Okay, today we're going to use a banana to simulate a blood draw.
The reason why it's good to use a banana to do a blood draw is with this banana skin,
particularly a banana still has some green, along the ridges we can simulate what we might
feel as we stick or incise a human.
When we feel that little pop or give into a human's vein.
It's good to use a banana for this.
Okay, the supplies you'll need to do a banana blood draw is you're going to need hand sanitizer.
You're going to need your tourniquet.
You're going to need your banana, preferably a green one.
You're going to need your PPE, in this case it would be gloves.
You're going to need your alcohol swabs, seventy percent isopropyl alcohol.
And then, you're going to need your vacutainer needle and your tubes.
We'll also need our two by two gauze.
And, we'll need a pen to label with when we're done.
I have my biohazard box nearby, in arm's reach.
And, I also have an extra needle, an extra set of tubes in case there are complications
or loss of suction.
Now, first thing that I'm going to to do is I'm going to wash my hands.
It's important to always wash your hands before and after every patient.
And, when using an alcohol wash, we need to rub our hands vigorously until the substance
is dried.
If you were washing your hands with soap and water, you'll need to sing the "Happy Birthday"
song twice in your head to wash your hands long enough.
Okay, so my hands are dry now.
Now, I'm going to don my gloves.
Make sure that you have a good, tight snug fit.
Now, as you see, with most of my gloves, my tips, my fingers are good and snug in the
gloves.
I don't have too much excess on the fingertips.
And, in phlebotomy you need a good, tight feel against your fingers so you can palpate
the vein easily.
So, I have my gloves on now.
Now, I'm going to take my tourniquet, and this is my pretend patient, Mr. Banana.
I've already ID'd him and compared him to the requisition that the doctor issued.
The ID matches up.
And, I have informed consent from the patient.
So, now let's go ahead and begin with the procedure.
I'm going to wrap the tourniquet around the patient, or around Mr. Banana here.
And, in this case, we're not going to be able to tie the banana all the way because this
tourniquet would be too rough on a banana.
So, we'll simulate this by just laying over the tourniquet, okay.
So, I have my tourniquet on.
And, I begin to palpate.
And, as we palpate, we use our two, non-dominant index fingers and we go over one side, feeling
over, coming back across, and picking our vein that we'd like to use.
So, we'll pretend that I go right here, okay.
And, what I'm going to do is I'm going to do a landmark.
You can use the body skin, such as freckles, little pimples as a landmark.
Or, you can take your little thumbnail and just press to make a little mark to save your
spot.
So, I've found my landmark.
Now, the next step is, as a new phlebotomist until you pick up your speed, you'll want
to release your tourniquet for a minute, as you cleanse your patient.
Take your alcohol swab.
You're going to go, start in the center where you want to do your puncture, and go in a
circle method inside out.
Never back in.
We want to push the dirt away from the site.
As that alcohol swab is drying, I'm going to go ahead and assemble my needle.
While I am assembling my needle, I'm also checking to make sure it's still in date.
And, it is.
And, the seal was intact.
I'm going to tear off the end of the multi-sample needle, insert it into my holder, tighten
carefully, okay.
So, what I'm doing now is I'm checking to make sure that my tubes are in date.
Also, I checked previously, my needle is in date.
We need the...needles can expire, their sterility can expire.
So, we also want to check the label on the needle too to make sure the needle label,
the paper sticker, is intact, which this needle is good.
This date is good on the tube.
And, the date is good on this tube.
The most common thing that will happen with a tube being expired is they loose their vacuum
suction.
So, you do not want to use expired tubes due to that fact.
And, you would not want to use expired needles because the guarantee of them being sterile
is no longer there.
Alright, so the alcohol is already dry on our patient.
So, let's go ahead and place our tourniquet back on, okay.
And, with my non-dominant hand, I'm going to anchor the vein.
And, by anchoring the vein, you take your thumb, you gently press down and back a little
bit to pull the skin tight.
With my dominant hand, I'm going to take the needle, release the cap, check for any barbs
or shards, anything out of the ordinary on the needle.
Make sure it's completely perfect.
And, it is.
I'm going to hold my needle with my safety cap pulled back, my thumb on top, and my two
index fingers below.
And, I'm going to stick: one, two, stick, okay.
Now, I'm in my vein.
I'm going to let go of my anchoring.
My non-dominant hand is going to do the work now.
I'm going to insert my blue tube in first, with the label side down.
We want the label down so you can see the blood come in.
And, for this demonstration, obviously we're going to pretend we have blood flowing into
the vein.
So, it's full.
We're going to pull it out gently, trying not to let your needle move.
And, you're going to invert this slowly three to five times and sit that down.
Then, you get your next tube, needle down, alright and we're pretending it's filling
up with blood now.
This will be our last tube.
So, before we disengage this tube, we're going to release our tourniquet, disengage our needle,
or excuse me, our tube.
Invert it three to five times.
You want to invert your tubes slowly three to five times each, depending on the chemical.
You don't want to shake it rough.
When you shake it rough, it causes hemolysis.
You want to go slow, gently inverting the blood into the chemical mixture.
Set it down.
We want to pinch our gauze and fold over again in four corners, because we need to make a
pressure bandage.
And, I have that ready.
I'm going to pull out my needle.
And, immediately cover with gauze and safety cap all in the same motion.
Okay, so as you pull your needle out, you want to immediately safety cap your needle
and go directly into the biohazard box.
You never want to lay it down on the table.
Immediately go to he biohazard box, drop the needle in freely and be careful not to stick
your finger into the container.
We never pull needles back out or any trash back out of the biohazard box.
So, I'm holding direct pressure on my site for a few moments.
I have my tape already torn, ready to go.
And, we're going to bandage our patient.
And, we want to make sure that he a good, tight seal.
You want to make sure it's tight on the bottom and tight on the top.
And, that's' how you practice doing a phlebotomy blood draw on a banana.
Alright, and as the very last step of phlebotomy, after you've bandaged your patient and disposed
of all your equipment and your patient's safe and not bleeding anymore, you're going to
label your needles, or excuse me, label your tubes with the patient's name, this time it
would be banana.
And, you also want to put today's date and your initials.
This needs to go on every tube that you draw.
And then, we'll put this.
I'll label the other one, banana, my initials, and the date.
Alright, and then both of these would go in your lab specimen bag.
There are various different styles available.
And then, you would transport this down to the laboratory, either by the pneumatic tube
system or hand carried.
And, that's the last step of the phlebotomy blood draw.