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WHO indict on drawing Blood: ideal Practices in Phlebotomy. Geneva: people Health Organization; 2010.


This thing covers all the steps recommended for safe phlebotomy and reiterates the embraced principles because that blood drawing and also blood repertoire (31). The chapter includes background info (Section 2.1), handy guidance (Section 2.2) and also illustrations (Section 2.3) pertinent to finest practices in phlebotomy.

The information provided in this section underpins that offered in the remainder of component II for details situations. Chapter 4 likewise provides information relevant come the procedure for drawing blood given below in ar 2.2, but focuses top top blood arsenal from donors.

Institutions deserve to use these guidelines to develop standard operation procedures. Such steps should clearly state the dangers to patients and health workers, and the way to mitigate those threats – discussed listed below in part 2.1.4 and also 2.2.

2.1. Background details on ideal practices in phlebotomy

Best techniques in phlebotomy show off the adhering to factors:

planning ahead;
using an ideal location;
quality of activities sampling.

2.1.1. Plan ahead

This is the many important part of delivering out any procedure, and also is commonly done at the begin of a phlebotomy session.

2.1.2. Using an proper location

The phlebotomist have to work in a quiet, clean, well-lit area, whether working with outpatients or inpatients.

2.1.3. High quality control

Quality assurance is critical part of finest practice in infection prevention and also control (1). In phlebotomy, it help to minimize the opportunity of a mishap. Table 2.1 lists the main materials of top quality assurance, and also explains why they space important.


2.1.4. Quality treatment for patients and health workers

Several components can boost safety standards and quality of care for both patients and also health workers, and also laboratory tests. This factors, disputed below, include:

Availability of appropriate supplies and also protective equipment

Procurement of gives is the direct responsibility of the bureaucratic (management) structures responsible for setting up phlebotomy services. Management should:

make available sufficient activities sample pipe to avoid dangerous techniques (e.g. Decanting blood to recycle activities tubes).

Several safety-engineered devices are accessible on the market; such devices reduce exposure come blood and injuries. However, the use of such tools should it is in accompanied by other infection prevention and also control practices, and also training in their use. No all safety tools are applicable to phlebotomy. Before selecting a safety-engineered device, users have to thoroughly investigate available devices to determine their proper use, compatibility v existing phlebotomy practices, and efficacy in protecting staff and patients (12, 33). Annex B provides further information on epidemic prevention and control, safety equipment and best practice; Annex C offers a an extensive guide come devices accessible for drawing blood, consisting of safety-engineered equipment.

For setups with low resources, cost is a driving variable in procurement the safety-engineered devices.

Where safety-engineered tools are no available, professional use the a needle and also syringe is acceptable.

Availability the post-exposure prophylaxis

Accidental exposure and details information around an incident have to be taped in a register.

Support services should be promoted for those that undergo accidental exposure. PEP can assist to avert HIV and also hepatitis B epidemic (13, 27). Hepatitis B immunization must be noted to all health workers (including cleaners and also waste handlers), one of two people upon entry into health-care solutions or as part of PEP (34). Annex D has actually details that PEP for hepatitis B and HIV.

Avoidance the contaminated phlebotomy equipment

Tourniquets room a potential resource of methicillin-resistant Staphylococcus aureus (MRSA), through up to 25% that tourniquets contaminated through absence of hand restroom on the component of the phlebotomist or reuse of contaminated tourniquets (35). In addition, recycle finger-prick devices and related point-of-care testing tools (e.g. Glucometers) contaminated with blood have been implicated in outbreaks of hepatitis B (4, 5, 36).

To prevent contamination, any type of common-use items, such as glucometers, need to be visibly clean before use on a patient, and single-use items should not it is in reused.

Training in phlebotomy

All staff should be trained in phlebotomy, to prevent unnecessary hazard of exposure come blood and also to reduce adverse occasions for patients.

Supervision by knowledgeable staff and structured cultivate is vital for all health and wellness workers, including physicians, who undertake blood sampling.
Patient cooperation

One that the crucial markers of high quality of care in phlebotomy is the involvement and cooperation that the patient; this is mutually helpful to both the health and wellness worker and the patient.

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Clear details – either composed or linguistic – should be available to every patient that undergoes phlebotomy. Annex F gives sample message for explaining the blood-sampling procedure come a patient.

2.1.5. Quality of activities sampling

Factors that affect the result of laboratory results during collection and also transportation include: