BLOOD COLLECTION: EVACUATED TUBE SYSTEM Flashcards
Preferred because efficient, relatively it is direct, safe for the patient allows and the blood drawer, and multiple tubes to be easily collected.
EVACUATED TUBE SYSTEM
ETS PURPOSE
To obtain a blood specimen for patient diagnostic or monitoring purposes from an antecubital vein using the evacuated tube system (ETS)
Parts of 2 way needle
Bevel
Shaft
Threaded hub
Rubber sleeve over needle
ETS materials needed
Evacuated blood collection tubes (various types depending on the required tests)
Tourniquet
Sterile gauze pad
Antiseptic prep pad
ETS needle (2-way needle)
ETS adapter
Sharps container
Permanent pen
Biohazard container
Disposable gloves
PPE
A test request must be reviewed for (4)
completeness
date and time of collection
status
priority
The______ process records the request and assigns it a unique number used to identify the specimen, related processes, and paperwork.
accession
The right approach for a successful patient encounter includes a: (3)
professional bedside manner
being organized and efficient
looking for signs that convey important inpatient information or infection-control precautions.
is vital to patient safety and meaningful test results.
Correct ID
(3) must be verified and matched to the test order and inpatient’s ID band.
Preparing the patient by explaining procedures and addressing inquiries helps reduce patient anxiety.
Name
Date if Birth
Medical Record number
Test results can be meaningless or misinterpreted and patient care compromised if_____ requirements have not been met.
diet
Exposure to____ can trigger a life-threatening reaction in those allergic to it.
latex
Proper_______ plays a major role in infection control by protecting the phlebotomist, patient, and others from contamination.
hand hygiene
______are required by OSHA to protect the phlebotomist from potential bloodborne pathogen exposure.
Gloves
Proper positioning is important to (2)
patient comfort
venipuncture success
The patient’s arm should be placed_____ in a straight line from shoulder to wrist to aid in vein selection and avoid reflux as tubes are filled.
_______enlarges veins and makes them easier to see, feel, and enter with a needle.
A ______make the veins easier to see and feel and helps keep them from rolling.
downward
Tourniquet application
clenched fist
Select a large, well-anchored vein.
The ______should be the first choice, followed by the_____.
The_____ should not be chosen unless it appears that no other vein can be safely or successfully accessed.
median cubital
cephalic
basilic
Releasing the tourniquet and opening the fist helps prevent________.
hemoconcentration
Cleaning the site with an______ helps avoid contaminating the specimen or patient with skin-surface bacteria picked up by the needle during venipuncture.
antiseptic
Letting the site____ naturally permits maximum antiseptic action, prevents contamination caused by wiping, and avoids stinging or burning on needle entry.
dry
Selecting appropriate equipment for the (3) of the vein is easier after vein selection.
Preparing it while the site is_____ saves time.
Attach a needle to an_____.
Put the first tube in the holder now or wait until after needle entry.
Gloves must be put on now if not already on.
size
condition
location
drying
ETS holder
The_____ aids needle entry. Pick up the tube holder with your____ hand, placing your____ on top near the needle end and____ underneath.
Uncap and inspect the needle for defects and discard it if flawed.
tourniquet
dominant
thumb; fingers
The fist aids needle entry.
______stretches the skin so the needle enters easily and with less pain, and keeps the vein from rolling.
____the patient.
Line the needle up with the vein and insert it _____into the skin using a smooth forward motion.
Stop when you feel a decrease in resistance, often described as a “pop,” and press your fingers into the arm to anchor the holder.
Anchoring
Warn
bevel up
Blood will not flow until the_____ pierces the tube stopper.
Place a tube in the holder and push it part way onto the needle with a_____ twist.
Grasp the holder’s____ with your middle and index fingers, pulling back slightly to keep the holder from moving, and push the tube onto the needle with your_____.
Releasing the_____ and _____allows blood flow to normalize.
needle
clockwise
flanges
thumb
tourniquet; opening the fist
Blood will not flow until the needle pierces the____.
Place a tube in the holder and push it part way onto the needle with a_____ twist.
Grasp the holder’s____ with your middle and index fingers, pulling back slightly to keep the holder from moving, and push the tube onto the needle with your____.
Releasing the_____ and _____allows blood flow to normalize.
tube stopper
clockwise
flanges; thumb
tourniquet; opening the fist
According to_____ standards, the____ should be released as soon as possible after blood begins to flow and should not be left on longer than____
CLSI
tourniquet
1 minute
Fill additive tubes until the vacuum is exhausted to ensure correct_______ and mix them immediately upon removal from the holder using three to eight gentle inversions to prevent clot formation.
Follow the CLSI order of draw to prevent ______between tubes.
blood-to-additive ratio
additive carryover
A clean, folded gauze square is placed over the site so pressure can be applied immediately after needle removal.
Remove the needle in one smooth motion without lifting up or pressing down on it.
Immediately apply pressure to the site with your free hand while simultaneously activating the needle safety feature with the other to prevent the chance of a_____.
needlestick
According to_____, the _______ and ______must go into the sharps container as a unit because removing a needle from the holder exposes the user to sharps injury.
OSHA
needle and the tube holder
To avoid mislabeling errors, label tubes…
before leaving the bedside or dismissing the patient
For accurate results, some specimens require special handling such as:
cooling in crushed ice (e.g., ammonia)
transportation at body temperature (e.g., cold agglutinin)
protection from light (e.g., bilirubin).
The patient’s arm must be examined to verify that____ has stopped.
The site must also be checked for signs of bleeding…
bleeding
beneath the skin.
If bleeding has stopped, apply a bandage and advise the patient to keep it in place for at least_____
Note: If bleeding persists beyond_____, notify the patient’s nurse or physician.
15 minutes
5 minutes
Materials such as_____ and ____ are normally discarded in the regular trash.
Some facilities require that contaminated items such as blood-soaked gauze be discarded in_____
needle caps and wrappers
biohazard containers
______the patient is courteous and professional.
Gloves must be removed in an_____ manner and_____ or decontaminated with_____ as an infection-control precaution
Thanking
aseptic
hands washed
hand sanitizer
________to the lab protects specimen integrity and is typically achieved by personal delivery, transportation via a______ or ______
Prompt delivery
pneumatic tube system, or by a courier service
