January, 2007

2007 Center for Phlebotomy Education, Inc.
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Managing Patients Who Lose Consciousness

Those who draw blood specimens must constantly be aware of the signs and symptoms of an impending loss of consciousness and be prepared to react. Signs can include pallor, perspiration, hyperventilation and/or anxiety. A proper response to such signs is key to protecting the patient from falling and the injuries that can result. However, collectors can prevent an injury before it happens if they take the following precautions:

  • make sure that all outpatients are drawn from chairs with arm rests that can stop a fainting patient from falling to the floor;
  • inpatients should be drawn while recumbent or sitting in arm chairs. When patients state that they have a tendency to pass out during a blood draw, it is best to draw them while they are in a recumbent position;
  • never turn your back on a patient after you have completed the draw. Many patients give no warning before passing out.
  • should a patient become dizzy or lose consciousness during a collection, release the tourniquet and remove the needle at once. Presence of mind must be maintained so that you don't sustain an accidental needlestick in the process.
  • if the patient loses consciousness, support him/her from falling to the floor and summon assistance. Lower the patient's head below the level of the heart to facilitate blood flow to the brain. This can also be accomplished by carefully, and with assistance, lowering the patient's head between the knees or by lowering the patient to the floor, being careful not to allow the patient to fall and sustain an injury.
  • avoid the use of ammonia inhalants. Patients who are asthmatic may develop respiratory distress as a result.

Specimen Collection Safety: Gloves

Do you ever draw blood without wearing gloves? OSHA insists on glove use for phlebotomy. You should, too. Gloves do not prevent needle penetration, but they will protect you from blood exposure to chapped or non-intact skin. Sure they deaden the sensitivity of your fingers, but you can locate the vein prior to gloving. If the vein is palpable but not visible, take note of its location in relation to creases on the skin, freckles, or other skin markers that can serve as guideposts. By so doing, you become less reliant on feeling for the vein after your gloves are on.

This Month in Phlebotomy Today

Need more than Phlebotomy Today-STAT!? Our flagship newsletter, Phlebotomy Today, is currently in its 8th year of publication. Here's what subscribers are reading about this month:

  • Feature Article: Blood Culture Collection, Part I
  • Sidebar: Blood Cultures: Protecting the Collector
  • Ask the Safety Lady: OSHA consultant addresses these burning questions:
    • Are labs required to designate a sink for handwashing only or can it double for other lab uses?
    • Our jackets for the phlebotomy team are embroidered with the employee's name and look very professional. Our safety officer says they are not compliant. Is this correct?
    • What types of shoes should I wear in the lab?
  • Phlebotomy in the News: a round-up of articles on phlebotomy and phlebotomists who made Internet headlines in December including these stories:
    • Lab Manager Recognized for High Phlebotomy Standards;
    • Polycythemia Outbreak Investigated;
    • Phlebotomist Perishes in Fire
  • According to the Standards: What the CLSI standards say about using cotton versus gauze for post-venipuncture care.
  • Tip of the Month: The Last Line of Defense
  • CEU Questions for managers and educators to use the January issue as an in-house continuing education tool. (Institutional subscribers only.)
  • On a Personal Note: A funny thing happened on the way to naming the new members-only section of phlebotomy.com.

For subscription rates and to subscribe to Phlebotomy Today, visit www.phlebotomy.com/PhlebotomyToday.html. The current month's issue will be emailed to you immediately upon subscribing.

Conference Corner

"Symposium for Clinical Laboratories: An Interactive Experience in Quality Systems" will be conducted May 2-5, 2007 at the Hilton San Diego Resort on Mission Bay in San Diego, California. Features of the symposium jointly sponsored by University of Wisconsin School of Medicine & Public Health and COLA includes:

  • General sessions on successfully implementing quality systems in your laboratory using proven tools and techniques;
  • Breakout sessions on preparing preparing for laboratory inspections, systemizing regulatory complaince, hiring and retaining laboratory personnel, and using quality tools to maximize revenue and profits;
  • CE to meet state requirements for continuing education for clinical laboratory testing personnel;
  • CME to meet CLIA regulations to qualify as laboratory director of a moderate complexity laboratory.

Exhibit area with displays of laboratory instruments, supplies, and services Internationally recognized experts giving presentations on implementing quality systems in the laboratory include:

  • James O. Westgard, Ph.D
  • Dennis Ernst, MT(ASCP)
  • Judy Yost, MA, MT(ASCP)
  • William Greg Cooper, CLS, MHA
  • Lucia M. Berte, MA, MT(ASCP) SBB, DLM; CQA(ASQ) CMQ

For Sympoisum registration or additional information go to www.cola.org. For questions concerning this event, please contact Symposium Operations Director Tricia Hudson at 800-981-9883, ext 427.

Featured FAQ

Each month, PT--STAT! will publish one of the hundreds of phlebotomy FAQs in the growing database of questions and answers available in Phlebotomy Central, the members-only section of the Center for Phlebotomy Education's web site. For information on joining Phlebotomy Central, visit www.phlebotomy.com/PhlebotomyCentral.html.

Question: I suspect some of our staff are not very skilled at drawing based on the frequency of their patients who require recollecting and the extent of the bruising they leave behind. Is there anything out there that suggests what the average number of recollects are per phlebotomist?

Response: A Q-Probe published in 1991 examined patient satisfaction and complications among 30,000 patients (80% survey return rate).(1) The survey gathered data on the size (average: 15.1mm) and frequency (16.1%) of bruising and the number of attempts by phlebotomists per patient (1.03). Ninety-three percent of venipunctures were eventually successful. (4.9% not attempted). But it doesn't state how many attempts were made before they were successful.

A CAP Q-Probe conducted in 1992 addressed the level of recollects at 70 hospitals. 95% were collected on first attempt; 2.8% required two attempts; 0.8% required three attempts and 1.1% required four or more sticks. Unfortunately, this data is a bit dated. I haven't seen any more recent studies published.

(References available in Phlebotomy Central)

For information on joining Phlebotomy Central or access to hundreds more FAQs, visit www.phlebotomy.com/PhlebotomyCentral.html.

Featured Product:
Archives CD

Ever since the first issue of Phlebotomy Today was published online in February 2000, thousands of healthcare professionals around the world have been clamoring for archives. This month, the Center for Phlebotomy Education releases them on CD.

Seven years of back issues will be included on the disk, 81 issues in all, for $49.95. The CD will be searchable by keyword or by individual issue, simplifying the location of articles on specific topics. Avid readers will be pleased to know the CD includes all of the editor's "On a Personal Note" essays.

The archives are in printer-friendly PDF format and will require Adobe Acrobat 7.0 to view and print. A link to Acrobat is provided on the CD. Although each issue includes the "Tip of the Month", the printer-friendly version is not included. (The Center is compiling 70+ tips, attractively designed and printed for selective posting and shipped with a durable acrylic frame. The Tip of the Month collection will be offered in early 2007.)

For more information on the archives CD, visit www.phlebotomy.com/Products.html.

Newsletter Information:

PT STAT! is a free, monthly newsletter provided by the Center for Phlebotomy Education, Inc., the world's most respected authority in blood specimen collection procedures. For a complete company profile and product list for all healthcare professionals who perform, teach or manage specimen collection procedures, visit us on the Internet at: http://www.phlebotomy.com.
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Copyright 2007, Center for Phlebotomy Education, Inc. All rights reserved. Newsletters may contain links to sites on the Internet owned and operated by third parties. The Center for Phlebotomy Education, Inc. is not responsible for the availability of, or the content located on or through, any such third-party site. Information in this document is provided "as is," without warranty of any kind, either expressed or implied, including but not limited to the implied warranties of merchantability, fitness for a particular purpose and freedom from infringement. The user assumes the entire risk as to the accuracy and the use of this document. We will not be liable for any damages of any kind arising from the use of this information, including, but not limited to direct, indirect, incidental, punitive, and consequential damages.