Which of the following needles should a phlebotomist use for a venipuncture using a winged infusion set and a 5 mL syringe?

Choice A Reason:
Covering the spill until maintenance arrives is not an appropriate response to a blood spill. This action does not neutralize any potential pathogens present in the blood, which could pose a risk of infection to others. Immediate cleanup is necessary to prevent the spread of infectious diseases, and simply covering the spill does not meet the Occupational Safety and Health Administration (OSHA) guidelines for bloodborne pathogens, which require the spill to be cleaned with an appropriate disinfectant.

Choice B Reason:
Pouring bleach on the spill and allowing it to soak for 60 seconds is the recommended action because bleach is a powerful disinfectant that can kill a wide range of pathogens, including those that might be present in venous blood. The Centers for Disease Control and Prevention (CDC) recommends a 1:10 dilution of household bleach for effectively disinfecting blood spills. After pouring the bleach, it is important to let it soak for an adequate amount of time, usually around 10 minutes, to ensure that all pathogens are killed.

Choice C Reason:
Evacuating the laboratory is not a necessary action for a blood spill unless the spill is extensive and poses additional risks that cannot be mitigated by standard cleanup procedures. In most cases, following the proper spill cleanup protocol, which includes wearing personal protective equipment (PPE) and using an EPA-registered disinfectant, is sufficient to handle the situation without needing to evacuate the area.

Choice D Reason:
Applying a liquid thickening agent on top of the spill is not a standard practice for blood spill cleanup. While a thickening agent might contain the spill, it does not disinfect the area. The priority in such situations is to disinfect and remove any potential infectious agents. Therefore, the use of a thickening agent would not be in compliance with the recommended procedures for blood spill cleanup by OSHA and the CDC.

Choice A Reason:
Standard precautions are a set of infection control practices used to prevent transmission of diseases that can be acquired by contact with blood, body fluids, non-intact skin (including rashes), and mucous membranes. These measures are to be applied to all patients, regardless of their diagnosis or presumed infection status. Standard precautions include hand hygiene, use of personal protective equipment (PPE), respiratory hygiene/cough etiquette, safe injection practices, safe handling of potentially contaminated equipment or surfaces in the patient environment, and aseptic technique.

Choice B Reason:
Safety devices, such as needles with engineered sharps injury protections, are designed to prevent needlestick injuries and the transmission of bloodborne pathogens. While they are an important aspect of a phlebotomist's work, they are not specifically part of the aseptic technique protocol. Aseptic technique focuses on preventing contamination of sterile surfaces and materials to prevent infection.

Choice C Reason:
Quality control logs are records that document the performance of equipment and procedures to ensure they meet the required standards. They are essential for maintaining the integrity of laboratory results and ensuring patient safety. However, quality control logs themselves are not a component of the aseptic technique protocol, which is more concerned with the immediate prevention of infection during clinical procedures.

Choice D Reason:
A disaster emergency plan is a comprehensive document outlining the actions to be taken in case of an emergency. This plan is crucial for ensuring safety and continuity of care during unexpected events but is not related to the aseptic technique protocol. Aseptic technique is a method used to prevent infection during medical procedures by maintaining a sterile environment.