Lokasi yang tidak diperbolehkan dia

Lokasi yang tidak diperbolehkan diambil darah adalah :
• Lengan pada sisi mastectomy
• Daerah edema
• Hematoma
• Daerah dimana darah sedang ditransfusikan
• Daerah bekas luka
• Daerah dengan cannula, fistula atau cangkokan vascular
• Daerah intra-vena lines Pengambilan darah di daerah ini dapat menyebabkan darah menjadi lebih encer dan dapat meningkatkan atau menurunkan kadar zat tertentu.
Ada dua cara dalam pengambilan darah vena, yaitu cara manual dan cara vakum. Cara manual dilakukan dengan menggunakan alat suntik (syring), sedangkan cara vakum dengan menggunakan tabung vakum (vacutainer).

Beberapa hal penting yang harus diperhatikan dalam pengambilan darah vena adalah :
• Pemasangan turniket (tali pembendung)
o pemasangan dalam waktu lama dan terlalu keras dapat menyebabkan hemokonsentrasi (peningkatan nilai hematokrit/PCV dan elemen sel), peningkatan kadar substrat (protein total, AST, besi, kolesterol, lipid total)
o melepas turniket sesudah jarum dilepas dapat menyebabkan hematoma
• Jarum dilepaskan sebelum tabung vakum terisi penuh sehingga mengakibatkan masukknya udara ke dalam tabung dan merusak sel darah merah.
• Penusukan
o penusukan yang tidak sekali kena menyebabkan masuknya cairan jaringan sehingga dapat mengaktifkan pembekuan. Di samping itu, penusukan yang berkali-kali juga berpotensi menyebabkan hematoma.
o tutukan jarum yang tidak tepat benar masuk ke dalam vena menyebabkan darah bocor dengan akibat hematoma
• Kulit yang ditusuk masih basah oleh alkohol menyebabkan hemolisis sampel akibat kontaminasi oleh alcohol, rasa terbakar dan rasa nyeri yang berlebihan pada pasien ketika dilakukan penusukan.

Pengambilan Darah Vena dengan Syring

Pengambilan darah vena secara manual dengan alat suntik (syring) merupakan cara yang masih lazim dilakukan di berbagai laboratorium klinik dan tempat-tempat pelayanan kesehatan. Alat suntik ini adalah sebuah pompa piston sederhana yang terdiri dari sebuah sebuah tabung silinder, pendorong, dan jarum. Berbagai ukuran jarum yang sering dipergunakan mulai dari ukuran terbesar sampai dengan terkecil adalah : 21G, 22G, 23G, 24G dan 25G.

Pengambilan darah dengan suntikan ini baik dilakukan pada pasien usia lanjut dan pasien dengan vena yang tidak dapat diandalkan (rapuh atau kecil).

Prosedur :
• Persiapkan alat-alat yang diperlukan : handskun, syring, perlak, kapas alkohol 70%, tali pembendung (turniket), plester, tabung dan pendokumentasian. Untuk pemilihan syring, pilihlah ukuran/volume sesuai dengan jumlah sampel yang akan diambil, pilih ukuran jarum yang sesuai, dan pastikan jarum terpasang dengan erat.
• Lakukan pendekatan pasien dengan tenang dan ramah; usahakan pasien senyaman mungkin ( Fase Orientasi).
• Identifikasi pasien dengan benar sesuai dengan data di lembar permintaan.
• Verifikasi keadaan pasien, misalnya puasa atau konsumsi obat. Catat bila pasien minum obat tertentu, tidak puasa dsb.
• Minta pasien meluruskan lengannya, pilih lengan yang banyak melakukan aktifitas.
• Minta pasien mengepalkan tangan.
• Pasang tali pembendung (turniket) kira-kira 10 cm di atas lipat siku.
• Pilih bagian vena median cubital atau cephalic. Lakukan perabaan (palpasi) untuk memastikan posisi vena; vena teraba seperti sebuah pipa kecil, elastis dan memiliki dinding tebal. Jika vena tidak teraba, lakukan pengurutan dari arah pergelangan ke siku, atau kompres hangat selama 5 menit daerah lengan.
• Bersihkan kulit pada bagian yang akan diambil dengan kapas alcohol 70% dan biarkan kering. Kulit yang sudah dibersihkan jangan dipegang lagi.
• Tusuk bagian vena dengan posisi lubang jarum menghadap ke atas. Jika jarum telah masuk ke dalam vena, akan terlihat darah masuk ke dalam semprit (dinamakan flash). Usahakan sekali tusuk kena.
• Setelah volume darah dianggap cukup, lepas turniket dan minta pasien membuka kepalan tangannya. Volume darah yang diambil kira-kira 3 kali jumlah serum atau plasma yang diperlukan untuk pemeriksaan.
• Letakkan kapas di tempat suntikan lalu segera lepaskan/tarik jarum. Tekan kapas beberapa saat lalu plester selama kira-kira 15 menit. Jangan menarik jarum sebelum turniket dibuka.
• Rapikan pasien dan lakukan pendokumentasian

Hasil (Inggris) 1:

Location of blood taken is not allowed:• The arm on the side of the mastectomy• Edema• Hematoma• The area where the blood is being ditransfusikan• Area scar• Areas with the cannula, fistula or vascular grafts• Intra-vein blood Retrieval lines in this area can cause the blood to become more dilute and can increase or decrease the levels of certain substances.There are two ways in the taking of the blood vein, that is manual way and the way of the vacuum. How to manually done using syringes (syring), whereas the way the vacuum by using vacuum tube (vacutainer).Some important things to note in the taking of the blood vein is:• Installation of the turniket (rope and extended)o installation in a long time and too hard can cause hemokonsentrasi (hematokrit value/PVC and cell elements), increased levels of substrate (total protein, AST, iron, cholesterol, total lipids)o removing the turniket after the removable needle can cause a hematoma• The needle is released before vacuum tubes filled resulting in racer air into the tube and damage the red blood cells.• Stabbingo stabbing that not once hit led to the influx of fluid network so it can activate clotting. In addition, the stabbing which many times is also potentially cause a hematoma.o tutukan improper needle properly entered into the vein cause blood to leak with due to hematoma• The skin is pricked still wet by rubbing alcohol cause hemolysis due to sample contamination by naphtha, a sense of burning and excessive pain in patients when it carried out the stabbings.The taking of Blood Veins with SyringThe taking of the blood vein manually with syringes (syring) is a way that is still prevalent in various clinical laboratories and medical services. Syringes is a simple piston pump consisting of a cylindrical tube, a plunger, and needles. Different sizes of needles are used ranging from the smallest up to the largest size is: 21G, 22G, 23G, 24G and 25 g.The taking of blood with this injection well done on elderly patients and patients with vein which is not reliable (fragile or small).Procedure:• Prepare the necessary tools: handskun, syring, perlak, cotton alcohol 70%, and extended the strap (turniket), plasters, tube and documentation. For the election of syring, choose size/volume according to the number of samples to be taken, select the appropriate needle size, and make sure the needle attached with closely.• Do the approach to the patient with a quiet and friendly; keep the patient as comfortable as possible (the phase Orientation).• Identify patients correctly in accordance with the data sheet on request.• Verify the State of the patient, such as fasting or drug consumption. Make a note of when patients take drugs, not fasting etc.• Ask the patient straightens his arm, select the arm that many do activities.• Ask the patient punching.• Plug the cord extended (turniket) approximately 10 cm above the fold of the elbow.• Select the median cubital vein sections or cephalic. Do perabaan (palpation) to ensure the position of veins; such a palpable vein small pipes, elastic and thick walls. If a vein is not palpable, do the sorting from the wrist to the elbow, or warm compresses for 5 minutes the area of the arm.• Clean the skin on the part to be taken with cotton alcohol 70% and let it dry. Skin that is already cleaned do not held anymore.• Skewer section of a vein with a needle position facing up. If the needle has entered into a vein, it would seem the blood goes into semprit (called flash). Try once the skewer touches.• After the blood volume is considered sufficient, off the turniket and ask for the patient opens his hands fist. The volume of blood taken is roughly 3 times the amount of serum or plasma that is necessary for the examination.• Place the cotton in place of injections and then immediately remove/drop needles. Press a little while ago cotton plaster for approximately 15 minutes. Do not pull the needle before the turniket is opened.• Tidy up patients and to do documentation

Hasil (Inggris) 2:

The location is not allowed blood drawn are:
• The arm on the side of mastectomy
• Local edema
• Hematoma
• The area where the blood is being transfused
• Regional scars
• Areas with a cannula, fistula or graft vascular
• Regional Decision intra-venous blood lines in this area can cause blood becomes thinner and may increase or decrease the levels of certain substances.
There are two ways in venous blood sampling, which means the manual and how to vacuum. How to manually done by using a syringe (syring), while the vacuum method using vacuum tubes (Vacutainer). Some important things that must be considered in venous blood sampling are: • Installation of a tourniquet (rope hedge) o installation in long and too loud can causing hemoconcentration (hematocrit value increase / PCV and elements of cells), increased levels of substrate (total protein, AST, iron, cholesterol, total lipid) o remove the tourniquet is removed after the needle can cause hematoma • The needle is released prior to the vacuum tube is fully charged, resulting in air masukknya into the tube and destroys red blood cells. • Stabbing o stabbing that was not completely in contact with tissue fluids causes the entry so that it can activate clotting. In addition, the stabbing that many times also potentially cause a hematoma. o tutukan correct improper needle into the vein causing blood to leak with consequent hematoma • The skin is pricked still wet with alcohol causes hemolysis samples due to contamination by alcohol, burning and excessive pain to patients when done the stabbing. Taking Blood Veins with Syring Taking venous blood manually with a syringe (syring) is a way that is still prevalent in many clinical laboratories and health care facilities. This syringe is a simple piston pump consisting of a cylindrical tube, plunger, and needle. Various sizes of needles are often used ranging from the largest to the smallest size is: 21G, 22G, 23G, 24G and 25G. Taking blood with these injections done in elderly patients and patients with venous unreliable (fragile or small). Procedure: • Prepare the necessary tools: handskun, syring, perlak, cotton alcohol 70%, hedge cord (tourniquet), plaster, tube and documentation. For syring election, choose the size / volume in accordance with the number of samples to be taken, choose the appropriate needle size, and make sure the needle attached tightly. • Perform patient approach with calm and friendly; try the patient as comfortable as possible (Phase Orientation). • Identification of patients with correctly in accordance with the data in the request form. • Verify the state of the patient, such as fasting or drug consumption. Record if the patient is taking certain medications, etc. are not fasting. • Ask the patient to straighten his arm, select the arm that a lot of activity. • Have the patient fist. • Attach the strap hedge (tourniquet) approximately 10 cm above the elbow fold. • Select a section The median cubital vein or cephalic. Perform palpation (palpation) to ascertain the position of the vein; Venous palpable as a small pipe, ductile and have thick walls. If the vein is not palpable, do the ordering from the wrist to the elbow, or a warm compress for 5 minutes arm area. • Clean the skin on parts to be taken with a 70% alcohol cotton and let it dry. Skin that has been cleaned do not hold anymore. • Puncture section of vein with a needle hole position facing upwards. If the needle has entered the vein, blood will look into the syringe (called flash). Try once stab hit. • After blood volume is considered sufficient, loose tourniquet and ask the patient opened his fist. The volume of blood taken is approximately 3 times the amount of serum or plasma needed for the examination. • Put some cotton at the injection site and immediately release / pull the needle. Press cotton while ago plaster for approximately 15 minutes. Do not pull the needle before the tourniquet is opened. • Trim the patient and do documentation