PROCEDURE 14-8: Perform an ESR Using the Westergren Method Theory and Rationale A well-mixed anticoagulated blood sample is drawn into a Westergren tube and left upright for an hour. The full length of red cells from the top of the column in that hour is the erythrocyte sedimentation rate, or sed rate. Reference ranges vary among institutions, but the generally accepted reference range is 0 to 20 mm/hr for women and 0 to 15 mm/hr for men. Materials ESR kit (Sediplast ESR System) EDTA anticoagulated patient blood sample gauze square disposable gloves biohazard waste container sharps container patient record Competency (Conditions) With the necessary materials, you will be able to (Task) demonstrate performing an ESR using the Westergren method (Standards) correctly in one hour. Wash your hands. Gather equipment and supplies. Greet and identify the patient and escort him or her to the laboratory draw area. Explain the procedure. Wash your hands and put on your gloves and PPE. Perform a venipuncture and obtain an EDTA-anticoagulated tube of patient blood; gently mix the anticoagulation tube for 2 minutes. Remove the stopper on the prefilled vial included with the Sediplast ESR System. Fill the vial to the indicated line with blood. Replace the stopper and invert several times to mix. Insert the pipette through the pierceable stopper, and push down until the pipette touches the bottom of the vial. The pipette will autozero the blood and any excess with flow into the closed reservoir compartment. Let the pipette stand for one hour, then read the numerical results of the ESR. Dispose of all used sharps and biohazardous waste in the appropriate containers. Remove the disposable gloves and discard appropriately. Wash your hands. Document the sed rate in mm/hr on the laboratory requisition or other designated area of the chart. Patient Education Instruct the patient beforehand in the general procedure. Do not promise the patient that the procedure will not hurt. It is more tactful to say that it might feel like a “brief sting.”Let the patient know when the actual puncture is about to happen. As necessary, provide information about how long the results will take and how they will be transmitted to the patient. Charting Example Sometimes charting may not be required for phlebotomy procedures because laboratory processing documentation is sufficient. If charting is required, it might look like this: 08/25/XX 7:30 a.m. Pt anxious about phlebotomy procedure. General explanations given before each step. Pt voiced concern over the amount of pain she would experience and that her veins were hard to get blood from. Venous specimen obtained for a CBC, Na, K, and Cl with appropriate tubes. Pt held pressure gauze onsite, site was bandaged, and pt was instructed to leave the bandage in place for 15 minutes. Pt escorted to the exit. Robert Larin, RMA (AMT) Pearson Copyright © 1995 - 2010 Pearson Education . All rights reserved. Pearson Prentice Hall is an imprint of Pearson . Legal Notice | Privacy Policy | Permissions
Posted on: Wed, 16 Jul 2014 09:39:31 +0000
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