BSC 1 Flashcards
CONSENT:
1. voluntary permission for medical procedure, test or medication will be given
2. may be given verbally or in writing
3. does not require a verbal expression of consent nor written consent
4. exactly what type of information must be given to inform the clients properly
5. parents or guardian consent is required
6. individual has a constitutional right to refuse a medical procedure such as venipuncture
- INFORMED CONSENT
- EXPRESSED CONSENT
- IMPLIED CONSENT
- HIV CONSENT
- CONSENT FOR MINORS
- REFUSAL OF CONSENT
_______: collection from the capillaries
- any sample that is less than ____mL
- skin puncture aka (3)
- good skin puncture can yield ___ of blood specimen
- can be substitute for ____
- site should be pre-warmed at ___C for ____mins
MICROSAMPLE
- 1mL
- Capillary/ Arteriolar/ Peripheral Puncture
- 0.5mL
- arterial blood gas
- 39-42C for 3-5mins
SKIN PUNCTURE
- only performed in _____
- standard lancet should be ____
- needles
- blades
- two other devices
- point of care testing
- 1.75mm
- Clover’s Hagedorn
- Barb Parker
- Tenderfoot, Tenderlett
SITES FOR SKIN PUNCTURE:
Finger
1. __ & __ of non dominant hand
2. puncture area should be ___ nerve endings
3. dept of puncture should not be deeper than ___
Heel
1. for infants less than ___
2. exact location: ____ or ____ surface of the heel
3. puncture should not be deeper than _____
Earlobe
1. collection is done in this site normally when testing for ______
2. also ideal in _____
3. pre warm the puncture site at __C
Finger
1. 3rd and 4th
2. off center nerve endings
3. 3.1mm
Heel
1. 1yr old
2. Medical/Lateral plantar
3. 2.0mm
Earlobe
1. abnormal histiocytes
2. Arterialized Blood Samples
3. 42C
ERRORS IN SKIN PUNCTURE
Sample Error
1. has __ Hgb, Hct, RBC, Platelet than venous but ___ WBC
Excessive Massage
1. increases tissue fluid component in the sample
2. w/ good puncture, phlebotomist can obtain ____ of blood w/o milking or squeezing
Excessive Crying
1. increases ____ from marginal pool
2. false _____
Sample Error
1. LOWER; HIGHER
Excessive Massage
1. MILKING
2. 0.5ML
Excessive Crying
1. CIRCULATING WBC
2. INCREASE WBC COUNT
SITES TO BE AVOIDED IN SKIN PUNCTURE
- Infant (1)
- Adult (3)
- Infant (1)
- central arc of heel and finger - Adult (3)
- thumb, index, 5th finger
- heavily calloused area
- edematous area
ARTERIAL PUNCTURE
- most common test performed using arterial blood sample
- most preferred site
- last resort site
- Arterial Blood Gas Analysis
- Radial
- Femoral
ARTERIAL PUNCTURE
Radial Artery
1. gauge
2. ____ should be performed
3. angle of needle
4. radial has two arteries:
- puncture site
- producer of oxygen
Brachial Artery
1. gauge
2. angle
Radial Artery
1. 23-25
2. Modified Allen Test
3. 45-60°
4. radial has two arteries:
- RadialArtery
- UlnarArtery
Brachial Artery
1. 18-20
2. 45-60°
ARTERIAL PUNCTURE: notes
- newborns whose umbilical artery can still be drained it can still be used for blood collection
- most appropriate anticoagulant for ABG is
- ____ of heparin per 1mL of blood - should be placed in ice water or coolant after collection to prevent the consumption of oxygen by the WBC
- best alternative if the arterial sites are not available is the
- Scalp artery
- heparin
- 0.05mL - Heparinized blood
- Arterialized Capillary Blood
MACROSAMPLING
- preferred method since it minimize specimen contamination
- discouraged by CLSI due to safety and specimen quality issue; for small, fragile or damage vein
- for hand vein and other difficult draw situation; used with the evacuated tube system or syringe
- EVACUATED TUBE SYSTEM
- SYRINGE/OPEN SYSTEM
- WINGED INFUSION SET (BUTTERFLY)
MATERIAL FOR BLOOD COLLECTION
Needles:
1. considered standard for routine venipuncture
2. for children and butterfly winged infusion set
3. for collection of blood form the scalp, or other small vein
3. for blood donation
4. length for G21-23
5. length for butterfly
ETS
1. color coded to identify the type of additives or the absence of additive or special tube property
2. can be in a form of anticoagulant, procoagulant, antiglycolytic agent and polyanethol sulfonate
3. with premeasured vacuum that draws the indicated volume of blood
Needles:
1. gauge 21
2. gauge 21-23
3. gauge 25
3. gauge 16
4. 1 or 1.45inch
5. 1/2 or 3/4 inch
ETS
1. Tube stopper
2. Additives
3. Evacuated Tube
MATERIAL FOR BLOOD COLLECTION
SOLUTION FOR SKIN ANTISEPSIS
- routine collection alcohol
- test for legal blood alcohol level uses (2)
- infants or adults with sensitivity to iodine or alcohol should be given
- 70% isopropyl alcohol
- Benzalkonium Chloride/ Zephiran
- chlorhexidine gluconate
SITES FOR BLOOD COLLECTION
-
-
NEW BORN UP TO 18 MONTHS
- TEMPORAL VEIN
- EXTERNAL JUGULAR VEIN
18 MONTHS FOR 3 YEARS OF AGE
- FEMORAL VEIN
- POPLITEAL VEIN
- two nerves that may be hit if tries to hit basilic vein:
- bleeding might not stop
- will cause an intense pain to the patient - more rubbery in consistency
- also rubbery but it is harder as compared to the vein and it has a pulse or it pulsate
- not rubbery
1.
- Brachial artery
- Median nerve
2. Vein
3. Artery
4. Nerve
H Pattern vs M Pattern:
- there’s vein that dissects or separate the three major veins
- cephalic and basilic will merge
- median vein is from cephalic and basilic
- median vein is just like median cubical vein
- H Pattern
- M Pattern
- M Pattern
- H Pattern
