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PMLS 2 > Blood Collection Equipment, Additives, and Order of Draw > Flashcards

Blood Collection Equipment, Additives, and Order of Draw Flashcards

1
Q

3 methods of blood collection

A
  • venipuncture
  • capillary puncture/skin puncture
  • arterial puncture
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2
Q
  • phlebotomy section/area
  • where phlebotomy procedures are performed
  • typically contains
    • table for supplies
    • special chair
    • bed or reclining chair
    • bed or padded table
A

blood drawing station

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3
Q
  • comfortable
  • have adjustable armrests
A

phlebotomy chairs

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4
Q
  • make blood collection equipment portable
  • handheld carriers
  • phlebotomy carts
A

equipment carriers

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5
Q
  • easily carried
  • contain enough equipment for numerous blood draw
  • “stat” or emergence situations
A

handheld carriers

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6
Q
  • gliding carts made up of steel or synthetic material
  • shelves carrying adequate supplies for many patients
  • not in the room, hallway only, nosocomial infection
A

phlebotomy carts

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7
Q
  • one for each patient
  • non-sterile, disposable latex, nitrile, neoprene, polyethylene, and vinyl
  • special gloves
  • barrier hand creams
  • key point: decontamination of hands after removal is essential
A

gloves and glove liners

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8
Q
  • substances that is used to prevent sepsis
  • prevent or inhibit growth and development of microorganism but doesn’t kill them
  • used to clean site prior to blood collection
  • 70% ethyl/isopropyl alcohol, benzalkonium chloride, chlorhexidine gluconate, hydrogen peroxide, povidone iodine (0.1% - 1% available iodine), tincture of iodine
A

antiseptics

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9
Q
  • chemical substances used to remove or kill microorganisms on surface and instruments
  • sodium hypochlorite (household bleach
A

disinfectants

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10
Q

dilution ratio for nonporous surface

A

1:100

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11
Q

dilution ratio for large amount of blood or other body fluid contamination

A

1:10

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12
Q

How many minutes of contact time is for disinfectants?

A

10 minutes

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13
Q
  • routine decontamination: alcohol based sanitizers
  • detergent containing wipes for visible soiled hand and there’s no hand washing facilities
A

hand sanitizers

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14
Q
  • 1 x 1 in
  • hold pressure over the site following blood collection procedure
  • use of cotton balls to hold pressure is not recommended
A

gauze pads

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15
Q
  • used to cover a blood collection site after the bleeding has stopped
  • paper, cloth, knitted tape
  • caution: adhesive _____ should not be used on babies younger than 2 of age because of aspiration and suffocation
A

bandages

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16
Q
  • where you play needles, lancets, and other sharp objects
  • with biohazard symbol
  • rigid, puncture resistant, leak proof, and disposable and have locking lids
  • caution: should not be overfilled because it creates dangers of sharps injury or other biohazard exposure
A

needles and sharps disposal containers

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17
Q
  • leakproof plastic bags
  • transporting blood and other specimens from collection site to the laboratory
  • biohazard label and outside pocket
A

biohazard bags

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18
Q

3 ways to perform venipuncture

A
  • syringe method
  • butterfly infusion method
  • vacutainer/ETS method
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19
Q

General equipment/materials needed:

A

cotton/gauze pad, tourniquet, 70% ethyl alcohol, needle disposal container

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20
Q

equipment/materials needed for syringe method

A

syringe, needles, transfer device, tubes

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21
Q

equipment/materials needed for evacuated tube method

A

tube holder, needles, evacuated tubes

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22
Q

equipment/materials needed for butterfly system

A

winged infusion set

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23
Q

Vein locating device

A
  • portable transillumination devices
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24
Q

Principle of transillumination devices in vein location

A

hemoglobin in the blood within the veins absorbs light, causing the vein to stand out as dark lines

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25
Q
  • to constrict flow of blood, makes the vein more prominent
  • flat strip, non-latex made material
  • can be reused?
  • 3 - 4 inches below puncture site (7.5 - 10 cm)
  • not longer than 1 minute
  • blood pressure cuff (sphygmomanometer) - for obese, pediatric, geriatric
A

torniquet

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26
Q

Materials for syringe method

A

needle, syringe, transfer devices

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27
Q
  • single sample needle
  • sterile and disposable
  • color coding for needles indicates the gauge
A

needle

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28
Q

The larger the gauge number, the _______ the needle bore and length`

A

smaller

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29
Q

20 - 21 g is commonly used for?

A

blood collection

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30
Q

23 g is used for?

A

children

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31
Q

21 - 23, and 25 is used for?

A

blood infusion/needle

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32
Q

gauge 20 color

A

yellow

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33
Q

gauge 21 color

A

green

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34
Q

gauge 22 color

A

black

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35
Q

gauge 23 color

A

blue

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36
Q

gauge 25 color

A

orange

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37
Q

gauge 26 color

A

brown

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38
Q

Needle lengths?

A
  • 1 or 1.5 inch
  • 1/2 to 3/4 in - butterfly needle
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39
Q

Gauge and use: 27

A

PPD skin test

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40
Q

Gauge and use: intramuscular injections

A

25

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41
Q

Gauge and use: butterfly or syringe collection

A

23

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42
Q

Gauge and use: syringe or ETS collection

A

22 - 20

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43
Q

Gauge and use: Ivs or blood donation

A

18 and 16

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44
Q
  • safety cap
  • fishing out
  • barrel that slides over the needle
  • device that slides over the needle after use
A

syringe method

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45
Q
  • glass or plastic
  • “breathing the syringe”
  • the large the syringe, the greater the amount of vacuum obtained”
  • fragile, thin, or “rolly” veins that tend to collapse
A

syringe

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46
Q

When collecting blood using syringe, add the ________ of blood needed to fill the tubes to ensure that the syringe is capable of drawing the total volume

A

total volume

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47
Q

A transfer device must be _____ when tubes are being filled in order to prevent blood in the tube from touching the needle in the transfer device

A

vertical

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48
Q
  • 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
  • 21- or 23- gauge
  • 1/2 or 3/4 in
  • safety devices - sleeves that slide over the needle
  • 5 - 12 in rubber tubing
A

butterfly method/system

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49
Q

Materials needed for ETS

A
  • multi-sample needle/double-pointed needle
  • tube holder/needle adapter/plastic holder
  • evacuated tubes
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50
Q
  • 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 in
  • bevel (facing upward)
A

multi-sample needle set/double pointed needle

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51
Q
  • help place and remove tubes
  • has an indentation about 1/4 inch
  • grasp the same way of holding the barrel of syringe
A

tube holder/needle adapter

52
Q
  • Sodalime, borosilicate glass or plastic
  • tubes are indicate by color of rubber stopper (color-coded)
  • with different additives or anti-coagulant present
  • has vacuum inside
  • has expiration date
  • sterile
  • different diameters: 10, 13, 16 mm
A

Evacuated tube system

53
Q
  • pulling air from the tube
  • draw exact volume of blood indicated
  • loss of it: fail to properly fill with blood
54
Q

Do tubes fill blood all the way to the stopper?

55
Q
  • improper storage
  • opening the tube
  • dropping the tube
  • needle bevel partially out of skin
A

causes of premature loss of vacuum

56
Q
  • preserve a specific blood constituent
  • used to improve sample quality or accelerate sample processing
  • aid in the separation of serum from cell
A

Tube additives

57
Q
  • additive that interrupts the process of coagulation
A

Anticoagulants

58
Q

Anticoagulant additives are?

A

EDTA, citrate, heparin, oxalates

59
Q

Additive that prevents glycolysis

A

Anti-glycolytic

60
Q

example of anti-glycolytic additive?

A

sodium fluoride

61
Q

example of clot activator additive

A

thixotropic gel separators

62
Q

Actions of anticoagulants

A
  • chelates or precipitates calcium
  • inhibits thrombin activity
63
Q
  • Range of Mix or # of inversion for anticoagulant: _____
  • EDTA and Heparin: ___
  • Citrate: ___
A
  • 3 - 8 x
  • 8x
  • 3 - 4x
64
Q

Anticoagulants with special use

A
  • acid citrate dextrose - DNA testing, HLA typing, transplant compatibility
  • citrate phosphate dextrose
  • sodium polyanethol sulfonate (SPS)
65
Q
  • action: chelates calcium
  • uses hematology test (CBC) and blood bank
  • Key point: excess causes RBC to shrink and change CBC results
A

Ethylenediaminetetraacetic acid (EDTA)

66
Q

2 forms of EDTA

A
  • Versene
  • sequestrene
67
Q

Forms of EDTA

A
  • 2 forms: Versene and Sequestrene
    -> Dipotassium EDTA (K2 EDTA)
    -> Tripotassium EDTA (K3 EDTA) - Sequestrene
    -> Disodium EDTA (Na2 EDTA) - Versene
68
Q

What color is the stopper for EDTA?

69
Q

What color is the stopper for citrate?

A

Light blue

70
Q
  • action: combines calcium in a non-ionized form
  • Concentration: 3.2 - 3.8 g/dL in a ration of 1 part of anticoagulant to 9 parts of blood (1:9)
  • 8x inversion
  • uses: coagulation studies
71
Q

Other variations of citrate tube

A
  • 3.8% or 0.129 M trisodium citrate
  • 3.2% or 0.109 M buffered sodium citrate
72
Q

Sodium citrate in ____ stoppers are used for erythrocyte sedimentation rate

73
Q

Fill lines of blood in light blue stopper?

A

Max, mid, min.

74
Q

Color of stopper with heparin additive

75
Q
  • aka Mucoitin Polysulfuric acid
  • ideal universal anticoagulant
  • naturally occurring anticoagulant
  • action: acts as antithrombin and antithromboplastin
  • Available in:
    -> Sodium, lithium, potassium, and ammonium salts
    -> lithium heparin (dry powder)
76
Q
  • Uses: BGA, Chemistry test (STAT request eg electrolytes), situation that needs a fast turn around time
77
Q

__________ is preferred over serum for potassium tests since RBC releases potassium as blood clots

A

Heparinized plasma

78
Q
  • Action: combines with calcium to form an insoluble salt
  • temperature sensitive anticoagulant
  • uses: hematology (CBC, Hgb, and Hct)
  • available in:
    -> ammonium oxalate: swells the cells
    -> potassium oxalate: shrinks the cells
    -> double balance oxalate (2:3)
79
Q

What is the color of the stopper of a tube of oxalate additive?

80
Q
  • action: forming weakly associated calcium components; inhibits the glycolytic enzyme enolase
  • weak anticoagulant
  • available in: Sodium flouride
  • concentration: 10mg/mL of blood (2mg/mL fluoride)
  • without any antiglycolytic agent, glucose decreases approximately 100mg/ml or 10mg/dL per hour
81
Q

Color of tube with fluoride additive?

82
Q
  • for blood culture collection
  • microbiology section
  • action: anti-coagulant, anti-complementary, anti-phagocytic, neutralizes aminoglycoside (antibiotic)
  • Disadvantage: inhibits (Gardnerella, Neiserria, strptobaccilus, peptostrptoco)
A

Sodium polyanethol sulfonate)

83
Q
  • Gold top
  • designed to help isolate/separate the serum to cell composition
  • with thixotropic polymer gel (specific gravity of 1.04; serves as physical barrier or gel separator)
A

Serum separator tube

84
Q
  • white top
  • in order to draw: after SST or before heparinized tube
A

plasma separator tube

85
Q

Additive: None
Specimen/Clinical use: Serum/chemistry and serology

A

Red (glass)

86
Q

Additive: clot activator
Specimen/Clinical use: serum/chemistry and serology

A

red (plastic/hemogard)

87
Q

Additive: K3 EDTA in liquid form
Specimen/Clinical use: Plasma/hematology

A

Lavender (glass)

88
Q

Additive: K2 EDTA/spray dried
Specimen/Clinical use: plasma/hematology

A

Lavender (plastic)

89
Q

Additive: Spray dried K2 EDTA
Specimen/Clinical use: Plasma/blood bank

90
Q

Additive: EDTA and gel
Specimen/Clinical use: Plasma/molecular diagnostic

91
Q

Additive: sodium citrate
Specimen/Clinical use: plasma/coagulation studies

A

light blue

92
Q

Additive: sodium heparin, Na2 EDTA
Specimen/Clinical use: Plasma/chemistry, toxicology, TDM

A

Royal blue

93
Q

Additive: lithium heparin, sodium heparin
Specimen/Clinical use: plasma/chemistry

94
Q

Additive: sodium fluoride, lithium iodoacetate
Specimen/Clinical use: plasma/glucose testing

95
Q

Additive: sodium polyanethol sulfonate (SPS), acid citrate dextrose
Specimen/Clinical use: serum/microbiology culture (SPS), HLA typing (ACD)

96
Q
  • Additive: clot activator and gel separator
  • Specimen/Clinical use: Serum/chemistry
A

Red/black, gold

97
Q

Additive: sodium heparin
Specimen/Clinical use: plasma/lead testing

A

tan (glass)

98
Q

Additive: K2 EDTA
Specimen/Clinical use: Plasma/lead testing

A

Tan (plastic)

99
Q

Additive: thrombin
Specimen/Clinical use: serum/chemistry

100
Q
  • Additive free tubes
  • mostly for clearing and discard purposes
  • yields serum sample
A

nonadditive tubes

101
Q

Order of draw: (section) - (color)
Sterile blood culture tubes -

102
Q

Order of draw: (section) - (color)
coagulation tubes -

A

light blue

103
Q

Order of draw: (section) - (color)
serum tube/plain tube -

104
Q

Order of draw: (section) - (color)
heparin tube -

105
Q

Order of draw: (section) - (color)
EDTA tube -

A

lavender/purple

106
Q

Order of draw: (section) - (color)
anti-glycolytic tube/fluoride -

107
Q

If SST or PST is available or needed, after 3rd tube or before heparinized tube:

A
  • “Stop, Light is Red, Green Light, Go”
  • “Stop, Light is Red, Stay Put. Green Light, Go”
108
Q

Order in which tubes are collected during multiple draw or are filled from a syringe

A
  1. Sterile blood culture tubes - yellow
  2. Coagulation tubes - light blue
  3. serum tube/play tube - red
  4. heparin tube - green
  5. EDTA tube - lavender/purple
  6. Antiglycolytic tube/fluoride - gray
109
Q
  • 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
A

Carry over/cross contamination

110
Q
  • complete system for blood collection
  • blood collection tube and collection apparatus combined in a single unit
  • ether ETS or Syringe technique
A

Combination system

111
Q
  • aka capillary puncture or micro sampling or micro collection
A

skin puncture

112
Q

length of lancet

113
Q

Depth of incision of lancet:
* infants and children:
* adults:

A
  • infants and children: <2.0 mm
  • adults: <2.5 mm
114
Q

Distance of lancet from skin surface to bone or cartilage

A

1.5 - 2.4 mm

115
Q

A fingerstick to obtain blood is preferred for children older than ____ year old

116
Q

Before blood collection, wipe the ____ drop of blood using cotton or gauze

117
Q

Cut orientation for skin puncture?

A

across fingertips

118
Q

During blood collection, ___________ the site to prevent hemolysis and excess tissue fluid

A

Do not milk

119
Q

Filling of ______ should be done rapidly

A

capillary tube

120
Q

In skin puncture, Prevent the induction of ______

A

air bubbles

121
Q

Person who can benefit from this method of collection (skin puncture) (4)

A
  • pediatric patients - sample volume limited
  • obese patients
  • chemotherapeutic patients
  • burn patients
122
Q

Order of filling micro sampling tubes?

A

*blood gas specimen
* EDTA specimen
* other additive specimens
*serum specimens

123
Q
  • Stop point
  • disadvantage:
    -> blade is exposed after use
    -> anxiety of the patient
A

Non-retractable lancets

124
Q
  • 2 types:
    -> automatically punctures the skin
    -> phleb pushes the blade
  • plastic device hides the blade in a plastic holder
A

retractable lancets

125
Q
  • 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
A

sample collection trays or carts

PMLS 2 (6 decks)

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