Blood Collection Flashcards
Antiglycolytic agent preserves glucose up to five days
Light gray
Gauges commonly used for blood collection
Gauge 21 (green) Gauge 23 (blue)
Disinfectants
70% isopropyl alcohol
Ethyl alcohol
The larger the needle, the _____ the bore,
smaller
Contains sodium heparin/lithium heparin
Dark green
Total blood volume
5 to 6 liters
Gauge used for blood donation
Gauge 18
Used when blood for culture is to be drawn
Povidone-iodine wipes/swabs
Non-additive tubes
Yellow-black
Red
Light blue
Coagulation tube
Light blue
Purpose of order of draw
To avoid cross-contamination of additives between tubes
Other term for evacuated collection tubes
Vacutainer tubes
Disadvantage of using 70% isopropyl alcohol
It can be hepatotoxic.
Collection tube
Patient’s full name
ID number
Date and time of collection
Phlebotomist’s initials
Contains sodium citrate
Light blue
Purpose of mixing tubes five to ten times
To avoid hemolysis
Plastic tubes order
Reverse PST and sodium heparin tube
Most commonly used in hematology
Purple top
Blood culture tube
Yellow-black
Separates serum from plasma
Serum Separator Tube
Forms calcium salts to remove calcium
Light blue
Composition of blood
45% formed elements
55% fluid
Used for CBC, blood cross matching, and blood culture
Serum Separator Tube
Additive tubes
Red-gray/gold Dark green Light green Lavender Pale yellow Light gray
Uses of red-gray/gold tube
Blood chemistry
Immunology
Serology
It chelates calcium to prevent coagulation
Purple/lavender tube
It is the study of blood, blood-forming organs and blood diseases/abnormalities.
Hematology
It is never the first tube drawn
Coagulation tube
Serum separator tube with gel separator (blood from serum) by centrifugation and clot activator
Red-gray/gold
Uses of dark green tube
Determination of lithium level
Determination of ammonia level
Used to prevent contamination
Blood culture tubes
Non-additive tubes
It preserves viability of organisms
Yellow-black tube
Use of light green
Blood chemistry
Disadvantages of microsampling
Small amount of blood is obtained
Repeated determinations cannot be done
Likely to hemolyse
Time consuming
Most commonly used in blood chemistry
Red top
Use of light gray tube
Glucose
Veins used in venipuncture
Median cephalic vein
Median basilic vein
Cephalic vein
General guidelines in blood collection
1 Correct patient identification
2 Correct specimen identification
3 Wear gloves at all times
4 Select a suitable site for blood collection
5 Prepare the equipment, the patient, and the puncture site
6 Collect the sample in the appropriate container
7 Dispose sharp objects properly
8 Recognize complications
9 Assess the need for sample recollection/rejection
10 Label the collection tubes at bedside or the drawing area
11 Promptly send the specimens with the requisition form to the laboratory
Use of purple/lavender tube
Hematology (CBC) Blood bank (cross matching)
Additive of pale yellow tube
Acid Citrate Dextrose
Complement inactivation
Pale yellow tube
Advantage of arterial puncture
Reflects oxygenation and acid-base status
Protime and prothrombin time
Light blue
Additive of yellow-black tube
Broth mixture
10 mL tube
Yellow-black
Microsampling technique could be used for:
1 infants less than 6 months
2 children when small amount of blood is needed
3 adults with poor veins or intravenous infusions
4 severely burned patients
Essential elements of a requisition form
1 Patient's full name 2 Patient's ID number 3 Patient's birth date and sex 4 Requesting physician's complete name 5 Source of specimen 6 Date and time of collection 7 Initials of the phlebotomist 8 The test/s requested
Inactivates thrombin and thromboplastin
Dark green
Impartial access to treatment or accommodation available or medically indicated, regardless of race, creed, sex, national origin, or sources of payment for care
Patient’s bill of rights
Disadvantages of venipuncture
Stasis causes hemoconcentration Difficult to perform in children, obese, and shock patients Hematoma and syncope Thrombosis Risk of infection
Distance behind puncture site in which moderate pressure is applied
1 cm
Blood collection using skin puncture
Microsampling technique
Plasma separator tube that contains lithium heparin anticoagulant and gel separator
Light green
Tubes that require full draw
Light blue
Purple/lavender
Light gray
Factors affecting hemoconcentration
1 Prolonged tourniquet application
2 Massaging, squeezing or probing a site
3 Long-term IV therapy
4 Sclerosed or occluded veins
Blood collection using veins as access
Venipuncture
Additives of light gray tube
Sodium fluoride
Potassium oxalate
Additive of purple/lavender tube
EDTA
5 ml tubes
Light blue
Purple/lavender
Location of the phlebotomy site for patients < 6 months
Heel of the foot
Advantages of venipuncture
Large blood sample is obtained
Multiple and repeated exams may be performed
Depth of puncture for heel of the foot
Not more than 2.6 mm
Mixing of venous, arterial, and capillary blood
Microsampling
Precautions in microsampling technique
Do not use the tip of the finger or the center of the finger
Avoid using the side of the finger
Index finger tends to have w thicker, callused skin
5th finger tends to have less soft tissue overlying the bone
Avoid puncturing a finger that is cold, cyanotic, swollen, scarred, or covered with rash
Do not use the thumb, big toe, and ear lobe as puncture site
Location of the phlebotomy site for patients > 1 year old
Hands
Location of veins used for venipuncture
Antecubital fossa
Temperature for pre-warming an infant’s heel
42 C for 3 to 5 minutes
Sites to be avoided when performing a venipuncture
Extensive scars from burns and surgery Upper extremity on the side of a previous mastectomy Hematoma Cannula/fistula/heparin lock Edematous extremities IV transfusions
Used to measure oxygen, carbon dioxide, and pH of blood
Arterial puncture
Arterial puncture sites
Brachial artery
Radial artery
Femoral artery
Potential source of test error
Indwelling lines or catheter
Uses of pale yellow tube
HLA tissue typing
Paternity testing
DNA studies
Normal hemoconcentration value
0.35-0.45
Advantages of microsampling
Easily accessible
Simple
Used for infants, children, critically ill, and obese
Solution used to reduce the risk of thrombosis
Heparin
Relationship of hemoconcentration and hematocrit
Direct
Effects of prolonged tourniquet application
Hemoconcentration of non-filterable elements
Increase in total protein, aspartate aminotransferase (liver enzymes), total lipids, cholesterol, and iron
Affects packed cell volume and other cellular elements
Exercise increases:
Creatine kinase
Aspartate aminotransferase
Lactate dehydrogenase
Platelet count
What is hemoconcentration?
It is the increase in concentration of large molecules and formed elements in blood.
Stress increases:
WBCs Adrenal hormones (cortisol and catecholamines)
Analytes affected by posture
Enzymes Proteins Lipids Iron Calcium
Patient preparation factors
1 Therapeutic drug monitoring 2 Exercise 3 Stress 4 Diurnal rhythms 5 Posture 6 Other factors (age, gender, pregnancy)
Prophylactic agent for HIV
Zidovudine
Disadvantages of arterial puncture
Technically more difficult Difficult to stop bleeding Hematoma Arterial spasm can cause blood flow problems Considerable discomfort Risk of infection
