NHA Certified Phlebotomy Technician (CPT)Patient PreparationHard
A phlebotomy technician is preparing to draw blood from a patient who is an amputee and has a prosthetic arm on their right side. Their left arm has an active IV infusion. Which of the following sites should the technician consider for venipuncture?
- ABelow the IV insertion site on the left arm.
- BA site on the foot, with physician's permission.
- CThe right antecubital area of the prosthetic arm.
- DA site on the dorsal side of the hand on the left arm.
Show answer & explanationAnswer & explanation
Correct answer: B. A site on the foot, with physician's permission.
Drawing blood from a prosthetic limb is impossible. Drawing from an arm with an active IV, even below the IV, can dilute the sample. Therefore, with both arms compromised, a foot vein (with physician permission) is the most appropriate next consideration, especially for adults.
Why the other options are wrong
- A. Drawing below an IV can lead to diluted samples or inaccurate results due to the IV fluid.
- C. A prosthetic arm is an artificial limb and cannot be used for venipuncture.
- D. Drawing from the same arm as an active IV, even if it's the hand, still carries a risk of fluid contamination or affecting the IV site.
Compromised Limb Venipuncture
When conventional venipuncture sites are unavailable due to conditions like amputation or active IVs in both arms, alternative sites such as foot veins may be used in adults, but only with explicit physician approval due to increased risk.
- Avoid prosthetic limbs.
- Avoid limbs with active IVs.
- Foot veins are a last resort in adults.
- Physician approval is mandatory for foot venipuncture.
Memory trick: No arms, no IV site, then foot with doctor's light.