A phlebotomist is performing a venipuncture on a patient who is allergic to alcohol. Which of the following is an appropriate antiseptic to use in place of alcohol?

Choice A reason:
The nondominant dorsal hand is not typically recommended for dermal specimen collection in toddlers due to the thinness of the skin and the proximity of bones and tendons, which increases the risk of injury.

Choice B reason:
The dominant lateral plantar heel is also not an ideal site for dermal specimen collection in toddlers. The heel is a common site for blood collection in neonates, but as children grow, the skin on the heel thickens, and the risk of hitting bone increases.

Choice C reason:
The nondominant third finger is the recommended site for dermal specimen collection in toddlers over one year of age. The palmar surface of the distal phalanx of the middle or ring finger provides a sufficient area for puncture while minimizing the risk of injury to underlying structures.

Choice D reason:
The dominant antecubital space is not a typical site for dermal specimen collection, especially in toddlers. This area is generally used for venipuncture due to the presence of larger veins suitable for this type of blood collection

Choice A reason:

Simply observing the site to see if the hematoma worsens is not an appropriate response. While monitoring the development of a hematoma is part of the process, it is not a proactive measure to address the immediate issue. The phlebotomist must take action to prevent further injury or complication.

Choice B reason:

Asking the patient to apply pressure may be part of the post-venipuncture care, especially after the needle has been removed, to aid in stopping any bleeding. However, this does not address the immediate concern of a developing hematoma during the draw.

Choice C reason:

Releasing the tourniquet and stopping the draw is the correct action to take when a hematoma is observed. This response is in line with the standard procedure for when a complication arises during venipuncture. Stopping the draw helps prevent further blood from pooling and exacerbating the hematoma.

Choice D reason:

While calling for a nurse and assessing the patient's condition is important, especially if the phlebotomist needs assistance or the patient shows signs of distress, it should not be the first action taken. The immediate response should be to address the hematoma by stopping the draw.