Principles of phlebotomy and intravenous therapy

46. Principles of phlebotomy and intravenous therapy

maternal venepuncture


CHAPTER CONTENTS




Indications317


Suitable sites318


Choosing a vein318


Pain relief318


Asepsis and skin preparation319


Equipment319


Possible complications319


PROCEDURE: maternal venepuncture 319


Role and responsibilities of the midwife320


Summary320


Self-assessment exercises320


References320

LEARNING OUTCOMES
Having read this chapter the reader should be able to:


• discuss the indications for venepuncture


• describe how venepuncture is undertaken safely and positively


• discuss the rationale for the choice of vein and equipment used


• highlight the possible complications and how they can be avoided


• summarise the role and responsibilities of the midwife.



Venepuncture is the puncturing of a vein with a needle, usually to obtain specimens of blood for laboratory analysis, but may also include the administration of drugs intravenously in an emergency. The ability of a midwife to undertake venepuncture facilitates individualised and holistic care for the woman from the same practitioner. This chapter considers the indications for venepuncture, the rationale for correct preparation and the procedure. The role and responsibilities of the midwife are summarised.



Indications





• Antenatal ‘booking’ bloods.


• Assessment of full blood count and presence of rhesus antibodies during pregnancy: further repeats if rhesus negative blood group, with Kleihauer test after delivery.


• Other tests may be taken if there is an existing disease (e.g. thyroid function tests, blood glucose monitoring, anti-epileptic drug levels) or if other conditions are suspected (e.g. sickle-cell anaemia, pre-eclampsia, thalassaemia, hepatitis B, hyperemesis gravidarum).


• Antenatal screening tests for fetal normality (e.g. alphafetoprotein).


• Cross-matching prior to blood transfusion, or group and save prior to operative delivery.

This is not an exhaustive list, but it does indicate that women are often asked to give blood specimens. Fear of needles or of fainting can be real fears; midwives should be sensitive to both the physical and psychological aspects of the skill. Care and time should be taken to gain an informed consent and measures used to improve the experience (see below) if the woman is very anxious.


Jun 18, 2016 | Posted by in MIDWIFERY | Comments Off on Principles of phlebotomy and intravenous therapy
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