[转帖]静脉采血的SOP

icchina

<p class="MsoNormal" align="center" style="MARGIN: 0cm 0cm 0pt; TEXT-ALIGN: center; mso-pagination: widow-orphan;"><b style="mso-bidi-font-weight: normal;"><span style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-bidi-font-family: 宋体; mso-font-kerning: 0pt;">静脉采血<span lang="EN-US">SOP</span>（注：写得很不错，值得感控人员借鉴。另：不是抽血培养）<span lang="EN-US"><p></p></span></span></b></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span style="FONT-FAMILY: 宋体; mso-bidi-font-family: 宋体;">Ⅰ</span><span lang="EN-US"><font face="Times New Roman">. </font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">目</span><font face="Times New Roman">
                </font><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">的：建立静脉穿刺标准操作规程，确保静脉穿刺操作的正确性和规范性。</span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span style="FONT-FAMILY: 宋体; mso-bidi-font-family: 宋体;">Ⅱ</span><span lang="EN-US"><font face="Times New Roman">. </font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">范</span><font face="Times New Roman">
                </font><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">围：适用于静脉穿刺。</span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span style="FONT-FAMILY: 宋体; mso-bidi-font-family: 宋体;">Ⅲ</span><span lang="EN-US"><font face="Times New Roman">. </font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">规</span><font face="Times New Roman">
                </font><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">程：静脉穿刺是实验室试验获取血液样本的主要技术和方法。</span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US"><font face="Times New Roman">1. </font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">静脉穿刺前准备</span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US"><font face="Times New Roman">1.1 </font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">确保穿刺用托盘准备好，内容包括所有采血用具（手套、止血带</span><font face="Times New Roman">
                </font><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">、注射器、试管、消毒液、棉签等）。</span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US"><font face="Times New Roman">1.2 </font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">所有的样本试管编号或贴上标签。</span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US"><font face="Times New Roman">1.3</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">请患者准备。做血液检验项目的病人，一般要求采血前禁食</span><span lang="EN-US"><font face="Times New Roman">8--12</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">小时，采血的前一天避免吃高脂肪、高蛋白类食物，避免饮酒。</span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US"><font face="Times New Roman">1.4</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">查看检验单，查对检验单上病人姓名、性别、年龄等项目与病人是否吻合，耐心检查需要空腹血检验的项目，询问病人是否</span><span lang="EN-US"><font face="Times New Roman"> 8</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">小时以内没有能量摄入；需要增添项目时先与出具检验申请单的医生联系。</span><font face="Times New Roman">
                </font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US"><font face="Times New Roman">1.5</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">洗手，带上手套，并注意常规防护。</span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US"><font face="Times New Roman">1.6</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">在受试者的穿刺位以上约</span><span lang="EN-US"><font face="Times New Roman">5</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">～</span><span lang="EN-US"><font face="Times New Roman">8</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">厘米处。紧紧地系上止血带，但不能太紧以至受试者不舒服</span><span lang="EN-US"><font face="Times New Roman">, </font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">止血带的捆绑时间不应超过</span><span lang="EN-US"><font face="Times New Roman">1</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">分钟。</span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US"><font face="Times New Roman">1.7</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">嘱受试者握紧拳头，选择合适的血管：当轻压或轻拍时能感觉其回弹的静脉即为合适血管。最常用的选择部位是血管丰富并且血管贴近皮肤表层的肘前区域。</span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US"><font face="Times New Roman">1.8</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">消毒：以穿刺点为圆心，用蘸有碘酒的棉签由内到外螺旋型涂抹，然后用</span><span lang="EN-US"><font face="Times New Roman">75</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">％酒精棉签脱碘，消毒范围为直径大约</span><span lang="EN-US"><font face="Times New Roman">3</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">厘米，注意消毒过的地方不能重复涂抹，在</span><font face="Times New Roman">
                </font><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">涂抹的过程中棉签必须也要同时旋转。如果手臂皮肤不足够干净的则需重新擦拭。</span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US"><font face="Times New Roman">1.9 </font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">穿刺部位干燥。</span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US"><font face="Times New Roman">1.10 </font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">在洁净后不要触摸穿刺部位</span><font face="Times New Roman">
                </font><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">。</span><font face="Times New Roman">
                </font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US"><font face="Times New Roman">2.</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">静脉穿刺方法</span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">注射器法</span><font face="Times New Roman">
                </font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">注射器是一个包括活塞和针筒的器具。当活塞往外抽时则产生吸力。当针插入血管后，产生的吸力能将血吸入针筒内。</span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US"><font face="Times New Roman">2.1 </font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">将针头斜面朝上</span><span lang="EN-US"><font face="Times New Roman">,</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">与针管的刻度同在一平面上</span><font face="Times New Roman">
                </font><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">使针与手臂成约</span><span lang="EN-US"><font face="Times New Roman">15</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">度角，使其方向与血管一致。</span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US"><font face="Times New Roman">2.2 </font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">迅速地刺穿已选定的静脉。</span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US"><font face="Times New Roman">2.3 </font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">若观察到回血现象</span><span lang="EN-US"><font face="Times New Roman">,</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">说明针已经准确地刺入血管。嘱受试者松开拳头。</span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US"><font face="Times New Roman">2.4 </font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">固定针具确保针头不移动。</span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US"><font face="Times New Roman">2.5 </font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">平缓地回抽注射器以抽取所需体积血液。当出现异常时如：病人出汗、面色苍白、晕倒时立即拔出针并急救；操作失败，取得病人谅解，再次进行操作（</span><span lang="EN-US"><font face="Times New Roman">“</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">对不起，由于</span><span lang="EN-US"><font face="Times New Roman">……</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">的原因需要再取一次血，请原谅</span><span lang="EN-US"><font face="Times New Roman">”</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">）。采样尽量在</span><span lang="EN-US"><font face="Times New Roman">1</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">分钟内完成。</span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US"><font face="Times New Roman">2.6</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">解开止血带。</span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US"><font face="Times New Roman">2.7 </font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">退针。当针头离开人体后，轻轻地把注射器往上拉动，防止血液从针头滴下。</span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US"><font face="Times New Roman">2.8 </font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">请受试人自行轻压棉签</span><span lang="EN-US"><font face="Times New Roman">3~5</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">分钟。手臂需举至高于心脏水平位置以控制血流。（如果是有出血倾向患者如紫癜</span><font face="Times New Roman">
                </font><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">，</span><span lang="EN-US"><font face="Times New Roman">ITP</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">，血液病等要压迫</span><span lang="EN-US"><font face="Times New Roman">5</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">～</span><span lang="EN-US"><font face="Times New Roman">10</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">分钟直到无血渗出）。同时告知病人报告时间。</span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US"><font face="Times New Roman">2.9 </font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">将血液样本完全转移到指定的管内。顺序</span><font face="Times New Roman">
                </font><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">血培养</span><span lang="EN-US"><font face="Times New Roman">—</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">血常规管</span><span lang="EN-US"><font face="Times New Roman">—</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">血凝管</span><span lang="EN-US"><font face="Times New Roman">—</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">血粘管－血沉管</span><span lang="EN-US"><font face="Times New Roman">—</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">生化及其他管。</span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US"><font face="Times New Roman">2.10 </font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">迅速把针头放入利器专用容器，针管放入医疗垃圾袋中。（加抗凝剂的采血管须颠倒混匀</span><span lang="EN-US"><font face="Times New Roman">6</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">～</span><span lang="EN-US"><font face="Times New Roman">8</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">次），将采血管与相应的检验单对好，编号，分类，尽快送检。</span></p>

楚楚

<p><font face="楷体_GB2312" size="3">胡教授一下子给我们发了这么多好东东，真有点消化不良了！只怪平时营养不良，暂时还没有适应这么丰富的营养大餐！谢谢啦！辛苦了！</font></p>[em01][em01][em01][em01][em01][em01][em01]

一枝梅

感谢哦，我学习了！很好，我顶！

byyglcq

真是好东西啊,我要好好学习了,谢谢

hzxsdyyywmq

<p>&nbsp;&nbsp;</p><p>&nbsp;&nbsp;&nbsp; 谢谢你的静脉抽血"SOP"范本,值得借鉴和引用,&nbsp;觉得应该好好学习学习.&nbsp;更制订更的SOP打下良好的基础。 </p>

hzxsdyyywmq

为制订更多的SOP打基础

回头鹿

<p>到那里都有好东西,我都来不及学了.</p>[em14][em14][em14]

ZL0031226

谢谢你们，感染控制论坛的专家，论坛就象一盏领航灯，为我们基层医院的医院感染管理人员指引了工作方向和目标，让我们得到了金钱都买不到的学习机会。

yanziym

SOP非常好，但有疑问，请各位老师指教，这些SOP是应该院感做的吗？护理部好像有专门的操作规程。此外，像静脉输液、导尿、换药等等，挺多得，而且我们这里的规程都是省里统一下发给护理部的，我们再制定，好像不合适。如何办？

赶太阳

感谢胡教授为我推荐了这个论谈,好东西可真不少,每次上来浏览都有很大的收获,有种上来就不想下去的感觉,太吸引人了.

lisa天使

果然不错。与实际真的很贴切，很实用！多谢

山明水秀

感谢哦，我学习了！很好

青青

已学习,步骤很细致,很严密,可建议护理部参照此SOP

happy600208

学习了，我会给护理部主任看的，院感工作离不开他们的支持，谢谢教授:hug:

柳荷

下载学习了,谢谢!:handshake

老朽

谢谢胡教授，下载下来，做个样本，也试试制定其他SOP，:$

xcjtzslyy

非常有操作性，谢谢！

ranliang2008

胡教授，谢谢您的静脉采血“sop”范本，我下载了，准备得空时好好吸取之“精华”。

枫叶红了

谢谢胡教授,你知识渊博是我们院感控制工作人员的引航者.

hapy

thank you very much,It's very beautiful SOP.:handshake :handshake