Lesson 1 Flashcards
Venipuncture
Sample for any hematologic test
blood
methods of blood collection
venipuncture (ETS & syringe), skin puncture
The collection of blood from the capillaries or arterioles
Skin puncture
Areas for skin puncture
plantar surfaces of middle finger/ forefinger, heel, big toe, earlobe
Collected sample is known as
capillary, arteriolar, peripheral blood
Puncturing devices
lancets
Gowers and Hagedorn needles
Bard Parker Blade no. 11
glass capillary pricker
pin & cork pricker
Kinds of lancets
Stern
Hemolet
BB
Redi-lance
Sera Sharp
What is less painful due to the lesser nerve endings compared to the fingers, toe and heel?
Earlobe puncture
What area would have less tissue juice contamination?
Earlobe
Why is there less tissue juice in the earlobe?
Due to less muscles and more free flow of blood due to the thin skin and more histocytes (macrophages in tissues) may be present
Which are are less intimidating, easier and more accessible compared to the earlobe puncture?
Finger, heel and toe
What are the sites to be avoided that may cause erroneous results or false negative results?
Edematous & congested areas
Inflamed & pallor areas
Extremities with intravenous line
What areas must be avoided due to the difficulty of collection by the phlebotomist?
Heavily calloused, scarred and burned areas
What is the ideal depth of skin puncture ranges in order to reach the capillary beds of the dermis?
2.5 to 3 millimeters
What may be used to enhance blood flow ?
Gentle massage or a warm towel
What must be avoided in order to avoid clotting?
Too much pressure or squeezing
Why is the first drop discarded?
In order to eliminate tissue juices which may cause false negative results and to remove extraneous materials from the sites of collection
What does not require such step of discarding the first drop?
Platelet Count
What is the skin puncture sample used for?
CBC, fasting or random plasma glucose tests
What is included in a Manual CBC?
Hematocrit
Hemoglobin
RBC count
WBC count
Differential count
What is included Automated CBC?
Hematocrit
Hemoglobin
RBC count
WBC count
Differential count
Platelet count
RBC indices
Hematocrit may be determined by?
Micromethod or Macromethod
Micromethod is:
Requires capillary tube, centrifuge and microhematocrit reader
Macromethod is:
Requires Wintrobe tube and centrifuge
Required rpm in micromethod:
10,000-13,000 for 5 minutes
Required rpm for macromethod:
2,500-3.000 for 10-15 minutes
What are used for hemoglobin determination?
Sahli-Hellige tube
hemometer
spectrophotometer
What is used for RBC, WBC and platelets counts?
Thoma pipets
What are used for the differential count of stained blood smear?
Glass slide and spreader
The collection of blood from the veins
Venipuncture
What is the obtained specimen from venipuncture?
Venous blood
Color of venous blood compared to arterial blood
Darker
“primum non nocere”
the first thing is not to inflict damage
What is an ideal phlebotomist?
Focus on the patient
Manage thoughts and listens for feelings
The three possible complications of venipuncture
Local immediate
Local delayed
General delayed
Local immediate complications
Not hitting the vein
Collapsed vein
Hitting through and through
Local delayed complications
Syncope or fainting
Thrombosis
Thrombophlebitis
General delayed complications
Latex allergies
Nausea
Diabetic shock
Convulsions or cardiac arrest
Anemia
Continued bleeding or hemorrhage
It is the bluish discoloration of the skin which is caused by the physical trauma of the veins
Hematoma
How do you aid hematoma?
Gentle massage to the site or use of hot compress
What is the false increase of blood cells which can be caused by prolonged application of tourniquet or too much pressing of the fingers, toes, heel or earlobe during skin puncture?
Hemoconcentration
Syncope or fainting is caused by:
Lack of oxygen in the brain
What do you call the blood clot in the site cause by physical trauma?
Thrombosis
What do you call the inflammation of the vein caused by physical trauma?
Thrombophlebitis
What general delayed complication that require cold compress to be placed in the forehead of the patient?
Nausea
What may occur due to hypoglycemia?
Diabetic shock
What may be given to those who are hypoglycemic?
Juice, candy or any sweet food
What to do when convulsions or cardiac arrest happen?
Must inform attending physician immediately and cardiopulmonary resucitation must be done
What is a low blood cell count that may occur after frequent collections are done?
Attending physician, consultant or hematologist must be informed immediately
Continued bleeding or hemorrhage of the site can be caused by:
Anticoagulant therapy of the patient or clotting factor deficiency
What to do when there is continued bleeding or hemorrhage?
Apply pressure on the site using gauze or non-latex elastic wrap for 5-15 minutes.
- attending physician, consultant or hematologist must be immediately informed
What are the materials used when performing venipuncture via ETS?
ETS adapter
Multi-sampler needle
Evacuated tube
Alcohol pads
Gauze/cotton
Micropore
What are the materials used when performing venipuncture via syringe?
Syringe
Evacuated tube
Alcohol pads
Gauze/cotton
Micropore
Approach, Greet & Identify Patient
Step 2
Test Requisition
Step 1
Explain procedure & obtain consent
Step 3
Verify collection requirements & identify sensitivities and potential problems
Step 4
Sanitize hands and put on gloves
Step 5
Position patient, apply tourniquet & ask patient to make a fist
Step 6
Select vein
Step 7
Clean & airdry the site
Step 8
Prepare collection equipment
Step 9
Reapply tourniquet & uncap and inspect needle
Step 10
Ask patient to make a fist, anchor and insert needle
Step 11
Establish blood flow, release tourniquet & ask patient to open fist
Step 12
Fill, remove, mix tubes in order of draw & fill syringe
Step 13
Withdrawal of needle, place gauze & activate needle
Step 14
Discard needle, attach transfer device, transfer blood and discard syringe & transfer device unit
Step 15
Label tube in the presence of the patient
Step 16
Check and apply bandage
Step 17
Dispose materials & reposition moved items
Step 18
Thank patient, remove gloves & sanitize hands
Step 19
Transport specimen to the lab promptly
Step 20
