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medical terminology > Chapter 4: Phlebotomy Equipment & Supplies > Flashcards

Chapter 4: Phlebotomy Equipment & Supplies Flashcards

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USMLE® Step 1 flashcards
1
Q

Venipuncture

Multisample Needle Method

A

Needle (with or without safety lock)

Tube holder 
Tube 
Alcohol Pad
Cotton 
Gauze 
Bandage 
Sharps Container 
Gloves 
Tourniquet
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2
Q

Venipuncture

Winged Infusion Needle Method

A

Butterfly needle

Tube holder
Tube
Alcohol Pad
Cotton
Gauze
Bandage
Sharps Container
Gloves
Tourniquet
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3
Q

Venipuncture

Syringe Method

A

Syringe & needle
Transfer device

Tube
Alcohol Pad
Cotton
Gauze
Bandage
Sharps Container
Gloves
Tourniquet
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4
Q

Glucose Testing (Same equipment for Capillary puncture)

A 
Lancet
Glucose Test Strip 
Glucose Analyzer Machine
Gloves
Alcohol Pad
Cotton 
Gauze or Bandage
Sharp Container
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5
Q

Capillary Test

A

Capillary Tube
Lancet
Hematocrit Centrifuge
Clay sealant

Alcohol Pad 
Cotton 
Gauze or Bandage 
Sharps Container 
Gloves
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6
Q

BLEEDING TIME SET (Same equipment for Capillary puncture except..)

A

Lancet
Blood Pressure Set
Timer
Filter Paper

Alcohol Pad 
Cotton 
Gauze or Bandage 
Sharps container 
Gloves
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7
Q

Sterile Gloves / Non-Sterile

A

Used for sterile procedures like surgeries

Used for phlebotomy

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8
Q

Tourniquet

A

Elastic band
Standard size to suit the size of the patient’s arm
Non-Latex Material

Function: To Create pressure and make the vein prominent or visible for venipuncture.

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9
Q
  1. Antecubital region
A

Tourniquet is applied 3-4 INCHES above the site of the puncture

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10
Q
  1. Appropriate pressure must be created while the tourniquet is in place.
A

Tourniquet should not be too tight on the patient’s arm – may STOP the flow of BLOOD to the arm.

Tourniquet should not be too loose on the patient’s arm – may NOT create ENOUGH PRESSURE required for the vein to become PROMINENT. (noticeable)

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11
Q
  1. Tourniquet recommended duration ?
A

Once placed on the patients arm must be removed within 60 seconds or 1 minute.

SHOULD NOT stay in place for more than 60 seconds or 1 minute.

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12
Q
  1. Proper application and removal technique
A

Not cause discomfort to the patients by either the application of the tourniquet being too tight or the tourniquet rolling up and PINCHING the skin.

Removal: properly untying (GENTLY PULL to release) ONE END of the tourniquet.

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13
Q
  1. Disposal of the tourniquet
A

Disposed into appropriate container after use. It must not be reused onto another patient to avoid cross infection.

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14
Q

Alcohol Pads

A

70% ISOPROPYL alcohol pads
used to clean and disinfect the site of the puncture

If SKIN IRRITATION occurs DISCONTINUE use on the patient

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15
Q

When using alcohol prep pads:

A
  1. Cleaning and disinfecting the alcohol site – CONCENTRIC CIRCLES moving from inside to outside or as recommended by the facility.
  2. Post application surface of the skin – let the skin air dry before performing the procedure.
  3. Check the expiration date of the product.
  4. Prior to opening the packet ensure that:
    a. the package is not damaged or the seal is not opened
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16
Q

ALTERNATIVE ANTISEPTICS used are..

A
  1. Chlorhexidine gluconate applicator, pad or swab
  2. Iodine applicator, pad or swab
  3. Benzalkonium chloride solution, pad or swab stick
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17
Q

Reason applying a bandage on a puncture site is to…

A
  1. Protect the area from direct exposure

2. Assist in wound healing process

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18
Q

NEEDLES

A

Function : Puncture the skin and enter the vein

Available in different…

Gauges & Lengths - Diameter of the needle
Lumen - used for venipuncture

Gauge needle Smaller – Lumen needle Larger
Lower the number (Gauge), Larger the Lumen (diameter)

Gauge needle Larger – Lumen needle Smaller
Higher the number (Gauge), Smaller the Lumen (diameter)

19
Q

A point

A

puncture the skin , first part of the needle that comes in contact with the skin of the puncture site

20
Q

Bevel

A

opening of the needle through which blood passes through

Bevel of the needle should face up before inserting the needle for drawing blood

21
Q

Lumen

A

the inside space of the tubular structure needle

22
Q

Shaft

A

Needle length – range from 1 inch to 1 1/2 inches

23
Q

Hub

A

end part of the needle

24
Q

NEEDLE GAUGE - Selection of the proper gauge needle depends on factors such as…

A

Vein , Size , Amount of blood to be collected and Age of the patient.

Children may have small veins as compared to adults

Small gauge needle that has a LARGER LUMEN – is used to perform the procedure on a
SMALLER VEIN, the blood sample collected may become CLOTTED.

Large gauge needle that has a SMALLER LUMEN – is used to perform the procedure on a
LARGE VEIN, the blood sample collected may become HEMOLYZED. (destruction of blood cells, specifically red blood cells.)

25
Q

Angle – Needle is inserted for Blood Draws:

Superficial Vein

A

15 degree

26
Q

Deeper Vein

A

30 degree

27
Q

Gauge Of Needle :

A

a. Smaller the gauge, larger the needle lumen

b. Larger the gauge, smaller the needle lumen

28
Q

GAUGE SIZE:

Largest Needle Size

A

18 Gauge

used for tongue piercing

29
Q

Most common use (phlebotomy)

A

20 - 21 Gauge

30
Q

Small Needle Size

A

22 Gauge

31
Q

Winged infusion needle is also known as a Butterfly needle

A

23 - 25 Gauge

25 gauge used in pediatrics and elderly

32
Q

TUBE INVERSION TECHNIQUE

Reason for inverting the tube several times is to..?

A

Appropriately MIX the blood and the ADDITIVE

Inversions for color tube for e.g. 5-8 TIMES

33
Q

What should be ensure when performing the inversion technique?

A

Ensure that the inversion is not forceful, since doing so may cause the blood sample to undergo HEMOLYSIS.

(The destruction of red blood cells which leads to the release of hemoglobin from within the red blood cells into the blood plasma.)

34
Q

If the inversion is NOT properly performed what happens to the blood?

(mixed well)

A

If the inversions are not properly performed, the blood sample may CLOT.

35
Q

BLOOD SPECIMENS IN PHLEBOTOMY

A

WHOLE BLOOD specimen (blood collection tube)

If a PLASMA specimen or SERUM specimen is required, following steps must be performed.

36
Q

PLASMA SPECIMEN STEPS:

(separate plasma) 15 minutes

A
  1. Collect the whole blood into the SPECIFIED COLOR Collection Tube
  2. Next, Centrifuge tube 15 minutes
  3. After the Centrifuging process, remove tube from centrifuge machine. Tube will have a TOP YELLOW LAYER of fluid. (PLASMA) Use a pipette transfer the plasma from the tube to a vial.
37
Q

SERUM SPECIMEN STEPS:

(separate serum) sit for 30-45 minutes – centrifuge 15 minutes

A
  1. Collect the whole blood into the SPECIFIED COLOR Collection Tube
  2. Let the collection tube sit for 30-45 minutes
  3. Next, centrifuge the tube 15 minutes
  4. After the centrifuging process, remove the tube from the centrifuge machine. The tube will have a TOP YELLOW LAYER of fluid. (SERUM) Use a pipette transfer the serum from the tube to a vial.
38
Q

TUBE ADDITIVES PURPOSE:

A
  1. Inhibit (STOPPING) the process of COAGULATION of blood after collection
  2. Initiate (START or ACTIVATE) the process of COAGULATION
    - The process through which blood changes from a liquid and becomes thicker, like a gel. Coagulation is part of a larger process called HEMOSTAISIS, which is the way that the body makes bleeding stop when it needs to.
  3. SEPARATING the BLOOD LAYERS after spinning the tube in the CENTRIFUGE
39
Q

COAGULATION (clotting)

A

A process that causes the blood to change its form from liquid to semisolid or gel-like substance also known as a CLOT.

40
Q

TYPES OF ADDITIVES :

ANTICOAGULANT

A

Inhibiting coagulation

Letting the blood collected in the blood collection tube STAY in the liquid form

Types:
> EDTA (Ethylene-diamine-tetra-acetic-acid)
> Sodium Citrate 
> Potassium Oxalate 
> SPS (Sodium Polyanethole Sulfonate) 
> Heparin 
> Sodium Fluoride
> Lithium Idoacetate
41
Q

CLOT ACTIVATORS

A

Added to the tube to activate the clotting mechanism

Enhance the process of clotting or coagulation. (For e.g Silica)

42
Q

THIXOTROPIC GEL

A

GEL added to the tube to SEPARATE THE LAYERS of blood.

Blood collected in tubes are spun (centrifuge) leads to the gel separating the layers of the blood.

43
Q

Capillary Tube Blood Collection

A

Lancet
Capillary Tube
Hematocrit centrifuge
Clay sealant

Alcohol Pad
Cotton
Gauze or Bandages 
Sharp container 
Gloves
44
Q

Neonatal Screening

(newborn screening (infants)
The volume of blood collected is lower than that of the volume of blood collected on a venipuncture.

A 
Gloves 
Lancet 
Alcohol Pads
Gauze Pads
Sharps Container 
Bandages

Newborn Screening Cards
Storage bag
Other equipment & supplies may be required

Warming device- 3 to 5 minutes
increase the flow of blood in the area (heel)
Width (not exceed) 2.4 mm
Depth (not exceed) 2.0 mm infants heel

New born 12 months - Medial or lateral side of the heel
More than 12 months to Adult- Middle or ring finger, (avoid an incision on the bone)

medical terminology (6 decks)

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