Blood Collection Equipment Flashcards
what are glove precautions for phlebotomy
- OSHA requires gloves for phelobotomy (change after each pt)
- powder free and nonsterile
What to use for routine venipuncture?
Phlebotomy tray or cart
Gloves
Hand sanitizer
Alcohol prep pads
Gauze pads Ye
Adhesive bandage or tape
Sharps (needle disposal) container
Permanent fine-tipped marking pen
Labels (preprinted)
Specimen transport bags
Evacuated tube holder or syringe
Evacuated tubes
Tourniquet
Needles
what do you need for a difficult venipuncture
Phlebotomy tray or cart
Gloves
Hand sanitizer
Alcohol prep pads
Gauze pads Ye
Adhesive bandage or tape
Sharps (needle disposal) container
Permanent fine-tipped marking pen
Labels (preprinted)
Specimen transport bags
Evacuated tube holder or syringe
Evacuated tubes
Tourniquet
Needles
winged infusion set
syringe
What do you need for a dermal puncture
Phlebotomy tray or cart
Gloves
Hand sanitizer
Alcohol prep pads
Gauze pads Ye
Adhesive bandage or tape
Sharps (needle disposal) container
Permanent fine-tipped marking pen
Labels (preprinted)
Specimen transport bags
Lancet
capillary tubes and sealant
micro collection tubes
use of alchol prep apds for phleb
- clean blood collection site with antiseptic (70% isoproyl)
- for blood culture or arterial puncture stronger antiseptics r required such as Betadine®, iodine, or chlorhexidine gluconate
- for blood alchool no alchohol prep pads
Gauze for phleb
- loose woven cotton for puncture site
- 2 by 2 is used for blood collection
- fold into quarters and tape to pt skin
- no cotton palls
Adhesive bandage for phleb
may be held by paper tape over puncture site
dont use on pt with fragile skin such as elderly, or infants/ small children
Sharps container phleb
- needle disposal container
- designed to protect healthcare personnel from accidental needlesticks by contamined needles
- sharps containers r rigid, leakproof, puncture resistant and marked with biohazard symbol + red
- never reach into, tamper with or attempt to open sealed sharp container
Tissue warmers pt
- warm towel, cloth, chemical warmer
- heel warmer for dermal punctuer on infants
- will hep for obse, elder,y and cancer pt
what are specimen transport bags
- plastic ziplock bags with biohazard symbol
- identify content as biohazard + containe specimen spills
- protect person handling specimen
- handle bag with specimen in it gentyl, keep it verticle, to prevent hemolysis from excessive agitation
What are tourniquets
- rubber tubing or strapping that is wrapped around
the arm to slow the flow of venous blood (blood in the veins) - causes a backup
of blood and increased pressure - used during venipuncture to
make it easier to locate a patient’s veins.
-applied 3 to 4 inches
above the puncture site, tightly enough to slow the blood flow but not stop it - enlargens vein
types of tourniquets
- most common are soft and pliable (1in by 18 in)
- rubber tubes, thin rubber bands, strips of elastic fabric
- new tourniquet on each pt
Needles for phleb
- needle is composed of hub (plastic), shaft, and bevel
- bevel should be facing up before needle is insertted
- sterile needes in peel-apart pacages or plastic cases
- always inspect needle for burrs (imperfections)
What is a double pointed needle?
- rubber sleeve over one end with a scew hub encirling needle, one side for venipuncture and other for collection tuve
- easier to draw multiple tubes
what is the needlestick safety and prevention act ?
- pit in palce in 2001
- needles should have safety feauters, engineering devices to prtoect phleb from accidental puncutre
- safety feature should ve one handed
3 types of phleb needle
1) a multiple-sample
needle, used as part of an evacuated collection system (a double-pointed needle and collection tube that contains a vacuum);
(2) a hypodermic needle, used with a syringe; and
(3) a winged infusion set (butterfly needle) that can be used
with either syringe or evacuated tube systems.
differneces in needles
- 3/4 to 1 1/2 inches
- gauges are diff (16 largest, 23 spallest)
- caps of needles are usually colorcoded (20 yellow, 21 green, 22 black in 1-1.5 in lengths)
- needles have manufacturing lables and seals on caps of bot ends + expiration date
what are butterfly needles (winged infusion sets)
- infants, small children, routine is difficult
- plastic wings attached to needles, 2 types of systems
-21-23 gauge needle - end of the plastic tubing has a hub end, designed to attach to a syring or rubber sleeve end
- safety device attached to platic wing end
- place needle in first to sharps container
- wings hold needle during insertion itno vein
- burtterfy needles are 3//4 in long with protective shiled
- good for nonstable pt
types of safe needles
- self blunting - After the blood is drawn, a
push on the collection tube
moves the blunt needle
forward through the outer shell
and past the needle point. The
blunt point can be activated
before it is removed from the
vein or artery. - self blunting butterfly needle - After collection and before the
removal of the needle, the wing
is flipped to the other side,
blunting the needle. - hinnged cap - use thubm to flip protective hinge cap
- protective sheuld- plastic cover over needle
- retractable needle- springloaded and retracts into barrel
syringes for phlebotomy?
- consists of a barrel and plunger
- barrel is usually graduation in mL or fractions of mL
- sizes r 1 mL, 3 mL, 10 mL
- 2 types fof hypoermic needles: slip tip and luer lock
- luer lock is preffered as no dager of synringe slipping of during procedures
- some syringes have preattached needle
what are transfer adapters
- safe way to tansfer bood form sunringe to tube
- can also be used with butterfyl needles
- adapters r available with female or male connectors
What is an evacuate tube holder
- barrel or adapter
- secialized plastic adapter for both needle and tube
- needles r designed to be screwed onto oen end of hte holder
- evacuated tube is insertedinto other end as needle is being inserted
- evacuation tube has a flange at end for tube
- needl without safety device = holder with safety device
- 2 sizes: standard size collection tube, smaller version for small diamter tube
What are evacutated tubes?
- premeasured vacuum
- most common for blood collection
- some tubes have additives
- tubes r sterile and have expiration date
- sizes rom 2-15mL
- color of stopper = additive inside
- fill with blood immediately
- some have slpashgaurd for sides of tube
- ex: BD tubes splashguard r called hemoguard
- splashguard is a safety device t oreduce aerosol mist
how do anticoagulants work for evacuated tubes?
- prevent speecimen from clotting by neutralizing or removing one of the essential factors
necessary for the clotting or coagulation process. Tubes containing an anticoagulant should
be mixed or inverted gently several times (usually 8 to 10 times)
What is thixotropic separator
gel
the gel seperates serum and plasma from cells
- after the specimen is centrifuged the gel creates a barrier between cells and plasma/serum
- cells r at bottm, liquid above gel
what are lancets?
- small cutting instruments
- several depths: : low blood flow,
1.5 mm; medium blood flow, 1.8 mm; and high blood flow, 2.0 mm - also have varying widths
-depth is less important than width of incision for blood flow
what are capiilary tubes and sealents?
aka microhematocrit tubes
- used to collect blood from dermal puncture
- use capillary action
types of capilllary tubes
red tip - anticoagulin - hemoglobin
blue tip - no anticoagulant
black tip- smaller diamter
Wjate are microcollection tubes
- plastic tubes that collect mor dthan capillary tubes
- some for speficif tests, others r multipurpose (some have capillary tube end, scoop, or widemouth)- must mix
What is the additive and lab section for red/gray or clear/red top?
no additive, used to coagulation and to purge air from butterfly tubing
What is the additive and lab section for light blue
additive is sodium citrate/ binsd calcium, used for coagulation
What is the additive and lab section for red
no additive or clot activator
used in chemistry and immunology
What is the additive and lab section for red/black or gold
additive is a Separator gel/
forms barrier and
clot activator and is used for chemistry
What is the additive and lab section for green
additive is heparin (n (sodium,
lithium, or
ammonium)/
inhibits thrombin)
used for chemistry, hematology, flow cytometry
What is the additive and lab section for green.grayor light green
additive is heparin and separator gel
used for chemistry
What is the additive and lab section for lavender
additive is EDTA/chelates
calcium
used for hematology and chemistry
What is the additive and lab section for pink
additive is EDTA spray (same as lavender with speical labeling)
used in blood banks
What is the additive and lab section for gray
additive is Sodium fluoride/
glycolysis inhibitor
and potassium
oxalate/binds
calcium
Chemistry
what does solid, translucent, etc mean on tube tops
Evacuated tubes that draw a full volume have a solid-color top. Evacuated
tubes with translucent splashguard tops contain less vacuum and draw less
volume. Volumes are indicated on the tube label with a line. The tubes that
draw less volume are often used for pediatric blood collection. Older-style
tubes for pediatric blood collection are physically smaller with a colored rubber stopper
what does a yellow stopper stand for? (2 types)
- sodium polyanethol sulfonate (neutralizes antibiotics) for microbiology/ blood cultures
- acid citrate dextorese (maintains cell viability) for blood banks and HLA lab
what does royal blue tube for?
- cnotain clot activator or EDTA specially formulated cap certified trace element free
- for chemistry/ trace elements
What is tan tube for?
- EDTA specially formulated cap certified lead free
- chemistry/ lead levels
What is white tube for
edta with separator gel
molecular diagnositic
What is orange or gery/ yellow tube for?
- thrombin for accelerates clotting
- for chemistry/ STAT Tests
how to discard tubes?
- use red top tubes without clot activator
- also can use tube with red and light gray rubber stopper
- discard tuve before coagulation (lith blue)
What are light blue topped tubes for?
- primarily in coagulation
- additive is sodium citrate which binds to calcium (necessary for coagulation)
- must be filled to draw capacity with no more vacuum
- 9:1 ratio of blood to sodium citrate
- used for PT, APTT, PTT, fibrinogen, and D dimers
what are red top tubes?
- glass or plastic
- for chemistry trsting (may be forserum testing - no additive or gel)
- glalss tube allows for access to clot
- plastic red top tubes may contain clot activator
- clot activator consists of very smallsilica particles to pseed up coagulation
what are serum separator tubes
- SST
- chemistry section
- rubber stop have red and black
- plastic are gold top
- contain clot activator and thixotropic seperator gel (helps prevent chemical changes from ceulluar metabolism and fivrinolysis)
- seperation makes it easier to aliquot serum
- sst r used for electroyltes, enzymes, glucose, hormones, lipids, and proteins
What is aliquoting?
- process of removing small
samples from the original specimen and placing them in another container
what are green topped tubes used for
- contain sodium, lithium or ammonium heparin (anticoagulant)
what are plasma separator tubes?
- light green or green gray stopper
- lithium and heparin
0 used to form barrier btwn blood cells and plasma - many facilities
what are lavender top tubes?
- contain EDTA to prevent blood clotting my binding to calcium (EDTA helps maintina cell shape and size better)
- used in hematology (CBC, differential, reticulocyte count, ESR)
What are pink top tubes used for?
- used for blood bank (immunohematology)
- label on pink top have additional info required by american association of blood banks
- used for blood typing, donor blood testing, cross matching blood, preparation of blood and blood products for transfusion
What are gray top tubees?
- used in chemistry section
0 contain potassium oxalate (antocoagulant that binds with calcium) and antiglycolytic agent (glucpse preservative, ex is sodium fluoride) that prevents rbc from using glucose and chaging it to lactic acid - gray top is preferred for glucsoe levels over ed or gold bc blood sample is drawn in a tube without glycolytic inhibitor, producing a lower glucose result (gray top r also used for lactic acid analysis and blood alcohol)
what are yellow top tubes used for (SPS)?
- contains sodium polyanethol sulfonate (SPS) and is used for blood cultures as SPS acts as an anticoagulant and neutralizes the effect of bacterial growth inhibitors such as antibiotics
- is sterile and must be draw before any other tube
- many facilities no longer use SPS tubes and instead use specialized blood culture collection bottles
yellow top tuvbe with acid citrate dextrose (ACD)
- maintains red cell viability or growth and is used for cellular studies in blood banks or HLA typing
What are royal blue topped tubes
- specialized tubes with different additives
- red bar = c,lot activator
- lawvender/blue = EDTA
- green = heparin
- royal blue r certified to have v low levels of trace elements such Al, lead, mercury, zinc, and other metals
- used for trace elements studies, toxicology, nutritional chemistry
tan top tubes
- spedialized tubes contianing EDTA
- certified to have v low levels of lead
- requirement when accurate blood lead level is needed
White top tubes
- contain EDTA and plasma separator gel
- required by lab performing molecular diagnostic tests that involve DNA based methods
orange top tubes
- contain thrombin (clotting factor()
- for STAT tests
FDP/ FSP
- fibrin degradation products aka fibrin split products
- found in an FDP test kit
- tube is light blue top, dark blue top, black top
- tube has thrombin and fibrinolytic inhibitor
- refrigerated tube
black top tube
used in some kits for ESR
what is the purpose of amber colored plastic for gold stopper Serum separator and light green plasam separator microclollection container??
protect specimen from light and used for bilirbubin testing
what is the order of the normal venipuncture?
- Nonadditive (red or clear discard tube, if required by your facility)
- Citrate (light blue)
- Serum tube (clot activator tube: red, royal blue, or orange)
- Serum separator (gold or red/black speckled)
- Plasma separator (light green or green/black speckled)
- Heparin (green)
- EDTA (lavender, pink, royal, tan, or white)
- Sodium fluoride (gray)
where does sterile tubes go if you draw them?
in replacement of nonadditive ?
how does venipuncture order diff for butterfly tubes?
- order of draw remain same but since assembly tube has air a discard tube must be drawn even for sterile blood draws (ensures other tubes will fill with the proper amt of blood)
syringe with butterfly ?
- must transfer blood with syringe to evacuated tubes (lessens chance of needlestick injury)
order for dermal puncture
- EDTA (lavender or pink)
- Heparin (green, light green)
- Sodium fluoride (gray)
- Nonadditive (red) or serum separator (gold)
what is an interfering substances?
0 produces incorrect lab test results
- can be caused by improper pt preparation or wrong order of tubes
why should light blue tube be collected first?
- when skin is punctured it releases tissue thromboplastin so not using light blue first will active the clotting system and render any resuls obtained invalid
- other additives also can interefer with other tubes so light blue first means no mess up with anticoagulation test
what is Becton Dickinson]
- manufacters equipment for blood and urine collection
- Vacutainer® and Microtainer® systems
- adlut has solid cap, pediatric has translucent case
- if they have separator gel they have a unique color
what is greiner bio-one
- VACUETTE® tubes designed for venous collection (Figure 8-32)
- MiniCollect® tubes designed for capillary collection
- solid top regardless of vacuum
- adult has black ring on cap
- pediatric blood collection tube has white ring
- separator gel has same color as without separator gel with yellow ring
Sarstedt
S-Monovette®, Microvette®, and Multivette® collection systems
- closed blood collection allows via syringe aspiration OR VACUUM
- color code similar to BD but cap on SST r brown
- microvette is blood sampling with capillary action or gravity flow
- for venous collectio na leur needle is connected to the capillary tube of the Multivette which automattically fills (tiny amt of sample)
what can tourniqueut transmit?
MRSA
who recommends single use tourniquets
CLSI
what are the msot common anticoagulats?
E (EDTA)
C (citrate)
H (heparin
O(oxalate)
phEDTA
purple tubes go to hematology and contain EDTA
springs creates colorful light-blue pansies
sodium ctirate tubes go to coagulation, have light-blue stoppers, and yield plasma
Sodium
Citrate
coagulation
light blue
plasma
HH: Heparin inhibits
heparininhibits thomin formationin
in-in-in
heparmin inhitibs thrombin
greenhouses have colorful plants
green tubes contain heparime for chemistry tests on plasma
GO or Gray ox
gray tubes typivally contain oxalate
LL
lavender last except fror gray (order of tubes)
what is EDTA
ethylenediminetetraaetic acid is commonly availiaby as dipotassium, tripotassium EDTA
- liquid = dilution of blood
- EDTA remove calcium from blood thus no coag
what type of EDTA is preferred for hema
spray dried edta
what are citrates ?
binds to calcium = no coag
- 9:1 ratio of blood to anticoag
what are oxalataes
- remove calcium and prevent clotting by biding and percipating calcium in the form of an insoluble
what is acid citrate dextrise
for immunohematology tests such as DNA testing and HLA phenotyping
what is citrate phospate dextrose (CPD)
- collecting blood for transfusion
what is sodium polyanethol sulfonate
- prevent coagulation by binding calcium
- used for blood culture collection bc slow down phagocytosis
what is antiglycolytic
substance that prevents glycolysis
how many times invert tubes with clot activator
5-10 inversiosn
