blood collection equipment, additives and order of draw

Question 1

what is the primary duty of a phlebotomist

Answer 1

to collect blood samples for the laboratory

Question 2

why does the phlebotomist must be familiar with all types of equipment

Answer 2

to select appropriate collection devices for the type and condition of the patent’s vein and the type and amount of specimen required

Question 3

why is it important to choose the appropriate tools and use them correctly

Answer 3

to help assure the safe blood collection of high quality blood specimens

Question 4

It is a dedicated area of a medical laboratory or clinic equipped for performing phlebotomy procedures on patients

Answer 4

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)

Question 5

Patients who have their blood drawn while in a seated position

Answer 5

phlebotomy chair
* disinfect phleb chair after multiple usage

Question 6

phlebotomy chair, ideal positions

Answer 6

arm shld be straight not bent
angle of the chair abt 35

Question 7

what are the 2 types of phleb chairs

Answer 7

1. reclinable chair
   can lean back
   allow patients to lie back if they feel dizzy/ faint
2. chair with adjustable arms and hydraulic height

Question 8

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

Answer 8

Handheld phlebotomy equipment carries or trays (handheld carries)

*including waste containers for sharps or hazardous materials
must replenish and maintain cleanliness

Question 9

They are convenient for STAT or emergency situations or when relatively few patients need blood work.

Answer 9

handheld carriers

Question 10

They have swivel wheels, which glide the carts smoothly and quietly down hospital hallways and in and out of elevators.

Answer 10

phlebotomy cart
* made of stainless stee or strong synthetic material

Question 11

when must a new glove be worn or removed

Answer 11

new pair must be worn for each patient
removed when the procedure is complete
* a good fit is essential (no space, not loosen)

Question 12

types of gloves used

Answer 12

non sterile
disposable nitrile
neoprene
polyethylene
vinyl

Question 13

It is a substance that we use to significantly lessen the no. of microorganisms on the surface of skin

Answer 13

antiseptics
* it is used to prevent sepsis, which is the presence of microorganisms or their toxic products within the bloodstreams

Question 14

what is the commonly used for routine blood collection

Answer 14

70% isopropyl alcohol (isopropanol)

Question 15

Why 70% isopropyl alcohol and not 100%?

Answer 15

If you use 100%, it can irritate or damage the skin. Hence, you need to dilute it in water. (the ideal is 70%)

Question 16

what is the difference between antiseptics and disinfectants

Answer 16

antiseptics - used for individuals
disinfectants - used for inanimate objects

Question 17

what are some examples that is used for blood collection

Answer 17

index card

Question 18

Substances or solutions regulated by the Environment Protection Agency (EPA) that are used to remove or kill microorganisms on surfaces and instruments

Answer 18

disinfections

Question 19

most commonly used disinfectants

Answer 19

EPA-registered sodium hypochlorite
chemical germicide products, 5.25% sodium hypochlorite (household bleach)

Question 20

disinfectants ratio
small spill -
large spill -

Answer 20

1:100 dilution - small spills
1:10 dilution - large spills

Question 21

for routine decontamination of hands as a substance for handwashing provided that the hands are not visibly soiled

Answer 21

Alcohol-based hand sanitizers

*to prevent cross contamination
*practice before and after blood collections

Question 22

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

Answer 22

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

Question 23

It is leak proof plastic bags that are commonly used to transport blood and other specimens from the collection site of the laboratory

Answer 23

biohazard bags

*marked with a biohazard label and often have outside pocket in which requisition forms can be placed

Question 24

SEND OUT

Answer 24

Bring a sample/ blood sample to another laboratory to do the requested test as it may not be available in the current lab.

Question 25

it is used to to easily identify patients

Answer 25

patient identification reader (barcode technology) *also used to generate labels for the specimen tubes

Question 26

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.

Answer 26

vein-locating devices

Question 27

how does vein-locating devices work

Answer 27

hemoglobin within the veins absorbs the light = stand out as dark lines

Question 28

It is a device that is applied or tied around a patient’s arm prior to venipuncture

Answer 28

torniquet *disinfect per usage *must be conncious when applying it

Question 29

why and how is torniquet used

Answer 29

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.

Question 30

ideal application of torniquet

Answer 30

1minute if longer = hemolysis However, it is a case to case basis. if still hard to find, it may be longer than a minute.

Question 31

what type of relationship does the needle's diameter and gauge have

Answer 31

inverse (opposite) relationship; that is, the higher the gauge number, the smaller the diameter of the needle.

Question 32

most commonly used gauge

Answer 32

21 - green 22 - black 23 - blue *23 for children and esp females

Question 33

Why do we have different numbers of gauges?

Answer 33

There are different thickness and thinness of the vessel or the vein itself.

Question 34

why do we user a lower gauge in blood donation

Answer 34

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

Question 35

what is the difference between traditional style needles and BD eclipse safety needles

Answer 35

BD eclipse safety needles have safety cap wile traditional does not

Question 36

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.

Answer 36

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

Question 37

ETS allows how many tubes to be collected with a single venipuncture

Answer 37

4-5 blood tubes

Question 38

Special blood-drawing needle

Answer 38

multisample needle

Question 39

why must the bevel be facing you not upside down, before inserting it through the skin

Answer 39

if not, yo will not be able to vacuum the blood appropriately it will touch the lining of the vessel

Question 40

where will you insert the evacuated tube

Answer 40

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.

Question 41

this needle has a backflow

Answer 41

multisample needle * when you insert the needle and hit the vein, you can see the bulb being filled with blood.

Question 42

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.

Answer 42

tube holders *this is where you placed your evacuated tube

Question 43

it is used with both ETS and the syringe method of obtaining blood specimens

Answer 43

evacuated tube

Question 44

in evacuated tube, tube selection is based on

Answer 44

age of patient amt. of blood needed for test size and condition of the patient's vein

Question 45

this has a vacuum, a negative pressure

Answer 45

evacuated tube - possibly draw the blood from the site after you insert the tube in the ETS components

Question 46

why must u not uncap the evacuated tubes

Answer 46

so that the negative pressure will stay intact

Question 47

tubes are handled properly and stored between ___ and ___

Answer 47

4°C and 25°C

Question 48

it is used for patients with small or difficult veins

Answer 48

syringe system *this system consists of a sterile syringe needle called a hypodermic needle and a sterile plastic syringe with a luer-lock tip

Question 49

syringe method is commonly used when...

Answer 49

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

Question 50

Refers to the order in which tubes are collected during a multiple-tube ETS draw or filled with blood from a syringe.

Answer 50

order of draw

Question 51

why must we follow the order of blood tube

Answer 51

to prevent contamination of blood specimens by carryover of additives that can interfere with some tests

Question 52

Substances that prevent blood from clotting (coagulating)

Answer 52

anticoagulants

Question 53

what are the 2 methods to prevvent blood from clotting

Answer 53

binding (chelating)/ precipitating calcium inhibiting the formation of thrombin needed to convert fibrinogen to fibrin in the coagulation process

Question 54

what do u write on the evacuated tubes

Answer 54

patient's info with non smudge pen in PRINT not script to ensures that the letters can be easily read

Question 55

order of draw

Answer 55

[stop light red stay put green lets go] SPS Lt. Blue Red SST PST Green Lavender - EDTA Gray - oxalate

Question 56

most common citrate used

Answer 56

sodium citrate

Question 57

most widely used oxalate

Answer 57

potassium oxalate

Question 58

A substance that prevents glycolysis, the breakdown or metabolism of glucose (blood sugar) by blood cells.

Answer 58

antiglycolytic agents * breakdown of glucose

Question 59

most common antiglycolytic agents

Answer 59

sodium fluoride *commonly used in combination with anticoagulant potassium oxalate or EDTA to provide a plasma specimen.

Question 60

A substance that enhances coagulation in tubes used to collect serum specimens. what are the 2 types and iversion.

Answer 60

clot activators 1. silica particles (SSTs - serum separator tubesand plastic red top) Clot within 30 minutes 2. Rapid serum tube (RST) normally cloths within 5 minutes 5 - 10 inversions Use clots cos we are after the serum

Question 61

why do we use clot activators

Answer 61

because we are after the serum (clear liquid after the blood clots)

Question 62

how long does it usually takes for blood to clot

Answer 62

15 to 30 minutes

Question 63

why do we clot blood before centrifuge

Answer 63

as the specimen may be hemolyzed