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WHO Guidelines on Drawing Blood Best Practices in Phlebotomy (Eng)

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WHO Guidelines on Drawing Blood Best Practices in Phlebotomy (Eng) WHO guidelines on drawing blood: best practices in phlebotomy WHO Library Cataloguing-in-Publication Data WHO guidelines on drawing blood: best practices in phlebotomy. 1.Bloodletting – standards. 2.Phlebotomy – standards. 3.Needlestick injuries – prevention and control. 4.Guidelines. I.World Health Organization. ISBN 978 92 4 159922 1 (NLM classification: WB 381) © World Health Organization 2010 All rights reserved. Publications of the World Health Organization can be obtained from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: [email protected]). Requests for permission to reproduce or translate WHO publications – whether for sale or for noncommercial distribution – should be addressed to WHO Press, at the above address (fax: +41 22 791 4806; e-mail: [email protected]). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. Printed by the WHO Document Production Services, Geneva, Switzerland Contents Acknowledgements .........................................................................................................................vii Acronyms .........................................................................................................................................xi Executive summary ........................................................................................................................xiii PART I BACKGROUND ...................................................................................................................... 1 1 Introduction .............................................................................................................................. 3 1.1 Overview ..................................................................................................................................... 3 1.1.1 Issues in phlebotomy ....................................................................................................... 3 1.1.2 The need for guidelines ................................................................................................... 4 1.1.3 Definitions ........................................................................................................................ 4 1.2 Purpose and scope ...................................................................................................................... 5 1.3 Objectives .................................................................................................................................... 5 1.4 Target audience ........................................................................................................................... 5 1.5 Indications for blood sampling and blood collection ...................................................................5 1.6 Structure of document ................................................................................................................ 6 PART II ASPECTS OF PHLEBOTOMY .................................................................................................. 7 2 Best practices in phlebotomy ...................................................................................................... 9 2.1 Background information on best practices in phlebotomy .........................................................9 2.1.1 Planning ahead ................................................................................................................ 9 2.1.2 Using an appropriate location .......................................................................................... 9 2.1.3 Quality control ................................................................................................................. 9 2.1.4 Quality care for patients and health workers ................................................................. 10 2.1.5 Quality of laboratory sampling ...................................................................................... 11 2.2 Practical guidance on best practices in phlebotomy .................................................................12 2.2.1 Provision of an appropriate location .............................................................................. 12 2.2.2 Provision of clear instructions ........................................................................................ 12 2.2.3 Procedure for drawing blood ......................................................................................... 12 2.3 Illustrations for best practices in phlebotomy ...........................................................................18 3 Blood-sampling systems ............................................................................................................21 3.1 Background information on blood-sampling systems ...............................................................21 3.1.1 Closed systems ............................................................................................................... 21 3.1.2 Open systems ................................................................................................................. 22 3.2 Practical guidance on blood-sampling systems .........................................................................22 3.2.1 Needle and syringe ........................................................................................................ 22 3.2.2 Choice of gauge ............................................................................................................. 22 3.3 Illustrations for blood-sampling systems ...................................................................................23 4 Venepuncture for blood donation .............................................................................................25 4.1 Background information on venepuncture for blood donation ................................................ 25 4.1.1 Minimum requirements for venepuncture for blood donation ....................................25 4.1.2 Before a blood donation ................................................................................................ 26 4.2 Practical guidance on venepuncture for blood donation ..........................................................27 4.2.1 Collecting blood ............................................................................................................. 27 4.2.2 After a blood donation ................................................................................................... 28 4.2.3 Adverse events in blood donation ................................................................................. 29 5 Arterial blood sampling .............................................................................................................31 5.1 Background information on arterial blood sampling ................................................................31 5.1.1 Choice of site.................................................................................................................. 31 5.1.2 Complications related to arterial blood sampling .......................................................... 31 5.1.3 Sampling errors .............................................................................................................. 32 5.2 Practical guidance on arterial blood sampling ...........................................................................32 5.2.1 Equipment and supplies ................................................................................................. 32 5.2.2 Procedure for arterial blood sampling using radial artery ............................................32 5.3 Illustrations for arterial blood sampling ....................................................................................33 iii 6 Paediatric and neonatal blood sampling .....................................................................................35 6.1 Background information on paediatric and neonatal blood sampling ......................................35 6.1.1 Choice of procedure and site ........................................................................................ 35 6.2 Practical guidance on paediatric and neonatal blood sampling ................................................35 6.2.1 Patient identification ....................................................................................................
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