BLOOD SPECIMEN HANDLING AND PROCESSING Flashcards
Pre-examination Errors that occur prior to testing comprises ____% of all errors encountered for laboratory samples
46-56
occur before the analytical portion of the testing occurs
Pre- analytical errors
The most crucial and potentially most dangerous pre-examination error.
PATIENT IDENTIFICATION
TOURNIQUET APPLICATION
No longer than __ minute
1 minute
Tourniquet applied longer than 1 minute it will result to _______ and it will lead to destruction of RBC’s
hemoconcentration
Tourniquet: _____ inches above the puncture site.
3-4
Tourniquet: Increase the _______ blood pressure
intravascular
reduction of fluid volume
Hemoconcentration
inability to circulate lowers the pH and causes potassium to be forced out of blood cells.
Hemoconcentration
Vigorous exercise INCREASES in
CK
AST
LDH
Bilirubin
creatinine
uric acid.
- Increase in moderate exercise due to the increased metabolic activity of skeletal muscle
Lactate and Pyruvate
NPO
Non Per Orem”
Non Per Orem - Fasting
“No food and water intake”
- Fasting time
8-12 hours no food
FBS
8 hrs
Lipid profile
12 hrs
FBS and lipid profile
12 hrs
triglycerides
12 hrs
Drawn at time intervals because of medication or biological rhythms.
TIMED SAMPLES
Diurnal effect: serum iron,
corticosteroids, and other hormones (____hours apart collection)
12
There are certain analytes nga increase sa morning decrease sa evening example is
cortisol
Common diurnal, cortisol test: drawn on patient at 8 am first extraction and the ___ pm second extraction
4
EVACUATED TUBES
Incorrect volume of blood
• Less blood dilutional effect-RBCs ________ in size and
decreased
Too much blood clot
T or F| Partially filled tubes cannot be poured together
T
Povidone-Iodine (Betadine): for ______________ ONLY
blood culture collection
Betadine increases
potassium
phosphorus
uric acid
prevents the anticoagulant form one tube from contaminating the next tube
Collect order
Common tests requiring chilling of specimens:
Ammonia
Acid Phosphatase
Catecholamines
Lactic Acid
pH/blood gasses
Maintained at 37 degrees Celsius:
Cold agglutinins
Cryoglobulin
Cold agglutinins, Cryoglobulin and maintained at
37 celcius
WARMING SAMPLES Maintained at body temperature
Wrap the sample in a ______ or _____
heel warmer or warmer block
- These analytes once expose sa light mag break down he result would be erroneous
Bilirubin
Vitamin C, E, and K
Tube used to prevent exposure to light
Amber Tube
Most efficient method to protect the sample from light
Wrap in aluminum foil or carbon paper
Labels must have the patient’s
complete name and
hospital number or unique identifier
Urine samples must have the label on the ______ and NOT on the ____.
container / lid
Anticoagulated blood collection tubes must be at least ____ percent full.
75
All coagulation tubes must be at least ___ percent full.
90
Delays in centrifuging or processing a sample must be
free of clots
Blood samples drawn above an _______________ are unacceptable.
intravenous (IV) injection site
The sample must be _________ if the results are not consistent with previous results on the patient.
re-collected
IATA
International Air Transport Association
DGR
Dangerous Goods Regulations
Infectious substance which, when exposure to it occurs, is capable of causing permanent disability, lifethreatening or fatal disease in otherwise healthy humans or animals.
BIOLOGIC SUBSTANCE, Category A.
An infectious substance that does not meet the criteria for inclusion in Category A.
BIOLOGIC SUBSTANCE, Category B.
_______ of the sample must be maintained during shipment
Integrity
Extreme variation in _________ must be avoided
temperature
All _____ and _____ must be separated from the cells before transporting
serum and plasma
WHOLE BLOOD
Maintain the specimen at _____
room temperature.
Do not place whole blood specimens in direct contact with
cool/ice.
Do not centrifuge if the sample requirement is
whole blood.
WHOLE BLOOD: STORAGE
Ref temp - 48 hrs
WHOLE BLOOD TESTS
CBC
Reticulocyte Count
ESR
PLASMA/SERUM
Allow the sample to clot in an upright position within ________.
15-30 mins
What must be done before centrifuging for plasma/ serum
Let it clot in an upright position for 15-30mins
Why must sample for plasma/ serum be allowed to clot first before centrifuging?
It would be prone to hemolysis if it hasn’t clotted
Samples for plasma/ serum must be centrifuged for about _____ at _____ RPM
15 mins at 2200-2500 RPM
Plasma/ serum is separated using a
Pipette
PLASMA/ SERUM SOTRAGE
Ref temp - 48hrs
Frozen temp - 1yr
PLASMA/ SERUM
TESTS
Crosshatching
Coagulation Test
Chemistry Test
Serology Test
Ref temp
2-6 degree celcius
Freezing temp
Below -20 degree celsius
Room temp
20-25 degree celsius