When calculating total blood volume for a full-term, 2-day-old infant, which of the following information should a phlebotomist consider?

Choice A Reason:

Positioning the needle at a 45° angle to the skin is not the recommended approach for venipuncture using a butterfly needle on dorsal hand veins. The correct angle for insertion is usually less than 45°, often around 15-30°, to ensure a shallow entry and reduce the risk of going through the vein.

Choice B Reason:

Holding the needle by the wings of the butterfly is the correct technique. This allows for better control and stability during insertion. The wings are designed to be held between the thumb and forefinger, providing an easy grip for the phlebotomist to maneuver the needle with precision.

Choice C Reason:

Instructing the patient to hold the collection tubes is not standard practice and could lead to pre-analytical errors. The phlebotomist should maintain control of the tubes to ensure proper blood flow and fill volume, as well as to prevent contamination or accidents.

Choice D Reason:

Applying the tourniquet at the antecubital area is not specific to the use of a butterfly needle for venipuncture on dorsal hand veins. While a tourniquet is used to engorge the veins and make them more prominent, its placement may vary depending on the selected puncture site and is not the action in question here.

Choice A Reason:

The evacuated tube system is designed for the collection of multiple blood specimens using interchangeable tubes. This system utilizes a double-pointed needle, one end of which goes into the patient's vein and the other into a vacuum tube. As the blood is drawn, it automatically fills the tube until the vacuum is exhausted. The phlebotomist can then easily replace the filled tube with another without removing the needle from the patient's vein, allowing for multiple samples to be taken during a single venipuncture.

Choice B Reason:

The hypodermic needle and syringe system is typically used for manual blood draws when the evacuated tube system is not suitable, such as with small or fragile veins. This system does not use interchangeable tubes; instead, the blood is drawn into a syringe and then transferred into the appropriate tubes, which can be time-consuming and increase the risk of hemolysis or contamination.

Choice C Reason:

A winged infusion set, also known as a butterfly needle, is often used for patients with difficult veins. Like the hypodermic needle and syringe system, it does not inherently allow for the use of interchangeable multi-sample tubes. Blood is collected into a syringe or a single tube attached to the butterfly needle, and changing tubes usually requires a new puncture for each sample.

Choice D Reason:

The lancet microcollection system is used for capillary blood collection, typically from a fingerstick or heelstick. It is used for small volume samples and does not accommodate interchangeable multi-sample tubes. This method is commonly used for pediatric patients or when only a small amount of blood is needed.