Therapeutic Phlebotomy help

[jwhitman]

I just started as a nursing coordinator at a local hospital . They currently perform therapeutic phlebotomies using IV catheters and using multiple vacutainer tubes. The hospital I came from used 18g apheresis catheters and colection bags from the blood bank and scales. We are looking at collection bags and scales. My question is this: Is there any benefit or difference with using apheresis needles vs standard IV catheters?

Thanks

[Music in My Heart]

Less likely to clot off, from what I've seen. Tend to run faster, too, both due to lower internal friction and generally shorter length.

That said, we do use angiocaths and IV tubing on certain patients who require a fluid infusion prior to the blood letting.

[iluvivt, BSN, RN]

I have used both and there are pros and cons to each system. If you are using a standard catheter over needle device (an IV catheter) you can easily disconnect and flush if needed and get blood samples before or after and use it as an IV after you are done if needed. If you are using a steel neeedle attached to a blood collection bag these are usually one piece systems.....so if you are struggling to get a certain volume and its getting sluggish ..you have limited troubleshooting options. You also need to look at the safety issues..why are you using multiple vacutainers?. The vacutainer does pose a few risks if the clinician is not familiar with working with a pressurized container. I used to use a blood transfer set and that way I could choose either a standard needle or an IV catheter. One of my co-workers does neither..she just spikes and primes some NS...empties it keeps the fluid pathway sterile and then uses and IV catheter to perform the venipunture and puts the bag to gravity

[EricJRN, MSN, RN]

We used to collect whole blood for therapeutic phlebotomy on outpatients when I worked for a hospital-based blood donor center several years ago.

We would use the standard donor blood collection system. That involved a needle, attached to tubing, which led to a collection bag that could be placed on a scale. An in-line mechanism for collecting extra Vacutainer tubes is also incorporated into those systems.

[iluvivt, BSN, RN]

The one we have with attached needle is called " blood drawing kit" by Kawasumi Labratories...this has a port to draw to draw blood as described above

[rlights]

We are in the process of implementing this skill at our hospital. Not sure where to start. I read the procedure in Mosby which seems relatively simple . Any recommendations of a company I should contact for product information and in-service?

[mappers]

We use 500 mL vacuated glass bottles and 22G IV needles. Clotting is rarely a problem. For us, we have fewer problems with light-headnesses after phlebotomy because it does take a little longer. Some patients have clotting issues, but they are pretty rare and the IV Catheter is much gentler on the vein. Most patients who have had both steel needles and caths prefer the cath.