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What is Venipuncture? While venipuncture can refer to a variety of procedures, including the insertion of IV tubes into a vein for the direct application of medicine to the blood stream, in phlebotomy venipuncture refers primarily to using a needle to create a blood evacuation point. As a phlebotomist, you must be prepared to perform venipuncture procedures on adults, children, and even infants while maintaining a supportive demeanor and procedural accuracy. Using a variety of blood extraction tools, you must be prepared to respond to numerous complications in order to minimize the risk to the patient while still drawing a clean sample. In its entirety, venipuncture includes every step in a blood draw procedure—from patient identification to puncturing the vein to labeling the sample. Patient information, needle placement, and emotional environment all play a part in the collection of a blood sample, and it's the fine details that can mean the difference between a definite result and a false positive. After placing the tourniquet and finding the vein, it's time for the phlebotomist to make the complex choice on what procedure will best suit the specific situation. Keeping this in mind, it should be noted that the following information is not an instructional guide on how to perform these phlebotomy procedures. Rather, the information below is intended to serve as an educational resource to inform you of the equipment and procedures you will use. Venipuncture Technqiues Venipuncture with an Evacuated or Vacuum Tube: This is the standard procedure for venipuncture testing. Using a needle and sheath system, this procedure allows multiple sample tubes to be filled through a single puncture. This procedure is ideal for reducing trauma to patients. After drawing the blood, the phlebotomist must make sure the test stopper is correctly coded and doesn't contact exposed blood between samples. Venipuncture with a Butterfly Needle : This is a specialized procedure that utilizes a flexible, butterfly needle adaptor. A butterfly needle has two plastic wings (one on either side of the needle) and is connected to a flexible tube, which is then attached to a reservoir for the blood. Due to the small gauge of the needle and the flexibility of the tube, this procedure is used most often in pediatric care, where the patients tend to have smaller veins and are more likely to move around during the procedure. After being inserted into a vein at a shallow angle, the butterfly needle is held in place by the wings, which allow the phlebotomist to grasp the needle very close to the skin. Phlebotomists should be careful to watch for blood clots in the flexible tubing. Venipuncture with a Syringe: This technique is typically only used when there is a supply shortage, or when a technician thinks it is the appropriate method. It uses the classic needle, tube, and plunger system, operating in a similar manner to the vacuum tube but requiring multiple punctures for multiple samples. Additionally, after the blood is drawn it must be transferred to the appropriate vacuum tube for testing purposes. If you choose to use this method, remember to check for a sterile seal, and use a safety device when transferring the sample. Fingerstick (or Fingerprick): This procedure uses a medical lance to make a small incision in the upper capillaries of a patient's finger in order to collect a tiny blood sample. It is typically used to test glucose and insulin levels. When performing a Fingerstick, the phlebotomist should remember to lance the third or fourth finger on the non-dominant arm. Never lance the tip or the center of the finger pad; instead, lance perpendicular to the fingerprint lines. Heelstick (or Heelprick): Similar to the Fingerstick procedure, this process is used on infants under six months of age. A medical lance is used to create a small incision on the side of an infant's heel in order to collect small amounts of blood for screening. As with a Fingerstick, the incision should be made perpendicular to the heel lines, and it should be made far enough to the left or right side of the heel to avoid patient agitation. Before performing a Heelstick, the infant's heel should be warmed to about 42 degrees Celsius in order to stimulate capillary blood and gas flow. Therapeutic Phlebotomy: This involves the actual letting of blood in order to relieve chemical and pressure imbalances within the blood stream. Making use of a butterfly needle, this therapy provides a slow removal of up to one pint of blood. Though the blood removed is not used for blood transfusions, the procedure and concerns are the same as with routine blood donation. As with any phlebotomy procedure, one should pay close attention to the patient in order to prevent a blood overdraw. Bleeding Time: A simple diagnostic test that is used to determine abnormalities in blood clotting and platelet production. A shallow laceration is made, followed by sterile swabbing of the wound every 30 seconds until the bleeding stops. Average bleed times range between one and nine minutes. As a phlebotomist, you should familiarize yourself with the application and cross-application of these procedures in order to recognize when a procedure is necessary, and what the risks are for each.
Spina bifida is a condition that affects the spine and is usually apparent at birth. It is a type of neural tube defect (NTD). Spina bifida can happen anywhere along the spine if the neural tube does not close all the way. When the neural tube doesn’t close all the way, the backbone that protects the spinal cord doesn’t form and close as it should. This often results in damage to the spinal cord and nerves. Spina bifida might cause physical and intellectual disabilities that range from mild to severe. The severity depends on: The size and location of the opening in the spine. Whether part of the spinal cord and nerves are affected.
What goes into providing anesthesia for cardiac surgery where a patient's heart is completely arrested? In this video, I take you into the operating room during a surgery and talk with Dr. Benji Salter, program director for Mt. Sinai Hospital's cardiothoracic anesthesiology fellowship program.
While no patient information is shown in this video, the patient did provide written consent for filming to occur during surgery. Permission was also obtained from Mount Sinai Hospital's Department of Anesthesiology as well as the hospital's Press Office.
Chapters
0:00 Start
0:44 Surgery background
1:40 Case preparation
2:45 Anesthesia equipment
6:21 Echocardiography
7:16 Preparing for bypass
8:34 Stopping the heart
9:06 Fellowship
10:46 Why cardiac anesthesia?
11:52 Coming off of bypass
13:06 Post-op recovery
The information in this video is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and information, contained in this video is for general information purposes only and does not replace a consultation with your own doctor/health professional.
#Anesthesiology #Residency #MedicalSchool
A renal biopsy is a procedure used to extract kidney tissue for laboratory analysis. The word “renal” describes the kidneys. A renal biopsy is also called a kidney biopsy. The test helps your doctor identify the type of kidney disease you have, how severe it is, and the best treatment for it.
Overweight does not necessarily equal unhealthy. There are actually plenty of overweight people who are in excellent health (1). Conversely, many normal weight people have the metabolic problems associated with obesity (2). That’s because the fat under the skin is actually not that big of a problem (at least not from a health standpoint, it’s more of a cosmetic problem). It’s the fat in the abdominal cavity, the belly fat, that causes the biggest issues (3). If you have a lot of excess fat around your waistline, even if you’re not very heavy, then you should take some steps to get rid of it. Belly fat is usually estimated by measuring the circumference around your waist. This can easily be done at home with a simple tape measure. Anything above 40 inches (102 cm) in men and 35 inches (88 cm) in women, is known as abdominal obesity. There are actually a few proven strategies that have been shown to target the fat in the belly area more than other areas of the body.
An animation of blood flow inside the hollow fiber of a hemofilter, or a dialyzer, and the flow of the dialysate in an opposite direction with increased extraction of waste and small molecules from the blood as the concentration of these molecules is reduced downstream and exposed to new dialysate.
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Watch this video to learn how and when to change a dressing for a child with a hemodialysis catheter. You should change your child's dressing if it becomes soiled with water or blood or if it comes off at home. Keeping a clean dressing on your child will limit risk of infection.
A Beautiful Smile at Lake Pointe is Sugar Land premier dentistry practice. Dr. Lance Jue has been serving patients' preventive, restorative and cosmetic dental needs here in Sugar Land for over 19 years. Book an appointment online now with Dr. Lance Jue
ThermiVa is a non-surgical vaginal tightening treatment for women who want to reclaim what childbirth or aging may have taken away. Using the same technology that’s used in ThermiTight and ThermiSmooth, radiofrequency energy is sent to the desired area (internally or externally), heating the tissue and stimulating the body’s own collagen. ThermiVa is performed in three treatments over the course of three months.
Glass ampules are often used to store medication, and as a nurse, you'll need to know how to use them.
In this video, I demonstrate how to clean an ampule using alcohol prep, how to open (or break) an ampule, as well as how to dispose of the ampule.
In addition, I show how to use an ample filter straw while drawing up (withdrawing) medication, how to use the syringe, and how to remove the air bubbles in the syringe.
This is another video in our series on clinical nursing skills.
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Detailed examination of the joints is usually not included in the routine medical examination. However, joint related complaints are rather common, and understanding anatomy and physiology of both normal function and pathologic conditions is critically important when evaluating the symptomatic patient. By gaining an appreciation for the basic structures and functioning of the joint, you'll be able to "logic" your way thru the exam, even if you can't remember the eponym attached to each specific test!