nurse and paramedic, but perhaps one of the most important skills is the ability to place an intravenous catheter into a vein. This procedure is most commonly referred to as “starting an IV”. In today’s medical community, intravenous cannulation is necessary for the administration of many antibiotics and other therapeutic drugs. Listed below are the procedures and guidelines for starting a successful IV. Following these instructions will provide a positive experience for the patient and clinician.
Instruct patient to have a blood test drawn that includes CBC, kidney, liver ,lipid, and electrolyte test so baseline on patients overall status is established before initial treatment.
The Aztecs, Mayans, Egyptians, and Mesopotamians were ancient civilizations that used bloodletting (phlebotomy) as a cure for many sicknesses. The Greeks were the first who distinguished the association between the human body and phlebotomy. 1Hippocrates believed the world existed on four basic elements: earth, air, fire, and water. In humans, it was: blood, black bile, yellow bile, and phlegm. By removing unnecessary body fluids it was used to help treat sicknesses. 2“Phlebotomy is the act or practice of opening a vein for letting or drawing blood as a therapeutic or diagnostic measure; venesection; bleeding.”
VI. Some individuals requiring blood are surgical patients; burn victims; accident victims; anemics'; hemophiliacs; seriously ill babies; and persons suffering from leukemia, cancer, kidney disease and liver disease.
The curiosity that I have with the medical practice perked my excitement for this ethnography paper. When considering which medical field I wanted to further investigate phlebotomy gained my focus. While enrolled in phlebotomy classes during summer semester at Aurora Community College I was provided mass amounts of knowledge in phlebotomy. One concern I had entering the nursing practice was venipuncture because of my past history of numerous blood draws and intravenous fluids. During these times I was often used as a pin cushion with the number of sticks to success being twelve in one visit. Never wanting to risk placing a patient of mine in this situation I enrolled into phlebotomy class. This new skill would assist me in my overall goal of
The first part of the history-taking process is creating an appropriate environment. Ideally, the interview takes place in an area that is safe, accessible, and free from distractions and interruptions. During this initial process, the interviewer introduces themselves and states their purpose and obtains consent to proceed with the health history interview. Additionally, the initial part of the interview is the time to establish the patient’s identity, age, and preferred way of being addressed. A relationship built on trust and respect for the patient’s privacy is necessary to developing a good rapport. It is important to remain unbiased and professional and furthermore, to treat the client with dignity. After introductions are made, the patient should be given time to tell their story in their own words. Active listening is a must during this interaction and involves both verba...
patient is going into DIC when in fact she is not. By checking a slide to verify the platelet