Step 13. After 30 seconds, remove the blood that hasaccumulated on the incision by gently “wicking” it onto acircle of Whatman No. 1 filter paper or Surgicutt BleedingTime Blotting Paper (International Technidyne Corp.,Edison, NJ). Do not touch the incision because this disturbsformation of theplatelet plugand prolongs the BT.Step 15. When the bleeding has stopped, record the timeto the nearest 30 seconds.Step 14. Continue to remove blood from the incisionevery 30 seconds in the manner described previouslyuntil the bleeding stops.PROCEDURE 12-6✦Bleeding Time(Continued)
CHAPTER 12✦Dermal Puncture313Step 16. Deflate the blood pressure cuff.Step 17. Clean the patient’s arm and apply a butterflybandage to hold the edges of the incision togethertightly. Cover this bandage with a regular bandage.Instruct the patient to leave the bandages on for24 hours.Step 18. Depending on the method and device used,normal BTs range from 2 to 10 minutes. The test can bediscontinued after 15 minutes and reported as greaterthan 15 minutes following hospital protocol. It isimportant to follow the manufacturer’s procedureexactly for reproducible results.Step 19. Dispose of used supplies. Remove the bloodpressure cuff.Step 20. Thank the patient, remove gloves, and washhands.Technical Tip 12-19.Consideration should be givento documenting that the patient understands thepossibility of a scar.Technical Tip 12-20.Often patients do not consideraspirin and herbal medication and will not offerthat specific information unless asked.Technical Tip 12-21.Never instruct a patient tostop taking prescribed medication. The health-careprovider must be notified and will make thisdecision before the bleeding time test is repeated.ABPROCEDURE 12-6✦Bleeding Time(Continued)
POINT-OF-CARE TESTINGThe development of portable hand-held instrumentscapable of performing a variety of routine laboratoryprocedures has increased the efficiency of patienttesting. Samples can be collected by dermal punctureand tested by phlebotomists or other health-care per-sonnel in the patient area. Test results are availablequickly and transportation of samples to the labora-tory is avoided. Dermal punctures are performed fol-lowing routine dermal puncture, unless modificationsare recommended by the instrument manufacturers.Phlebotomists performing point-of-care testing(POCT) should follow all manufacturer recommen-dations. The most routinely performed POCTs arediscussed in Chapter 15.314SECTION 3✦Phlebotomy TechniquesPreexamination Consideration 12-4.Ingestion of aspirin, medications containingsalicylate (aspirin), and drugs such as ethanol,dextran, streptokinase, streptodornase, andvarious herbs within the last 7 to 10 days of thetest may cause a prolonged bleeding time.
CHAPTER 12✦Dermal Puncture315✦Dermal puncture is the method of choice forblood collection on children younger than 2years to avoid causing anemia because smalleramounts of blood can be collected. Deep veinpuncture in children is dangerous and may causecomplications.
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Term
Spring
Professor
ADNAN MKOEBO
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