Tip:
Highlight text to annotate it
X
This is our patient...(laughter) So, our patient,
happens to be, how old? --7 months.-- 7 months old.
It's really good when we have the mom, because the mom can help us.
You get what I mean? Sometimes the partents aren't good to have in the room,
because they can't take what goes on. So there's
a choice that you have to make: Do you want mom in? or Do you want to call
another phlebotomist to help you get through the procedure.
You get what I mean by that? Okay. So, now we're gonna,
How ya doin' sweetie? How ya doin'? (sing-songy) Yeah, yeah. We want to try and make friends with the baby, because
we have to do various things. It can't take us a long time, because,you know, just like you,
they get frustrated so we're going to try and lay him down.
It's very important not to have ANYTHING on this bed.
Whatever you bring to this bed you need to account for. You get what I mean?
Because babies love to put things in their mouths, right? Okay, so we're going to,
I cut the tourniquet in half, and we're going to try to tie the tourniquet on and see if we can feel a vein on Camden (sing-songy). Yes, yes, yes.
And you can see how you gotta hold his arm just like that. And you see how they twist? Very easy.
So basically this is just one phlebotomist holding.
That's another mom or another phlebotomist doing that. Now I need somebody to
find and feel and draw the blood. You get what I mean?
If we're drawing a lot of blood, again, we would have to go
in the arm to get that. If we're only drawing, maybe like a CBC and doing a PKU or something of that
nature, we're gonna go in their foot. Look at that! ...kickin' me away already! (laughter)
So,
it's mandatory, if we draw, if it's
from the feet, from the heel,
we have to warm that site up for 5 minutes. You warm that
site for five minutes before you do the draw. Commonsensically, why do you think we're doing that?
(students speaking quietly)
Yes, it brings the capillaries up to the surface, making it easier
to do the blood draw. So what we would do, let's say, the proper ID,
everything's been established. Now the interesting thing about the ID,
with the baby, you know, if the mom is there,
on the requisition it's gonna have the mom's name as well as the
infant's name. Do you understand what I mean by that? Okay and if it's an inpatient
baby, then again, they're gonna have the ID band on as well.
Outpatient, of course, would not. Okay. So, I've done the ID,
Now what I'm I'm going to do is, again,
Oh! You wanna sit up! It's been warmed for the 5 minutes, right?
I still have to alcohol the s~ite (sing-songy)
Alright? I would still,
Now hopefully, this is a good thing, he's being interactive. That's great! (laughter)
(More laughter) Now what I'm going to need to do is get my lancet.
And I'm going to put it about right here. I thought I
brought the baby foot. Yes. You can see where
you would have to poke a baby's heel. Do you see those two spots?
That's where you would actually poke that baby's heel.
So I'm going to do that. Hey you, (sound of lancet) and into the sharps container.
The very first thing I need to do is wipe the first drop away.
I have to, (laughter) wipe the first drop away.
And then I can do the collection. If it was on the PKU (form). If I was doing a PKU,
what I would be doing is putting the
blood droplets on this piece of paper. (Sing-songy) Yes, that's you! And mom, can you hold
his hand for me? Thank you. So I'm going to
squeeze, squeeze, squeeze like this. Squeeze, squeeze, squeeze... Blot!
Squeeze, squeeze, squeeze... Blot!
Squeeze squeeze squeeze get that good droplet going...
Blot! Almost done, okay dude?
Almost done, Blot! Yes, yes! One more? Okay?
One more, here we go! Blot! Alright! (laughter) So I get my cotton (gauze) and I cover the site. Okay?
So that was just if I had the PKU. But if I still had other,
you know, like, tubes to draw, or other tests, you could say...
These are the microtainers, we use for
infant, you know, draws. Because it's less volume. Can you see that?
And if I, let's say that, I had another
test at this age,
could be the bilirubin. You see how this is an
amber color? Bilirubin we have to protect from light, so it's an amber color.
So, if I needed more blood, I wouldn't have stopped, you know,
gotten the cotton. I would've just kept on getting
that blood droplet like this. You know, it's not easy,
but it's possible. --Babies move a lot.-- (laughter). Yep. Okay?
Squeeze, squeeze, squeeze. Almost done... He hasn't even cried or anything. (laughter)
You know what I'm saying? Okay, we're all done, mom. Hold baby for me?
You know, because if I turn around, I don't want him to fall.
Then I would have to... cap this off.
Because it's an open top there... And this would be the top for the bilirubin...
We want to invert it, just like we do
all the other tubes.
and again I have to take my labels and just to show you. Hold on one sec, excuse me.
I'm gonna just run over on this side and get a label or two.
So I have signed, timed
and dated, the specimen. This one is going to go to the laboratory,
like this. Now you can understand, you get that?
Otherwise, you couldn't put it on the long way. It goes on just like that.
And again, the mom's label,
or the baby's label, I should say, because
that's what I got, would go like that. I have to still sign off on my sheet,
time, date, sign off on my requisition there, and, again, you have to make sure,
again, for infants, that there's nothing that's left on (the bed). As far as bandaging,
you never want to bandage a baby per se.
so you really want the mom to keep it on
until it's kinda sealed, not kinda, it's, you know, clotted off.
And, if that's the case that you have to bandage,
if anything, a SMALL bandage and put the sock
or whatever they have on the foot back on. Educate that mom to take that off as soon as they think it's safe.
And, so forth and so on. Okay? Thank you for making it a teachable moment.
--No problem.-- (murmurs of appreciation) We really, really appreciate it.
Everybody get that? We might see Camden once or twice more before it's over with, and we can
do some more things, okay?