A phlebotomist is preparing to perform venipuncture for blood collection from a 6-year-old patient. Which of the following needles should the phlebotomist use?

Choice A Reason:
Notifying the provider about the error is an important step, but it does not correct the error in the patient's chart. Communication with the provider ensures that they are aware of the mistake and can make informed decisions regarding patient care. However, the physical correction of the documentation is also necessary to maintain accurate medical records.

Choice B Reason:
Asking an administrator to erase the error is not a recommended practice. Erasing or using correction fluid can make the chart appear tampered with, which can have legal implications. It is essential that the original entry remains visible to preserve the integrity of the medical record.

Choice C Reason:
Striking a line through the error and initialing is the correct method for correcting a written error in a patient's chart¹². This approach allows the original entry to remain legible, which is crucial for legal and clinical reasons. It also shows that the correction was made by an authorized individual, as the initials indicate who made the change.

Choice D Reason:
Erasing the error and entering the correct information is not an acceptable practice for the same reasons as choice B. It is important not to remove or conceal the original entry, as this could be considered falsifying medical records.

Choice A reason:
A 16-gauge needle is quite large and is typically used for rapid fluid administration or blood donation in adults. It is not suitable for pediatric patients due to the size of their veins and the potential for causing trauma and discomfort.

Choice B reason:
An 18-gauge needle is also large and commonly used for adult patients in situations where larger volumes of blood are needed quickly. For a 6-year-old patient, this gauge would be too large and could cause significant pain and increase the risk of damaging the vein.

Choice C reason:
A 23-gauge needle is recommended for pediatric patients, including those who are 6 years old. It is small enough to minimize discomfort and the risk of injuring the vein, yet it allows for adequate blood flow for collection³. This size needle is often used with a winged infusion set, which is suitable for the smaller, more fragile veins of pediatric patients.

Choice D reason:
A 27-gauge needle is very small and is typically used for intradermal injections or for very small veins, such as those in neonates. While it would cause minimal discomfort, it may not provide an adequate flow rate for venipuncture in a 6-year-old patient.