Required section · Section 5 of 6
Sequence the draw and handle a developing complication
Two decisions sit at the center of safe venipuncture: getting the sequence right, and recognizing when to stop. The ordering exercise below asks for the full sequence from order verification through handoff, without skipping the identification step just because the rest of the technique is routine.
The second decision is a complication in progress. If a hematoma develops, if blood flow stops unexpectedly, if the patient reports sharp or electric pain, or if signs of syncope appear, the correct response is to stop the collection and follow the local adverse-event response, not to push through to finish filling a tube. After collection, direct pressure and observation continue until bleeding is controlled; how long that observation lasts and when to escalate depend on local policy and on the individual patient.
A nearly full tube is not a reason to continue past a stop sign. The specimen already in hand may still be usable, or it may need to be discarded depending on what happened; either way, the patient's safety is evaluated first and the specimen question follows.
A good sequence protects specimen quality, and a fast stop protects the patient; neither one is optional because the other one went well.
| Sign | Immediate action |
|---|---|
| Hematoma developing | Stop the draw and follow the local adverse-event response |
| Blood flow stops unexpectedly | Stop and reassess rather than repositioning blindly; follow local policy on attempts |
| Sharp or electric pain reported | Stop immediately; this can signal nerve involvement |
| Signs of syncope | Stop, secure the patient's safety, and follow the local emergency response |
Ordering exercise
Place these steps in the order a collector should actually perform them for this case.
1. Collect tubes in order of draw
Perform the venipuncture and fill citrate, then heparin, to the manufacturer fill line.
2. Verify order and requisition
Match the printed order to the patient before opening any supplies.
3. Label at the bedside
Label both tubes in the patient's presence with reconciled identifiers, time, and collector ID.
4. Resolve the identity discrepancy
Use the approved local identification pathway to reconcile the wristband name change with the order.
5. Observe and hand off
Apply pressure, observe for complications, and hand the specimen off through approved transport.
6. Select and prepare the site
Choose an approved site, apply the tourniquet, anchor the vein, and let the antiseptic dry.
7. Release tourniquet; after withdrawal, activate safety device
Release the tourniquet promptly. After the needle is fully withdrawn, activate the safety feature according to its instructions for use.
Knowledge checks
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Knowledge check 1
Section status
Finish this section
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The module finishes after every required section is marked done and every check in those sections is correct.