blood collection equipment, additives and order of draw Flashcards
what is the primary duty of a phlebotomist
to collect blood samples for the laboratory
why does the phlebotomist must be familiar with all types of equipment
to select appropriate collection devices for the type and condition of the patent’s vein and the type and amount of specimen required
why is it important to choose the appropriate tools and use them correctly
to help assure the safe blood collection of high quality blood specimens
It is a dedicated area of a medical laboratory or clinic equipped for performing phlebotomy procedures on patients
blood-drawing station
aka phlebotomy section/ area
- primarily outpatients (walk in patients, not admitted in)
all equipment and materials for blood collection must be available (replenished if needed)
make sure all materials are complete and clean (disinfect)
Patients who have their blood drawn while in a seated position
phlebotomy chair
* disinfect phleb chair after multiple usage
phlebotomy chair, ideal positions
arm shld be straight not bent
angle of the chair abt 35
what are the 2 types of phleb chairs
- reclinable chair
can lean back
allow patients to lie back if they feel dizzy/ faint - chair with adjustable arms and hydraulic height
come in a variety of styles and sizes designed to be easily carried by the phlebotomist and to contain enough equipment for numerous blood draws
Handheld phlebotomy equipment carries or trays (handheld carries)
*including waste containers for sharps or hazardous materials
must replenish and maintain cleanliness
They are convenient for STAT or emergency situations or when relatively few patients need blood work.
handheld carriers
They have swivel wheels, which glide the carts smoothly and quietly down hospital hallways and in and out of elevators.
phlebotomy cart
* made of stainless stee or strong synthetic material
when must a new glove be worn or removed
new pair must be worn for each patient
removed when the procedure is complete
* a good fit is essential (no space, not loosen)
types of gloves used
non sterile
disposable nitrile
neoprene
polyethylene
vinyl
It is a substance that we use to significantly lessen the no. of microorganisms on the surface of skin
antiseptics
* it is used to prevent sepsis, which is the presence of microorganisms or their toxic products within the bloodstreams
what is the commonly used for routine blood collection
70% isopropyl alcohol (isopropanol)
Why 70% isopropyl alcohol and not 100%?
If you use 100%, it can irritate or damage the skin. Hence, you need to dilute it in water. (the ideal is 70%)
what is the difference between antiseptics and disinfectants
antiseptics - used for individuals
disinfectants - used for inanimate objects
what are some examples that is used for blood collection
index card
Substances or solutions regulated by the Environment Protection Agency (EPA) that are used to remove or kill microorganisms on surfaces and instruments
disinfections
most commonly used disinfectants
EPA-registered sodium hypochlorite
chemical germicide products, 5.25% sodium hypochlorite (household bleach)
disinfectants ratio
small spill -
large spill -
1:100 dilution - small spills
1:10 dilution - large spills
for routine decontamination of hands as a substance for handwashing provided that the hands are not visibly soiled
Alcohol-based hand sanitizers
*to prevent cross contamination
*practice before and after blood collections
clearly marked with a biohazard symbol and be rigid, puncture resistant, leakproof, disposable and have locking lids to seal the contents when filled to the appropriate volume
Needle and Sharps Disposal Containers
*Needles that are disposed of in these containers are hazardous and may cause transmission of infection
color yellow or red
It is leak proof plastic bags that are commonly used to transport blood and other specimens from the collection site of the laboratory
biohazard bags
*marked with a biohazard label and often have outside pocket in which requisition forms can be placed
SEND OUT
Bring a sample/ blood sample to another laboratory to do the requested test as it may not be available in the current lab.
it is used to to easily identify patients
patient identification reader (barcode technology)
*also used to generate labels for the specimen tubes
tend to be expensive, there are portable devices on the market that use transillumination to make it easier to locate veins that are difficult to see or feel.
vein-locating devices
how does vein-locating devices work
hemoglobin within the veins absorbs the light = stand out as dark lines
It is a device that is applied or tied around a patient’s arm prior to venipuncture
torniquet
*disinfect per usage
*must be conncious when applying it
why and how is torniquet used
to compress the veins and restrict blood flow.
restriction of venous blood flow distends or inflates the vein, making them larger and easier to find and stretches the vein walls so they are thinner and easier to pierce with a needle.
ideal application of torniquet
1minute
if longer = hemolysis
However, it is a case to case basis. if still hard to find, it may be longer than a minute.
what type of relationship does the needle’s diameter and gauge have
inverse (opposite) relationship; that is, the higher the gauge number, the smaller the diameter of the needle.
most commonly used gauge
21 - green
22 - black
23 - blue
*23 for children and esp females
Why do we have different numbers of gauges?
There are different thickness and thinness of the vessel or the vein itself.
why do we user a lower gauge in blood donation
To have a larger size of the bore of the needle. To collect at least 450ml of blood. So, the blood flow of the blood must somehow be fast
what is the difference between traditional style needles and BD eclipse safety needles
BD eclipse safety needles have safety cap wile traditional does not
it is a closed system in which the patient’s blood flows through a needle inserted into a vein directly into a collection tube without exposure to air or outside contaminants.
evacuated tube system
*close system: insert the needle to the vein and place the blood tube, the blood flow will be directed to the blood tube and do not need to remove the cap of the tube to transfer the blood
ETS allows how many tubes to be collected with a single venipuncture
4-5 blood tubes
Special blood-drawing needle
multisample needle
why must the bevel be facing you not upside down, before inserting it through the skin
if not, yo will not be able to vacuum the blood appropriately
it will touch the lining of the vessel
where will you insert the evacuated tube
Only insert the evacuated tube to the rubber sleeve of the needle if you already hit the vein.
Once inserted but if it did not hit the vein, you could do a vein search before inserting the evacuated tube.
this needle has a backflow
multisample needle
- when you insert the needle and hit the vein, you can see the bulb being filled with blood.
A clear, plastic, disposable cylinder with a small threaded opening at one end (often also called a hub) where the needle is screwed into it and a large opening at the other end where the collection tube is placed.
tube holders
*this is where you placed your evacuated tube
it is used with both ETS and the syringe method of obtaining blood specimens
evacuated tube
in evacuated tube, tube selection is based on
age of patient
amt. of blood needed for test
size and condition of the patient’s vein
this has a vacuum, a negative pressure
evacuated tube
- possibly draw the blood from the site after you insert the tube in the ETS components
why must u not uncap the evacuated tubes
so that the negative pressure will stay intact
tubes are handled properly and stored between ___ and ___
4°C and 25°C
it is used for patients with small or difficult veins
syringe system
*this system consists of a sterile syringe needle called a hypodermic needle and a sterile plastic syringe with a luer-lock tip
syringe method is commonly used when…
collecting 1-2 blood tubes to be collected
vein is to difficult to find
*make sure needle and barrel is locked
*only pull the plunger. NEVER push
Refers to the order in which tubes are collected during a multiple-tube ETS draw or filled with blood from a syringe.
order of draw
why must we follow the order of blood tube
to prevent contamination of blood specimens by carryover of additives that can interfere with some tests
Substances that prevent blood from clotting (coagulating)
anticoagulants
what are the 2 methods to prevvent blood from clotting
binding (chelating)/ precipitating calcium
inhibiting the formation of thrombin needed to convert fibrinogen to fibrin in the coagulation process
what do u write on the evacuated tubes
patient’s info with non smudge pen in PRINT not script to ensures that the letters can be easily read
order of draw
[stop light red stay put green lets go]
SPS
Lt. Blue
Red
SST
PST
Green
Lavender - EDTA
Gray - oxalate
most common citrate used
sodium citrate
most widely used oxalate
potassium oxalate
A substance that prevents glycolysis, the breakdown or metabolism of glucose (blood sugar) by blood cells.
antiglycolytic agents
* breakdown of glucose
most common antiglycolytic agents
sodium fluoride
*commonly used in combination with anticoagulant potassium oxalate or EDTA to provide a plasma specimen.
A substance that enhances coagulation in tubes used to collect serum specimens. what are the 2 types and iversion.
clot activators
- silica particles (SSTs - serum separator tubesand plastic red top)
Clot within 30 minutes - Rapid serum tube (RST) normally cloths within 5 minutes
5 - 10 inversions
Use clots cos we are after the serum
why do we use clot activators
because we are after the serum (clear liquid after the blood clots)
how long does it usually takes for blood to clot
15 to 30 minutes
why do we clot blood before centrifuge
as the specimen may be hemolyzed
