Clarification of the characteristics of needle-tip movement during vacuum venipuncture to improve safety

Illicit Drug Delivery Via Administration of Human Blood

The physiological, psychological, and social consequences associated with illicit drug use are well documented. In addition to the effects directly related to the drug(s), the delivery mechanism can precipitate other serious health conditions. A case is reported where an individual stopped by law enforcement was discovered to be in possession of a vial containing a red-colored fluid, which the person stated was blood and contained fentanyl. Analysis by headspace GC, ELISA, and LC-TOF/MS screening in with mass spectral confirmation revealed the presence of several substances, including ethanol, methamphetamine, amphetamine, MDA, 6-monoacetylmorphine, codeine, morphine, alprazolam, delta-9 THC, ephedrine, pseudoephedrine, and norpseudoephedrine; serology testing verified the fluid was consistent with human blood. Methamphetamine was present at a dosage form amount (11 mg). The purpose of this study was to detail the analytical findings, interpret their meaning, and discuss the public health concerns associated with the drug delivery by the administration of human blood.

Blood Withdrawal from Intravenous Catheters by ED Nurses: Comparison of Two Practices

CONTRIBUTION TO EMERGENCY NURSING PRACTICE

ABSTRACT PROBLEM: Laboratory tests are essential to diagnosis and treatment in the emergency department, but they can result in prolonged waiting times for patients, multiple needle pricks, and complaints about pain and discomfort. The goal of this project is to assess if a change in the blood collection process will lead to any improvement and benefit in care delivered with regard to time, patient comfort, and cost.

METHODS

A feasibility study was conducted to evaluate the change in practice from cost, time, and applicability perspectives. Using an observational approach, data were collected about the management of a possible change in practice in the emergency department at American University of Beirut Medical Center. Trials of 2 proposed changes to practice were conducted and compared with the current practice. The nurses were trained in the proper use of blood withdrawal using a Vacutainer Luer adaptor.

RESULTS

It was shown that intravenous line insertion and blood collection processes using the Vacutainer Luer adaptor were conducted in 46.2 seconds, which is less time spent than the current process but requires a small investment.

IMPLICATIONS FOR PRACTICE

Allowing registered nurses to withdraw blood with the start of a peripheral intravenous line will significantly reduce length of stay and costs and enhance patient experience in the emergency department at American University of Beirut Medical Center.

Phlebotomy, a bridge between laboratory and patient

The evidence-based paradigm has changed and evolved medical practice. Phlebotomy, which dates back to the age of ancient Greece, has gained experience through the evolution of medicine becoming a fundamental diagnostic tool. Nowadays it connects the patient with the clinical laboratory dimension building up a bridge. However, more often there is a gap between laboratory and phlebotomist that causes misunderstandings and burdens on patient safety. Therefore, the scope of this review is delivering a view of modern phlebotomy to "bridge" patient and laboratory. In this regard the paper describes devices, tools and procedures in the light of the most recent scientific findings, also discussing their impact on both quality of blood testing and patient safety. It also addresses the issues concerning medical aspect of venipuncture, like the practical approach to the superficial veins anatomy, as well as the management of the patient's compliance with the blood draw. Thereby, the clinical, technical and practical issues are treated with the same relevance throughout the entire paper.