[Lec] Blood Collection Equipment, Additives, and Order of Draw Flashcards
Blood is collected by several methods (3)
ACV
- Arterial puncture
- Capillary puncture
- Venipuncture
General Blood Collection Equipment and Supplies
- Blood-drawing station
- Phlebotomy Chairs
- Equipment Carriers
- Phlebotomy Carts
- Gloves and Glove Liners
- Antiseptics
- Disinfectants
- Hand Sanitizers
- Gauze Pads
- Bandages
- Needle and Sharps Disposal Containers
- Biohazard Bags
- Slides
- Pen
-Watch - Patient Identification Equipment
Is a dedicated area of a medical lab or clinic equipped for performing phlebotomy procedures on patients, primarily outpatients sent by their physicians for lab testing
Blood-drawing station
Patients who have their blood drawn while in a seated position must be seated in here. Or at a minimum, a comfortable chair with arm rests to provide support for the arm and prevent falls
Phlebotomy Chairs
2 Styles of Phlebotomy chairs
A: Chair w/ adjustable arms and hydraulic height adjustment
B: Reclinable chair
Come in a variety of styles and sizes designed to be easily carried by the phlebotomist and to contain enough equipment for numerous blood draws. Convenient for STAT or emergency, situations or when relatively few patients need blood work
Handheld Carriers
A new pair must be used for each patient and removed when the procedure is completed. Nonsterile, disposable nitrile, neoprene, polyethylene, and vinyl examination ____ are acceptable for most phlebotomy procedures. A good fit is essential
Gloves and Glove Liners
Are typically made of stainless steel or strong synthetic material. They have swivel wheels, w/c glide the carts smoothly and quietly down hospital hallways in and out of elevators
Phlebotomy Carts
Types of gloves that are acceptable for most phleb procedures (5)
NsDNeoPVex
- Nonsterile
- Disposable nitrile
- Neoprene
- Polyethylene
- Vinyl examination
Used to prevent sepsis, which is the presence of microorganisms or their toxic products within the bloodstream.
Antiseptics
Most commonly used antiseptic for routine blood collection
70% isopropyl alcohol (isopropanol)
Examples of Antiseptics Used in Blood Collection (7)
- 70% ethyl alcohol
- 70% isopropanol
- Benzalkonium chloride (eg Zephiran chloride)
- Chlorhexidine gluconate
- Hydrogen peroxide
- Povidone-iodine (0.1%-1% available iodine)
- Tincture of iodine
Substances or solutions regulated by the Environmental Protection Agency (EPA) that are used to remove or kill microorganisms on surfaces and instruments
Disinfectants
Disinfectants examples
- EPA-registered sodium hypochlorite or chemical germicide products
- 5.25% sodium hypochlorite (household bleach)
Disinfectant dilution (2)
- 1:100 dilution - small spills
- 1:10 dilution - large spills
Alcohol-based _______ for routine decontamination of hands as a substitute for handwashing provided that the hands are not visibly soiled
Hand Sanitizers
Used needles, lancets, and other sharp objects must be disposed of immediately in special containers referred to as ____. All must be clearly marked w/ a biohazard symbol and be rigid, puncture resistant, leakproof, disposable, and have locking lids to seal the contents when filled to the appropriate volume
Needle and Sharps Disposal Containers
Are leakproof plastic bags that are commonly used to transport blood and other specimens from the collection site to the lab. They are marked w/ a biohazard label and often have an outside pocket in w/c requisitions or other forms can be placed
Biohazard bags
Many healthcare facilities use barcode tech to identify patients. The barcode is on the ID band and phlebotomists carry barcode readers to identify patients and generate labels for the specimen tubes
Patient Identification Equipment
Venipuncture Equipment (3)
VTN
- Vein-Locating Devices
- Tourniquet
- Needles
Are optional and tend to be expensive, there are portable devices on the market that use transillumination to make it easier to locate veins that are difficult to see or feel. The hemoglobin in the blood in the veins absorbs the light, causing the veins to stand out as dark lines
Vein-Locating Devices
A device that is applied or tied around the arm prior to venipuncture to compress the veins and restrict blood flow. Restriction of venous flow distends or inflates the veins, making them larger and easier to find stretches the vein walls so they are thinner and easier to pierce with a needle
Tourniquet
____ _____ is indicated by a no. that is related to the diameter of the lumen. A ____ diameter and gauge have an inverse relationship; that is, the higher the gauge no., the smaller the diameter of the needle
Needle/Needle gauge
Traditional style needles is composed of:
Yellow 20-gauge, green 21-gauge, and black 22-gauge
BD Eclipse safety needles is composed of:
Black 22-gauge, green 21-gauge
A closed system in w/c the patient’s blood flows through a needle inserted into a vein directly into a collection tube w/o exposure to air or outside contaminants. System allows numerous tubes to be collected w/ a single venipuncture
Evacuated Tube System
3 Basic Components of Evacuated Tube System
- Special blood-drawing needle
- Tube holder
- Evacuated tubes
ETS needles are called _____ because they allow multiple tubes of blood to be collected during a single venipuncture
Multisample Needles
Is a clear, plastic, disposable cylinder w/ a small threaded opening at one end (often also called a hub) where the needle is screwed in it and a large opening at the other end where the collection tube is placed
Tube Holders
Used with both the ETS and the syringe method of obtaining blood specimens. Tube selection is based on the age of the patient, the amount of blood needed for the test and the size and condition of the patient’s vein
Evacuated Tubes
Manufacturers guarantee reliability of additives and tube vacuum until an expiration date that is printed on the label provided the tubes are handled properly and stored between 4 degrees and 25 degrees C
Expiration Dates
Used for patients w/ small or difficult veins. This system consists of a sterile syringe needle called a hypodermic needle and a sterile plastic syringe with a Luer-lock tip
Syringe System
Substances that prevent blood from clotting (coagulating) by either of 2 methods
Anticoagulants
Anticoagulants 2 processes:
- By binding (chelating), or precipitating calcium so it is unavailable to the coagulation process
- By inhibiting the formation of thrombin needed to convert fibrinogen to fibrin in the coagulation process
EDTA. Remove calcium from the body by binding it to form an insoluble salt. This makes calcium ions unavailable for the coagulation process so the blood tube is prevented from clotting
Ethylenediaminetetraacetic acid
Prevent coagulation by binding (or chelating) calcium.
Citrate
Most common citrate
Sodium Citrate
Citrates are used for coagulation tests (2):
- Prothrombin Time (PT)
- Partial Thromboplastin Time (PTT)
Prevents clotting by inhibiting thrombin (an enzyme needed to convert fibrinogen to fibrin necessary for clot formation) and factor X. Must be mixed immediately upon collection to prevent clotting and fibrin generation
Heparin
Remove calcium and prevent clotting by binding and precipitating calcium in the form of an insoluble salt. Commonly added to tubes containing glucose preservatives to provide plasma for glucose testing
Oxalate
Most widely used oxalate
Potassium oxalate
Special-Use Anticoagulants (3)
- Acid Citrate Dextrose (ACD)
- Citrate Phosphate Dextrose (CPD)
- Sodium Polyanethol Sulfonate
A substance that prevents glycolysis, the breakdown or metabolism of glucose (blood sugar) by blood cells
Antiglycolytic Agents
Most common antiglycolytic agent. And is commonly used in combination with the anticoagulant potassium oxalate or EDTA to provide a plasma specimen
Sodium fluoride
A substance that enhances coagulation in tubes used to collect serum specimens. Silica particles are the clot activators in serum-separator tubes (SSTs) and plastic red-top tubes
Clot Activators
Normally clots w/in 5 mins
Rapid Serum Tube (RST)
Refers to the order in w/c tubes are collected during a multiple-tube ETS draw, or filled w/ blood from a syringe. To prevent contamination of blood specimens by carryover of additives that can interfere w/ some tests
Order of Draw
