Sometimes, we need to do this for patients whose veins cannot handle the pressure of

the vacuumized tubes.

The equipment that we're going to need is, obviously, we're going to need our evacuated

tube.

We will need a barrel syringe.

We'll need a hypodermic needle with a safety cap.

We'll also need a transfer device.

We'll need our gauze, our alcohol swabs, and, of course, our tape.

Let's go ahead and tear off a piece of tape.

Put that on the corner of the table.

We'll need our tourniquet.

Go ahead and apply this now.

I've already asked my patient for consent and I also explained the procedure.

And, I've also previously washed my hands.

So, we're going to palpate with our two index fingers of our non-dominant hand.

And, we need to ask our patient sometimes to make a fist, okay.

And, I've found my vein of choice.

Let's go ahead and landmark, okay.

Release.

Assemble our needles.

Make sure that our needles are in date and that our syringe is in date.

If this was expired, then we'd know that the needle and the syringe would no longer be

sterile.

With our syringe, you'll see that there's a Luer tip in here.

What Luer means is thread.

So, we can thread this on like a screw.

That's good and tight.

Set there.

We'll go ahead and apply our gloves now, okay.

And, we'll cleanse our patient right before we put our tourniquet back on.

Start in the center, circle concentric method, inside out.

Place to the side.

Place our tourniquet.

Make sure that our ends are up.

Have our patient make a fist, okay.

Go ahead and pull back our safety cap and release the cap down.

Check our needle.

Make sure everything's okay with it.

It's good.

And, also with the syringe, before you stick your patient, you want to pull back on the

plunger to loosen it.

Sometimes the needle's been sitting for a couple of years.

So, you just want to plunger a little bit before you stick the patient.

Anchor your vein.

And, one, two, stick.

You want to slowly pull back.

With this test we're performing, it's a serum test, I'm going to need three milliliters

of blood.

So, very slowly I'll pull back the plunger until I have three milliliters of blood.

I can tell when I have three milliliters of blood because my syringe is a graduate cylinder,

which means it's been marked on the side.

You'll see the blood slowly move in.

Gradually pull back your plunger.

This will take a little bit of time because, obviously, if we're doing this, our patient

cannot tolerate the suction from regular tubes.

It's also important to go very slow because if we pull our plunger back, we can hemolyze

our specimen by pulling back the plunger too fast, okay.

And, as we're doing this, keep in mind your patient may be nervous.

It's okay to talk to your patient.

It probably would put them at ease too.

This could take a couple of minutes to draw the amount of blood you need.

It looks like I almost have my three milliliters of blood.

So, what I'm going to do is I'm going to release my tourniquet, grab my gauze, fold it over

once, fold it over twice, pull my needle out, apply pressure, immediately safety cap.

And, this instance only, we can sit the syringe down on our disposable chuck and finish bandaging

our patient.

Okay, we have our patient bandaged.

Now, the next step, since we drew this into a syringe, we now need to move it from the

syringe into the evacuated tube.

Very carefully, you'll unscrew the safety cap needle.

Dispose of this in the biohazard.

You'll need your transfer device.

Make sure that it is in date also.

Attach your transfer device.

It screws in just like the needle.

Turn your syringe upside right.

And, insert your tube from the bottom.

Make sure that you face your label away.

This way, you can see when the tube is done collecting.

And, just gently press in and let the vacuum do the work for you.

Alright, and then we disengage our tube.

And, we'll invert three to four times, okay.

And, we'll discard our assembly into the biohazard box.

At this time, we''ll go ahead and put our patient's name on, the date, time, and our

initials.

And, we'll place into the biohazard bag and send our specimen to the lab.