STANDARD OPERATING PROCEDURE (SOP) : Preparation of phlebotomy site

BLOOD CENTRE NAME

SCOPE AND APPLICATION

Cases of transmission of bacterial infection in blood are fortunately rare, but when they do occur can be fatal. Thus, careful preparation of the skin at the phlebotomy site before venepuncture is very important.

RESPONSIBILITY

The phlebotomist collecting the blood unit from the donor is responsible for preparation of phlebotomy site.

REFERENCES

• Technical Manual of American Association of Blood Banks, 18^th Edition 
• Model standard operating procedures for blood transfusion service, WHO, New Delhi 2002 

MATERIALS REQUIRED

• Sterilising tray
• Demethylated spirit
• Cotton/gauze/swabs
• Blood pressure apparatus
• Sterile gauge
• Povidone Iodine 

PROCEDURE 

• Apply blood pressure cuff keeping phlebotomy area clear of the tubes of apparatus
• Inflate the cuff till 80 mm of Hg and ask the donor to press the hand grip
• Palpate the antecubital area and select most prominent vein then deflates the cuff
• After selection of the vein for venepuncture, apply spirit, povidone-iodine and finally spirit swab, in this order, to the skin at the phlebotomy site
• Start disinfection of the skin of about an area of 5 cm diameter from the centre outwards in a circular motion using spirit swab
• Do not touch the site prepared for venepuncture. Should it be necessary, touch the skin away from the point of needle insertion. If the puncture site is touched, repeat skin preparation procedure as detailed earlier
• Discreetly check the used swab. If it is physically soiled/contaminated, take a new swab and repeat skin preparation procedure as detailed earlier.
• Dispose off used swab(s) into a waste bin meant for bio-hazardous materials. 
• Allow the skin to air dry. Do not wipe the area with cotton wool, fan or blow on it.
• Cover the disinfected area with dry and sterile gauge until the phlebotomy.