New to Home Health - ?'s about 1st visit and PT/INR!!

Posted

Hi,

I am new to home health and have my first client tomorrow. I am going out for a surgical wound eval, initial assessment and PT/INR draw. I am pretty rusty on venipuncture (I have been in ambulatory clinics since RN school) and could use some tips!! I know I am to use the blue tubing and have been told that it is tricky to get them to fill to the top. Any tips/tricks for blood draws, specifically PT/INR?? PLEASE!

Keld401

Keld401

Specializes in Home Health. Has 3 years experience. 4 Posts

Do you have a Coagucheck machine available? Its like a glucometer, and gives you instant readings with a fingerstick. Alot of agencies are using them now. If you have to do a blood draw, I use a 23 g butterfly, waste a small amount into a red tube, then fill the blue. It has to be all the way to the line or the sample won't be usable. If you dont waste into the red tube the air in the butterfly tubing takes up space in the blue tube and it won't fill. Good luck, enjoy your first day!

Thank you so much! One more question: Venipunture vs. IV start - do i advance the catheter after flash or just stop once I get return? Then, leave the tourniquet on until I have my specimen, remove tourniquet, remove specimens tubing and then remove the catheter, correct? I appreciate the help! :)

AMN74

AMN74

Has 26 years experience. 124 Posts

Apply tourniquet, look for a vein that you can SEE well, or feels juicy. Gloves on, clean with alcohol, stick vein. You can stop at the flash of blood, no need to advance to just draw blood. Then attach tube to butterfly, make sure it FILLS up, if not enough blood lab will reject your specimen. Take off tourniquet, pull out butterfly apply pressure, apply bandaid, watch for any bleeding for a few minutes. If you have not done a vp for a long time, or your agency has not "checked you off" on the procedure, ask for someone to go with you the first time.

LaRN

LaRN

272 Posts

i use a blood pressure cuff as a tourniquet, just make sure not to pump it up too much. and someone mentioned it already, but make sure you let a little blood run into another vial before you fill the blue one up. rotate the tube gently a few times.

don't forget to find out exactly how much coumadin your patient is taking. don't rely on the chart, ask the patient. you have to do this on every visit with pts on coumadin.

cara vander wiel

cara vander wiel

Specializes in ICU, Critical Care, Home Care. Has 27 years experience. 5 Posts

I am surprised that your agency is not sending someone with you on your first visit. This seems wrong.