BLOOD COLLECTION EQUIPMENT, ADDITIVES, AND ORDER OF DRAW Flashcards by Math Ematics

Methods of Blood Collection:

Venipuncture
Capillary Puncture or Skin Puncture
Arterial Puncture

How well did you know this?

Not at all

Perfectly

 Phlebotomy Section/Area
 Where phlebotomy procedures are performed
 Typically contains
 Table for supplies
 Special chair
 Bed or reclining chair
 *Bed or padded table

BLOOD DRAWING STATION

How well did you know this?

Not at all

Perfectly

 comfortable
 have adjustable armrests

PHLEBOTOMY CHAIRS

How well did you know this?

Not at all

Perfectly

Make blood collection equipment portable

EQUIPMENT CARRIERS

How well did you know this?

Not at all

Perfectly

 Easily carried
 Contain enough equipment for numerous blood draw
 “stat” or emergency situations

 Handheld Carriers

How well did you know this?

Not at all

Perfectly

 Gliding carts made up of steel or synthetic material
 Shelves carrying adequate supplies for many patients
 Not in the room, hallway only, nosocomial infection

 Phlebotomy Carts

How well did you know this?

Not at all

Perfectly

 One for each patient
 Non sterile, disposable latex, nitrile, neoprene,
polyethylene and vinyl
 Special gloves
 Barrier hand creams
 KEYPOINT:
 Decontamination of hands after glove removal is ESSENTIAL.

GLOVES and GLOVE LINERS

How well did you know this?

Not at all

Perfectly

 Substances that is use to prevent sepsis
 PREVENT or INHIBIT growth and development if Microorganism
BUT DOESN’T KILL THEM
 Used to clean site prior to blood collection

ANTISEPTICS

How well did you know this?

Not at all

Perfectly

 70% Ethyl alcohol
 70% Isopropyl alcohol (isopropanol)
 Benzalkonium Chloride
 Chlorhexidine gluconate
 Hydrogen peroxide
 Povidone Iodine (0.1%-1% available iodine)
 Tincture of Iodine

 Antiseptics used

How well did you know this?

Not at all

Perfectly

 Chemical substances used to remove or kill
microorganisms on surface and instruments

DISINFECTANTS

How well did you know this?

Not at all

Perfectly

SODIUM HYPOCHLORITE dilution for nonporous surface

1:100

How well did you know this?

Not at all

Perfectly

dilution for large amount of blood or other body fluid
contamination

1:10

How well did you know this?

Not at all

Perfectly

 10 minutes contact time
 KEYPOINT: Fresh bleach solution should be made daily or as
needed

SODIUM HYPOCHLORITE (Household Bleach)

How well did you know this?

Not at all

Perfectly

 Routine decontamination: Alcohol based sanitizers
 Detergent containing wipes for visibly soiled hand and
there’s no hand washing facilities

HAND SANITIZERS

How well did you know this?

Not at all

Perfectly

 2x2 inches size gauze pad
 Hold pressure over the site following blood collection
procedure
 USE OF COTTON BALLS TO HOLD PRESSURE IS NOT
RECOMMENDED

GAUZE PADS

How well did you know this?

Not at all

Perfectly

 Used to cover a blood collection site after the bleeding
has stopped
 Paper, cloth, knitted tape
 Caution: Adhesive bandages should not be used on
babies younger than 2 years of age because of
aspiration and suffocation

BANDAGES

How well did you know this?

Not at all

Perfectly

 Where you place used needles, lancets, and other
sharp objects
 With BIOHAZARD SYMBOL
 Rigid, puncture resistant, leak proof and disposable
and have locking lids
 CAUTION: It should not be overfilled because it creates
dangers of sharps injury or other biohazard exposure

 NEEDLES AND SHARPS DISPOSAL CONTAINERS

How well did you know this?

Not at all

Perfectly

 Leakproof plastic bags
 Transporting blood and other specimens from collection
site to the laboratory
 BIOHAZARD label and outside pocket

 BIOHAZARD BAGS

How well did you know this?

Not at all

Perfectly

Can be performed by means of 3 different
methods:
A. Syringe method
B. Butterfly infusion method
C. Vacutainer/ETS method

Venipuncture

How well did you know this?

Not at all

Perfectly

Venipuncture
 Equipments/Materials needed

In general:

Cotton/Gauze Pad, Torniquet, 70% ethyl
alcohol, needle disposal container

How well did you know this?

Not at all

Perfectly

 For syringe method

Syringe, needles, transfer device,
tubes

How well did you know this?

Not at all

Perfectly

For evacuated method-

Tube holder, needles,
evacuated tubes

How well did you know this?

Not at all

Perfectly

 For butterfly system-

winged infusion set

How well did you know this?

Not at all

Perfectly

Portable transillumination devices
 Transillumination?
 Inspecting organ by passing light through its wall
 Principle: Hemoglobin in the blood within the veins
absorbs the light, causing the vein to stand out as
dark lines

Vein locating Device

How well did you know this?

Not at all

Perfectly

 Constrict the flow of blood  Makes the vein more prominent  Flat strip, non-latex made material  Can be reused?  3 to 4 inches above puncture site (7.5- 10 cm)  Not longer than 1 minute  Blood pressure cuff (sphygmomanometer)  Obese, pediatric, geriatric

Torniquet

A. Syringe method Materials:

Needle  Syringe  Transfer device

 Single sample needle  Sterile and disposable  “ The larger the gauge number, the smaller the needle bore and length. “  Color coding for needles indicates the gauge

Needles/Hypodermic

ommonly used needles size

20-21g

size of needle for blood collecltion

21 and 22

sieze of needle for children

sed for butterfly infusion/needle

21-23

used for butterfly infusion/needle

21-23

Color coding for needle gauges yellow

green

black

blue

orange

brown

 1 or 1.5 inch  ½ to ¾ inchesbutterfly needle

Needle length

PPD skin test

Intramuscular injections

Butterfly or Syringe collection

Syringe or Evacuated system collection

Ivs or Blood donation

“ Fishing out “  Syringe barrel that slides over the needle  Device that slides over the needle after use

Safety cap

used for transfering the blood from syring to evacuated tube

Transfer device

A _must be vertical when tubes are being filled in order to prevent blood in the tube from touching the needle in the transfer device.

transfer device

Winged infusion sets

Butterfly method/system

Short needle with a thin tube with attached plastic wings  Used for infants and children and patients with fragile veins (cancer patients)  Could be connected to syringe or evacuated tubes

Butterfly method/system

21- or 23- gauge  ½ to ¾ inches  Safety device- sleeves that slides over the needle  5-12 inches rubber tubing

Butterfly method/system

materials for __: a. Multisample Needle/ Double-pointed needle b. Tube holder/needle adapter/ plastic holder c. Evacuated tubes

Evacuated tube system

 Both ends are sharp  The tube end has a rubber cover to prevent leakage between tubes  20,21,22 ( 21 and 22)  Length: 1 to 1.5 inches  Bevel (facing upward)

Multi-sample needle set/ Double pointed needle

 Help place and remove tubes  Has an indentation about ¼ inch  Grasp the same way of holding the barrel of syringe

Tube holder/Needle adapter

 Sodalime, Borosilicate glass or plastic  Tubes are indicated by color of rubber stopper (color-coded)  With different additives or anti-coagulant present  Has vacuum inside  Has expiration date  Sterile

Evacuated collection tubes

 Pulling air from the tube  Draw exact volume of blood indicated  Loss of vacuum: fail to properly fill with blood KEY POINT: Tubes do not fill blood all the way to the stopper.

Vacuum

 Improper storage  Opening the tube  Dropping the tube  Needle bevel partially out of skin

Causes of premature loss of vacuum

Preserve a specific blood constituent  Used to improve sample quality or accelerate sample processing  Aid in the separation of serum from cell

Tube Additives

interrupt the process of coagulation  EDTA, Citrate, Heparin, Oxalates

Anticoagulants

Prevents Glycolysis  Sodium Fluoride

Anti-glycolytic

Against coagulation of blood  Actions:  Chelates or precipitates Calcium  Inhibits thrombin activity

Anticoagulants

 Action: Chelates Calcium  2 Forms: Versene and Sequestrene  Uses: Hematology Test (CBC) and Blood Bank  KEY POINT: Excess EDTA causes RBC to shrink and change CBC results

Ethylenediaminetetraacetic acid (EDTA)

 Action: Combines calcium in a non-ionized form  Uses: Coagulation studies  FYI: Sodium Citrate in Black stoppers are used for Erythrocyte Sedimentation Rate (ESR)

Citrate

 Aka Mucoitin Polysulfuric acid  Ideal universal anticoagulant  Naturally occurring anticoagulant  Action: Acts as antithrombin and antithromboplastin  Uses: BGA, Chemistry test (Stat request e.g Electrolytes), situation that needs a fast turn around time  KEY POINT: Heparinized plasma is preferred over serum for potassium tests since RBC releases potassium as blood clots

Heparin

 Action: Combines with Calcium to form an insoluble salt.  Temperature sensitive anticoagulant

Oxalates

 Action: Forming weakly dissociated calcium components  Inhibits the glycolytic enzyme enolase

Fluoride

 For blood culture collection  Microbiology section  Action:  Anti-coagulant  Anti-complementary  Anti-phagocytic  Neutralizes aminoglycoside (antibiotic)

Sodium Polyanethol Sulfonate

 Gold Top  Design to help isolate/ separate the serum to cell composition  With THIXOTROPIC POLYMER GEL

Serum Separator Tube

 White Top  In order of draw: After SST or before Heparinized tube

Plasma Separator Tube

 Additive free tubes  Mostly for clearing or discard purposes  Yields serum sample

Nonadditive Tubes

Order of Draw

1. Sterile blood culture tubes- Yellow 2. Coagulation tubes- Light blue 3. Serum tube/ Plain tube- Red 4. Heparin tube- Green 5. EDTA tube- Lavander/Purple 6. Anti-glycolytic tube/ Fluoride- Gray “ Stop, Light is Red. Green Light, Go. “ - “ Stop, Light is Red, Stay Put. Green Light, Go.

Transfer of additive from one tube to the next  Occurs when:  Blood in additive tube touches the needle during ETS blood collection  When blood is transferred from a syringe into ETS tube

Carry Over/ Cross contamination

 Complete system for blood collection  Blood collection tube and collection apparatus combined in a single unit  Either: ETS or Syringe technique

Combination System

 Aka Capillary puncture or Microsampling or Microcollection  Length of lancet: 1.75 mm  Depth of incision:  Infants and children: <2.0 mm  Adults: <2.5 mm  Distance from skin surface to bone or cartilage: 1.5-2.4 mm

Skin Puncture

 Stop point  Disadvantage:  Blade was expose after used  Anxiety of the patient

Non-retractable lancets

 2 types:  Automatically punctures the skin  Phleb pushes the blade  Plastic device hides the blade in a platic holde

 Retractable lancets

 Holds all the equipment necessary for proper sample collection  Biohazard symbol is needed to meet OSHA blood borne standard precautions  Always prevent contamination  Place a towel before placing the tray on the bed of the patient  Get the towel after

Sample Collection Trays or Carts

Which needle has the smallest bore?

the bigger the number the smaller the needle eg. 23 over 25. 25 is the smallest

An anticoagulant is an additive placed in evacuated tubes in order to

Prevent the blood from clotting.

A green-stoppered evacuated tube contains what kind of anticoagulant?

Heparin

When serum is needed for testing, blood must be collected in which of the following colored tubes?

Red

Unsterile tubes may

Cause false positive blood cultures B. Infect the patient through backflow

The torniquet should be applied how many inches above the proposed venipuncture site?

3-4

. Leaving the torniquet on a patient’s arm for an extended length of time before drawing blood may cause

Hemoconcentration

Which of the following listed materials is not used in syringe method of venipuncture?

material needed: Syringe, needles, transfer device, tubes not neede: tube holder

ALL BUT ONE is used to have plasma as sample.

orange stooper

None Serum/ Chemistry and Serology

red glass

Clot activator Serum/ Chemistry and Serology

Red (Plastic/Hemogard)

K3 EDTA in liquid form Plasma/ Hematology

Lavander (Glass)

K2 EDTA/spray dried Plasma/ Hematology

avander (Plastic)

Spray dried K2EDTA Plasma/ Blood bank

Pink

EDTA and Gel Plasma/ Molecular diagnostic

White

Sodium Citrate Plasma/ Coagulation studies

Light blue

Sodium Heparin, Na2 EDTA Plasma/ Chemistry, Toxicology, TDM

Royal blue

Lithium Heparin, Sodium heparin Plasma/ Chemistry

Green

Sodium fluoride, Lithium iodoacetate Plasma/ Glucose Testing

Gray

Sodium Polyanethol Sulfonate (SPS), Acid Citrate Dextrose Serum/ Microbiology culture (SPS), HLA Typing (ACD)

Yellow

Clot activator and gel separator Serum/ Chemistry

Red/ Black, Gold,

Sodium heparin Plasma/ Lead testing

Tan (Glass)

K2 EDTA Plasma/Lead testing

Tan (Plastic)

Thrombin Serum/ Chemistry

Orange

*Apply__ 3-4 inches (7.5-10cm) above the selected site. *◦Purpose: Obstruct the return of venous blood–Distend the veins

tourniquet