It is almost 3 weeks since I had my professional exam paper and i have to admit that lots of thing i've forgotten! huhhhhhh..memang selame ni belaja untuk exam je ke?? huhhh..
Tak boleh jadi nih. kene belaja balik nih! cemane nk keje kalau banyak bende dah lupe T__T nanti sie2 je selalu kene marah..huhu
Taking blood procedure is a routine for a house officer. So why don't we have some tips review on it. It seems to be very simple..yahhhh it is a simple procedure especially if you're patient is young. But what if your patient is old? when their vessels are collapsing.
1) Prepare things you need in kidney dish before you approach patient (nampak professional sket) heheh. So what are the things you need for blood taking procedure? Needle and syringe is a must! alcohol swab. cotton. tourniquet. tubes for investigations. and GLOVE! (i usually did not wear glove..tp skrg mcm dah insaf je. kene jugak gune glove!!)
2) Smile. Introduce. Explain why this procedure has to be done and Permission - Apply what we've learnt in PPD module ;)
3) Apply tourniquet. Not so tight not too loose. Just nice to help us to see and feel the veins easily. there are many types of tourniquet but usually gune latex glove jek..
4) Choose the most suitable site. Firstly access where is the most prominent vein! choose the big one! not necessary it is to be visible. Sometimes yang tak visible but palpable laaa yg senang nak keluar darah :)
4) If still not visible or palpable. Ask patient to make a fist to further distend the veins. from my experience..many doctors yang tepuk2 tangan patient (on veins area) intended to make the veins more visible. Dont know whether it works or not. hehe.
5) If both veins on both arms are suitable. Choose the non dominant one ye..
6) Then Apply alcohol swab. besides it helps kill the organism on the puncture area it also shines the skin making the veins more visible.
7) By using you left index finger feel the veins. While the rest of your left fingers stretching the skin(this tips is very important for old people cos their skin is much loose)
8) Needle and syringe hold by the right hands and start puncture confidently on tat particular vein you palpating.
9) once puncture..alert the abrupt blood flow upwards inside the needle. Once you noticed it..stay on that position and syringe out the blood quickly. nanti clot susah. usually..if you are on the correct position..the blood easily be syringed out without you have to force it out :) if you're not then the blood flow jadi tersekat2 mehhh..really frustrating!
10) Finish sucking then release the tourniquet. take cotton and then take out the needle :)
habes dah. simple but sometimes it can be really frustrating in case of older / obese patient and patients who are on blood thinners. huhu..
Technique in Taking Arterial Blood Gasses(ABG) is almost the same but what makes it different is the site la kan. name pon arterial. In taking arterial blood you must have a very sensitive pulp finger so that it can sense the arterial pulsation easily. Plus u have to wear glove..agak mencabar sket. but as long as you a pro in anatomy..it helps u a lot :)
haaa..before you puncture the artery..you need to syringe in heparin and then syringe out it back to prevent the blood from clotting. kalau tak nanti..system will reject ur sample and you have to re-do. huhu..if you have the ABG analyzer in your place..you can simply ask the nurses to do it for you or you can do it by urself immediately.. but if you have to send it to laboratory.. you need to put the sample on ice pack then baru hantar ke lab..
