NHSGGC - Venepuncture
TLDRThis instructional video script demonstrates two venepuncture techniques: the butterfly needle and the quick shield. It emphasizes the importance of patient consent, comfort, and proper preparation including PPE, tourniquet application, and skin cleaning with chlorhexidine wipes for 30 seconds. The script details the steps for locating a suitable vein, performing the puncture at a 30-degree angle, collecting blood samples, and safely disposing of needles to prevent needlestick injuries. Key phrases like 'think thirty' for timing and the audible 'click' for activating safety devices are highlighted for safe and effective practice.
Takeaways
- 🧼 Personal Protective Equipment (PPE) is essential and includes wearing a white apron and blue nitrile gloves for venepuncture.
- 🔍 Two different venepuncture devices are used: the butterfly needle and the quick shield, each with its specific set of equipment.
- 💉 The butterfly needle requires a butterfly needle, vacuette container, blood bottles, a Clinell wipe with chlorhexidine, a tourniquet, and a gauze swab.
- 🌡 The quick shield device includes a quick shield holder, needle, blood bottle, skin cleaning agent, tourniquet, and gauze swab.
- ✅ Consent and comfort are vital before beginning any procedure, ensuring the patient understands and is at ease.
- 🔎 Finding a suitable vein involves using fingers to feel for a bouncy, refillable vein without a pulse in the ante cubital fossa.
- 📌 The tourniquet should be placed about three finger breadths above the puncture site and tied in a way that is easy to release.
- 🧽 The skin must be cleaned with a wipe for 30 seconds and allowed to dry before inserting the needle to prevent contamination.
- 🚫 Maintaining a non-touch technique is crucial to avoid contaminating the blood sample and causing a needle stick injury.
- 🔄 After blood collection, blood bottles should be inverted gently to mix with additives without causing hemolysis, which can affect results.
- 🗑 Safe disposal of used needles is mandatory, using a sharps bin to prevent needlestick injuries and contamination.
Q & A
What is the first consideration mentioned in the script for performing venepuncture?
-The first consideration is to think about Personal Protective Equipment (PPE), which includes wearing a white apron and blue nitrile gloves.
What are the two different venepuncture devices demonstrated in the script?
-The two different venepuncture devices demonstrated are the butterfly needle and the quick shield.
What is the purpose of using a Clinell wipe with chlorhexidine in venepuncture?
-The purpose of using a Clinell wipe with chlorhexidine is to clean and decontaminate the skin area before venepuncture, as it is commonly used within the organization for the majority of clinical skills.
What is the alternative to a Clinell wipe with chlorhexidine if needed?
-An alternative to a Clinell wipe with chlorhexidine is an alcohol wipe containing at least 70% isopropyl alcohol.
What is the recommended method for finding a good vein for venepuncture?
-The recommended method is to use two or three fingers to feel the patient's arm or hand for a bouncy, refillable vein that does not pulse and is in the right direction.
Where should the tourniquet be applied in relation to the puncture site?
-The tourniquet should be applied roughly three finger breadths above where the puncture site will be.
How long should the skin be cleaned with the wipe before venepuncture?
-The skin should be cleaned for 30 seconds, ensuring a good decontamination of the area.
What is the importance of allowing the cleaned area to dry before inserting the needle?
-Allowing the cleaned area to dry is important to prevent the introduction of moisture into the puncture site, which could potentially contaminate the sample or cause discomfort to the patient.
What is the correct angle for inserting the butterfly needle into the vein?
-The correct angle for inserting the butterfly needle is 30 degrees.
How should the vacuette container be attached to the butterfly needle?
-The vacuette container should be attached to the butterfly needle by gently unscrewing the sheath and then securely attaching the vacuette where the blood bottles are inserted.
What is the significance of the audible click when activating the safety device on the butterfly needle?
-The audible click signifies that the needle has been completely retracted into the device, ensuring safety and preventing needlestick injuries.
What should be done with the used butterfly needle after the procedure?
-The used butterfly needle should be disposed of in a sharps bin immediately after use, following the 'skin to bin' principle to minimize the risk of needlestick injuries.
What is the difference between the butterfly needle and the quick shield device in terms of needle insertion?
-The difference lies in the design of the needle and the flashback chamber. The quick shield has a grey cap that needs to be unscrewed and attached to the collection device, and its flashback chamber is less obvious, requiring closer inspection for the appearance of flashback.
How should the blood bottles be handled after filling during venepuncture with the quick shield device?
-After filling, the blood bottles should be removed from the device, inverted a few times to gently mix the contents with the additives, and then placed in the correct order in the tray.
What is the procedure for removing the needle after taking blood samples with the quick shield device?
-The procedure involves removing the tourniquet, placing a gauze swab over the needle without pressing down, and then activating the safety device by hearing an audible click before disposing of the needle in a sharps bin.
Outlines
😷 Personal Protective Equipment and Equipment Setup
The script begins with an introduction to the importance of Personal Protective Equipment (PPE), specifically mentioning the use of a white apron and blue nitrile gloves. The presenter then transitions to discussing the equipment needed for venepuncture, including two different devices: the butterfly needle and the quick shield. The butterfly needle setup involves a butterfly needle, vacuette container, blood bottles, a Clinell wipe with chlorhexidine, and a gauze swab. For the quick shield, the presenter lists the quick shield holder, needle, blood bottle, cleaning solution, tourniquet, and gauze swab as necessary components. The summary emphasizes the preparation and setup process before performing venepuncture.
💉 Demonstration of Butterfly Needle Venepuncture Technique
The presenter proceeds to demonstrate the butterfly needle technique for venepuncture. This includes obtaining patient consent, ensuring patient comfort, locating a suitable vein, applying a tourniquet, and cleaning the skin with a chlorhexidine wipe for 30 seconds. The presenter details the correct insertion angle of the needle, the importance of allowing the skin to dry before insertion, and the process of attaching blood bottles to collect the sample. The summary also covers the steps to safely remove the needle, activate the safety device, and dispose of the needle in a sharps bin to prevent needlestick injuries.
🛡️ Transition to Quick Shield Device and Demonstration
This section introduces the Quick Shield device as an alternative to the butterfly needle for venepuncture. The presenter outlines the similarities in the initial steps, such as gaining patient consent, ensuring comfort, applying the tourniquet, and cleaning the skin. The setup for the Quick Shield includes the device itself, a needle with a grey cap, and blood bottles. The summary highlights the process of unscrewing the cap, attaching the needle to the collection device, and the correct positioning of the needle for insertion. It also emphasizes the non-touch technique to prevent contamination and the importance of observing the flashback in the chamber as an indicator of successful vessel entry.
Mindmap
Keywords
💡Venepuncture
💡PPE
💡Butterfly Needle
💡Quick Shield
💡Vacuette Container
💡Chlorhexidine
💡Tourniquet
💡Flashback
💡Safety Mechanism
💡Hemolysis
💡Sharps Bin
Highlights
Introduction to Personal Protective Equipment (PPE) for venepuncture, emphasizing the use of a white apron and blue nitrile gloves.
Demonstration of two different venepuncture devices: butterfly needle and quick shield.
Explanation of equipment setup for butterfly needle including vacutte container, blood bottles, and skin cleaning materials.
Use of Clinell wipes with chlorhexidine for skin decontamination in acute services, with an alternative of 70% isopropyl alcohol wipes.
Importance of patient consent and comfort before starting venepuncture procedure.
Technique for finding a suitable vein, including characteristics like bounciness, refilling, and non-pulsing direction.
Proper application of the tourniquet three finger breadths above the puncture site.
Cleaning the skin with a Clinell wipe for 30 seconds and allowing it to dry before needle insertion.
Assembly of the butterfly needle, including unsheathing the needle and attaching the vacuette container.
Insertion technique for the butterfly needle with a 30-degree angle until flashback in the chamber is observed.
Attaching blood bottles to the butterfly needle using a non-touch technique and monitoring fill levels.
Inversion of filled blood bottles to mix with additives without causing hemolysis.
Safety mechanism of butterfly needle, including retraction into the device to prevent needlestick injuries.
Demonstration of the quick shield device setup, including needle preparation and attachment to the holder.
Similar initial steps for quick shield as for butterfly needle, such as gaining consent, applying tourniquet, and skin cleaning.
Insertion technique for the quick shield needle with careful observation for flashback in the chamber.
Attachment of blood bottles to the quick shield device and monitoring fill levels, similar to butterfly needle.
Safety mechanism of quick shield, including an audible click when the safety shield locks over the needle.
Summary of key phrases and techniques used in the venepuncture procedure, such as 'think thirty' for timing and angles.
Transcripts
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