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HEMA 1: LAB > Blood Collection Prt. 2 > Flashcards

Blood Collection Prt. 2 Flashcards

1
Q

Causes of Hemolysis

A

• Use a needle that is too small
• Pulling syringe plunger back too fast
• Expelling blood strongly into the tube
• Forcing the blood from a syringe into an evacuated tube
• Shaking or mixing the tubes vigorously
• Performing blood collection before the alcohol has dried at the collection site

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2
Q

Causes of Hematoma

A

• The vein is too fragile or too small for the needle size
• The needle penetrates all the way to the vein
• Needle is partly inserted into the vein
• Needle is removed while tourniquet is still on
• Excessive probing
• Pressure is not adequately applied after venipuncture

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3
Q

Three Types of Blood Collection

A

• Venipuncture -> venous blood
• Capillary Puncture -> mixture of venous and arterial blood
• Arterial Puncture -› arterial blood

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4
Q

• Most common technique used to obtain blood.
• Requires ample skill to ensure accurate results and preservation of patient vein integrity
• Drawing blood of venous blood for transfusion, apheresis, diagnostic testing, experimental procedures, treatment

A

Venipuncture

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5
Q

Venipuncture methods

A

Syringe method
ETS
Butterfly collection

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6
Q

: 1st critical step.

A

Correct Patient Identification

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7
Q

Selection of the site

A

median cubital (preferred), median basilic, cephalic veins.

If not veins of the wrist, back of the hand, ankle, or foot (consult if there are circulatory problems).

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8
Q

avoid areas

A

w/ hematoma
burns
scars
edema
IV line
mastectomy site

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9
Q

Apply the tourniquet-

A

3-4 inches above the site.

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10
Q

Remove the needle and apply pressure
> do not allow px to_____
- This will reopen the wound and result in hemorrhage.

A

bend the arm.

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11
Q

LABEL SPECIMEN
-> no_______
- (4)and any information required by the institution

A

pre-labeling

name
date and time
age/sex
initials of the phlebotomist

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12
Q

Common mistakes during venipuncture procedures are:

A

> failure to dry site
bevel down
failure to mix blood ASAP
failure to release the tourniquet
excessive pulling of the plunger

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13
Q

IV site/Med lock

A

> never drawn on the same side -› opposite arm
distal or below IV line (noted)

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14
Q

• Transfusion
> may collect blood
> should be…

A

indicated and drawn on the opposite arm.

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15
Q

• HD shunt/Fistula
> it is avoided
> ask for the patient’s status
> may draw distal…

A

at least 4 inches below.

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16
Q

REMEMBER: each phlebotomist is allowed only___ attempts.

A

two

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17
Q

• The classical way of obtaining venous blood
• Open svstem
• The preferred technique in veins that are easily collapsed

A

SYRINGE METHOD

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18
Q

• Favored because it can tell if the vein is hit through the backflow which is made visible in the needle hub

A

SYRINGE METHOD

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19
Q

SYRINGE METHOD ORDER OF DRAW:

A
  • Blood culture
  • Coagulation tests
  • Plasma tubes (tubes with other additives)
  • Serum Tubes
20
Q

• Multiple tube draw
• Closed system (lesser contamination)
• A faster way of collecting blood

A

EVACUATED TUBE SYSTEM

21
Q

EVACUATED TUBE SYSTEM

• ORDER OF DRAW

A
  • Blood culture
  • Coagulation tests
  • Serum Tubes
  • Plasma tubes (tubes with other additives)
22
Q

NOTE:
- The main advantage of the evacuated tube system is that it allows multiple blood draws
- However, the proper order of draw should be followed to avoid…

A

cross-contamination or carryover of additives from one tube to another

23
Q

• Open or closed system

  • Closed system
    • air will not contaminate the blood
    • ETS is used

-> Open system
• blood is exposed to blood
• Syringe is used

A

WINGED INFUSION METHOD

24
Q

Winged infusion method

Needle gauge

A

• 25-gauge needle -> for collapsable veins

25
Q

For Butterfly with ETS, a_____ is needed

A

Discard tube

26
Q

Complications for Venipuncture

A

• Hematoma (most common)
• Ecchymosis
• Syncope
• Bleeding
• Nerve Damage
• Arterial puncture
• Dizziness

27
Q

dermal puncture or capillary puncture

A

Skin puncture

28
Q

Skin puncture in infants

A

• Lateral or Medial plantar surface of the heel for infants

NOT ON POSTERIOR CURVATURE

29
Q

Skin puncture

puncture not more than_____ to prevent hospital induced anemia or osteomyelitis

A

2.4mm

30
Q

Skin puncture sites

A

3rd or 4th finger
big toes
heel
last resort is the earlobe

31
Q

Skin puncture for adults is done due to

A

obesity
burns
extremely small veins

32
Q

Capillary puncture

• Blood is a mixture of

A

capillary
venous
arterial blood
interstitial and intracellular fluid

33
Q

Order of Draw for Skin Puncture

A

• Blood Gases
• Slides/Smears
• EDTA Microtainer Tubes (CBC)
• Plasma/Other Tubes
• Serum tubes

34
Q

Complications in Skin puncture

A

• Collapse of vessels
• Osteomyelitis of the heel bone
• Nerve Damage
• Hematoma
• Scarring
• Localized or generalized necrosis

35
Q

Skin/ capillary puncture

SOURCES OF ERROR

A

• Hemolysis
• Failure to dry the site
• Failure to wipe the 1st drop of blood
• Vigorous massaging or milking the area
• Accidental capturing of bubbles
• Picture of the proper site of skin puncture (Turgeon)

36
Q

• Wipe the first drop of blood to avoid…

A

contamination of tissue juices

37
Q

Premature neonates (up to 3kg)

A

Heel

0.85mm

38
Q

Infants under 6 months

A

Heel

2.0mm

39
Q

Child aged 6 months to 8 years

A

Finger 1.5mm

40
Q

Child older than 8 years and adults

A

2.4mm

41
Q

Mainly done for arterial blood gas
- 02, CO2, pH levels in the blood
- arterial blood reflects true oxygen, carbon dioxide, and pH
eve

A

Arterial puncture

42
Q

• Can also be done if venipuncture or capillary puncture is not possible
• the most dangerous type of blood collection

A

Arterial puncture

43
Q

•___ leak, while___ spray (high pressure)
• areas (3)

A

Veins; arteries

Brachial, Radial, Femoral (thigh area)

44
Q
  • Have the patient make a fist and occlude both the ulnar (opposite the thumb site) and radial (close to the thumb site) arteries by compressing with two fingers over each artery
    -> Have the patient open his or her and observe for bleaching of blood
    -Release the pressure on the ulnar artery only and note if blood return is present
A

Modified Allen’s Test

45
Q

Complications in Arterial Puncture

A

• Arteriospasm
• Hematoma
• Nerve Damage
• Vasovagal response -› faint/syncope
• Drop in blood pressure -› due to psychological distress or excessive blood collected
• Sweating and Pallor
• Lack of consciousness

HEMA 1: LAB (10 decks)

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