Diploma in Health and Social Care Assignment Sample
1.1 Summarise current legislation, national guidelines, policies, procedures and protocols in relation to obtaining venous blood samples
“UK legislation and regulation” as well local authorities have covered process and guidelines for venous blood sample collection. From process of collection to its use and storage have been covered properly in UK. “The Blood Safety and Quality Regulations 2005 (c. 50)” has imposed quality and safety requirements in venous blood collection and storage. As per this regulation, storage and distribution of venous blood would be performed in tests activities and for hospital facilities that have included transfusion activities that are performed by hospital blood banks (Legislation.gov.uk, 2023). Along with this blood establishment is authorised under this regulation and a person would be responsible for management of hospital blood banks. This regulation was amended in 2010 and became “The Blood Safety and Quality (Fees Amendment) Regulations 2010 (c. 554)”. This amendment adds the fee payable by blood establishment or a person in management of hospital blood bank gives a notification under regulation 12 (1) (Legislation.gov.uk, 2023). Hence, this regulation has provided a statutory process to collect and to store blood samples and this makes sure its highest usages for hospitality facilities and for development of blood banks.
“WHO Guidelines” on drawing venous blood has executed best practice in phlebotomy and provided guidelines in using needle and syringe, gauge choice and provided an illustration of blood sampling systems (Who.int, 2023). Based on these guidelines, hospitals and diagnostic centres are bound to use effective processes at time of blood sample collection. Hence, this has covered the successful management blood sample collection and this makes sure sustainable and effective venous blood sample collection. “SYNLAB UK & Ireland Tests” has provided guidelines for collection of blood from venepuncture and instructed that blood should not be collected from a vein proximal to infusion site. It is needed to collect from opposing arm as long as it can be done (Tests.synlab.co.uk, 2023). “The National Institute of Health” has developed a protocol for blood sample collection from veins. As per protocol, patients are needed to ask for formation of fist for making the veins more prominent. Then a vein is needed to enter swiftly at a 30 degree angle and then introduction of needle would be done along with the vein at the easiest angle of entry. After sufficient blood collection, a tourniquet is released before withdrawing the needle (Ncbi.nlm.nih.gov, 2023). This protocol has developed overall procedure of venous blood collection management in UK. In addition, “The National Centre for the Replacement Refinement & Reduction of Animals in Research (NC3Rs)” has shared its guidelines in blood sampling. This guideline has covered equipment, aseptic technique arterial puncture, cardiac puncture, volume of blood to be removed, sign of shock and anaemia as well as provided approvals and training, competency (Nc3rs.org.uk, 2023). In such a way, this body has maintained a significant process and progress management by providing training to practitioners to properly manage the blood sample collection management. Hence, the overall venous blood collection and its storage is guided by UK regulation, legislation, guidelines and protocols.
2.1 Describe the structure of venous blood vessels
Blood vessels are networks of tubes in which blood is used to be pumped. The blood vessels along with heart and blood form cardiovascular system. According to Camasão and Mantovani (2021), blood vessels have carried a total of three main functions and these are carrying pumped blood away from heart, returning blood to heart and to allow blood to come in contact with tissue to exchange nutrients, oxygen, and carbon dioxide and waste materials. Blood vessels are classified in three parts and these are arteries, capillaries and veins (Wang et al. 2022). All these parts of blood vessels have chosen a specific function among a total of three mentioned functions. Veins or venous blood vessels have done function of carrying blood to heart and take part importantly to blood regulating system in body.
Figure 1: Structure of venous blood vessels
(Source: Training.seer.cancer.gov, 2023)
Veins are blood vessels collectively known as venous blood vessels that are located throughout the body and execute functions to collect less oxygenated blood and return it towards heart. Hence, venous blood vessels are structured to take part in circulatory system and work with other parts of blood vessels such as capillaries and arteries as well as with heart and help the body to keep blood moving. The veins consist of three layers and the innermost “tunica intima” contains “squamous epithelium” surrounded by “connective tissue membrane with elastic fibres” (Training.seer.cancer.gov, 2023). Middle layer is called “tunica media” and contains smooth muscle which is the thickest layer of veins. This layer helps to change vessel diameter for regulation of blood flow and blood pressure. Outermost layer is a “tunica externa” that helps to attach vessels to surrounding tissue. This outermost layer has connective tissue and consists of elastic and collagenous fibres (Training.seer.cancer.gov, 2023).
Innermost layer of vein, tunica intima consists of flat shaped epithelial cells and such cells allow for smooth flow of fluid and are connected with valves. It ensures the fluid flow maintenance continuously in one direction (Naito et al. 2020). Tunica media is the middle coat of venous blood vessels and comprises with combination of smooth muscle fibres and connective tissues. All three layers have less smooth muscle and connective tissue and for this, the wall of the vein is thinner than arteries. Hence, the vein gives less pressure to blood than arteries and is able to hold more blood. Main function of veins is to carry blood towards heart and the valves are arranged in veins to keep its function smoother. Large and medium sized veins contain “venous valves” that help to keep blood flow towards the heart. Along with this, venous valves are important in arms and legs that prevent backflow of blood in response to pull of gravity. Thus, all parts of veins have combined in a structure to develop venous blood vessels together to take part in circulatory system and help to send blood towards heart after circulation throughout the body.
2.2 Discussion of blood-clotting methods as well as the factors that impact blood clotting process
The blood-clotting process in the human body is known as “Haemostasis” that is a normal reaction to an injury that causes bleeding. As stated by Poventud-Fuentes et al. (2021), Haemostasis is a way in the human body that stops the injured blood vessels from bleeding. On the other hand, one of the most significant factors of haemostasis is the clotting of blood. The processes that cause blood clotting are “Injury”, “construction of blood vessels”, “platelet clotting” and “coagulation cascade”.
The foremost phase of blood clotting is initiated by an injury in the body when a blood vessel becomes damaged in the body. As opined by Asatullayev and Jabborova (2022), the blood vessel injury could be in the shape of a small tear in the wall of blood vessels which leads to bleeding. On the other hand, the “blood vessel constructed” by the body controls blood loss. The construction of blood vessels controls the blood flow in the injured area. After this process, the primary haemostasis is even understood by the process of “platelet clotting”.
Figure 2: Process of Blood Clotting
(Source: Clevelandclinic.org, 2023)
The primary haemostasis process happens when the body develops a “temporary plug” for sealing the injured or damaged body part. As per the views of Scridon (2022), platelets that got circulated in the blood stick to the injured tissues and get activated. This activation refers to developing more platelets which help to form a “platelet plug” for ceasing the blood loss from the injured area. Furthermore, the “secondary haemostasis” is known as the “coagulation cascade” where the platelet plugs to stop bleeding. The succeeding stage that helps to stabilise the plug is known as “secondary haemostasis”. As stated by Abdelfadiel et al. (2023), the coagulation factors present in this stage activate the sequence named “coagulation cascade”. Due to this, the clotting effect amplifies when the sequence continues. In this stage, the platelet plug forms like bricks and the “fibrin” acts as a “mortar”. These together form a stable and solid blood clot.
The factors of blood-clotting act as components found in the plasma and are linked with the process of blood clotting. However, there are “13 numerals”, there are just “2 blood clotting factors” that are responsible for blood clotting. The blood-clotting factors are “Factor-I” which is understood as “Fibrinogen” and “Factor-II” is known as “Prothrombin”. On the other hand, Matiash et al. (2021) stated that the “Factor III” of blood-clotting refers to the tissue factor and is known as “thromboplastin tissue”. Similarly, the Factor-V of blood clotting is known as the “proaccelerin” and “labile factor”. Similarly, “Factor-VII” to “Factor-XIII” is even responsible and present in the blood clotting process. As stated by Hu (2019), vitamin K is used by the Liver to develop some of the blood clotting factors such as “Factors II”, “VII”, “IX” and “X”. Majority of clotting components are synthesised in the liver.
2.3 The venous blood vessels position in nerves, arteries, and other structures
Blood vessels are the channels, as well as conduits that help to distribute the blood within the body tissues. As stated by Tohirova and Shernazarov (2022), the blood vessels constructed up two “closed tissues” that begins and ends in the heart. The position of “venous blood vessels” in “arteries” develops of three layers in the artery wall. The inner layer is called “Tunica intima” where the venous blood vessel is present and is surrounded by connective tissue along with elastic fibres. On the other hand, the middle layer present in the “artery wall” is known as “Tunica media” and primarily acts as a smooth muscle. These smooth muscles do not just develop support for the venous blood vessels but even help to change the vessel diameters. As per the views of Kumar et al. (2020), arteries are known as muscular blood vessels which help to carry blood rich in “Oxygen” from the heart to the body. The outer layer in arteries which is known as “tunica adventitia”, is connected with tissues and has amounts of “collagenous” and “elastic fibres”. This outermost layer helps to attach the venous blood vessels to the surrounding tissues.
Figure 3: Formation of Artery Wall
(Source: Cancer.gov, 2023)
Furthermore, the position of “venous blood vessels” in “nerves” mainly in the “sympathetic nervous system” helps to innervate the blood vessels. As stated by Tinajero and Gotlieb (2020), the outer layer of the tiny vessels and nerves is known as the adventitia which helps to deliver nutrients and oxygen from the blood cells to the body. Moreover, it even helps to remove waste particles from the body. Similarly, this helps to give support and structure to the venous blood vessels. The specialised receptors of the “sympathetic nervous system” are located in the “carotid arteries” and “aortic arch” which give information about the pressure of blood flow, as well as the oxygen content. As per the views of Schubert et al. (2023), the body’s sympathetic actions ensure blood vessel relaxation and construction. Furthermore, Capillaries are vessels that are formed with a thin layer and are composed of a single endothelial layer. Due to the thin layers of capillary, the metabolites and nutrients have occurred with diffusion.
Besides that, venules are even other structures of venous blood vessels that help to get blood from capillaries. As opined by Sorimachi et al. (2021), nearly 70% of the total volume of blood is present in the veins. Moreover, the venous nervous system helps to gather a large volume of blood in the body through venous blood vessels which are of low pressure and large volumes. The formation of blood vessels occurs with the help of two processes such as “angiogenesis” and “vasculogenesis”. Deep venous blood vessels run underneath the tissue and muscle and are the primary areas of venous systems. As opined by Lichota et al. (2020), deep veins present in the venous blood vessels carry 90% of blood. Moreover, it includes the “popliteal vein” and “femoral vein”.
References
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