Obtaining a blood sample through the subcutaneous reservoir.
Objective:
To obtain a sufficient amount of blood for the requested analytical determination.
Equipment:
– Trough or trolley for cures. – Sterile drapes. – Sharps container.
Material:
– 1 pair of sterile gloves. – Sterile dressings. – Sterile gauze.
– Antiseptic solution. – Physiological saline solution. – 3 syringes of 10-20 ml. – Needles with special bevel and extension of 22G/20G (nutrition or transfusion). – 1 obturator. – 2 Intravenous needles. – Diluted sodium heparin (commercial preparation). – Hypoallergenic plaster. – Tubes for blood samples according to the type of analysis. – Nursing records.
Procedure:
– Wash hands. – Prepare the necessary material. – Preserve the patient’s privacy. – Inform the patient of the procedure to be performed. – Ask for the patient’s cooperation. – Place the patient in the supine position, with the head turned to the opposite side where the reservoir is implanted. – Assess the appearance of the skin covering the subcutaneous chamber (make sure there is no redness, edema, subcutaneous infiltration, ulceration or suppuration). – Put on sterile gloves. – Create the sterile field and place all the necessary material for the puncture. – Load a 10 cc syringe with 5 ml of diluted heparin sodium and another with saline. – Purge the needle system with special bevel and extension pole with physiological saline. – Clamp the system. – Clean the area with antiseptic solution and let it dry. – Locate the device by palpation. – Immobilize the chamber with the fingers of the non-dominant hand. – Insert the needle perpendicularly to the reservoir membrane, looking for the center of the chamber and avoiding previous injection points, advancing it firmly until it meets the metal stop. – Declamp the system. – Inject 5 c.c. of physiological saline solution to check permeability. – Aspirate 5-7 c.c. of blood. – Clamp and discard. – With a new 10 cc syringe aspirate the amount of blood required for the analysis, previously unclamping.
– Clamp again. – Inject the 5 ml of diluted heparin. – Clamp the system. – Screw the obturator on the distal end of the system. – Place a sterile gauze under the needle to avoid skin erosion. – Place a sterile transparent dressing. – Introduce the required amount of blood into each tube. – Discard the sharps in the container intended for this purpose. – Collect the material. – Leave the patient in a comfortable position. – Remove gloves. – Wash hands. – Send for laboratory analysis. – Record in the nursing documentation: procedure, reason, date and time, incidences and patient’s response.
Observations:
Never inject liquids through the reservoir with syringes of less than 10 ml, since the silicone of the chamber may crack and extravasate the medication.[/et_pb_text][/et_pb_column][/et_pb_row][/et_pb_section]
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