MLS LECTURE 5 Flashcards
What are the things that can be known from a blood test?
- Glucose rate
- Alcohol
- Drugs
- Genetic testing
- Infections
Lab test information provided can include:
- Lab where a test is performed
- Availability
- TAT
- Special instructions
- Specimen type
- Volume of specimen
- Minimum volume needed
- Collection container
- Collection type
- Transport instruction
- Storage instructions
- cause of rejection
-normal value-reference range - Critical value
- Test limitation
How important are we as lab workers?
we play an important role in the process of collection since we give about 80% of the information needed to diagnose and treat a patient
True or False: Accurate patient identification could give you the perfect time to do a test as a lab worker.
True; accurate patient identification = timely results
quality lab sample = quality test results
What would happen if you rejected a blood sample (patient safety and experience)?
1- Delay in results
2- Delay in treatments
3- Delay in discharge
4- Dissatisfaction
Why would a patient be dissatisfied if the blood samples are rejected?
because there will be additional needle sticks and blood loss, which could be discomforting, affect the patient negatively, and is time-consuming
What would happen if you rejected a blood sample (lab and clinical staff)?
1- Extra work
2- additional cost, time, and supplies
3- Delay in processing other tests, which might increase STATS
Give the reasons for rejecting blood samples:
1- Hemolyzed samples
2- QNS (Quantity not sufficient)
3- Wrong collection tube
4- Improper paperwork (mainly labelling the samples)
What is the meaning of hemolysis?
the breaking open of red blood cells
When can hemolysis occur?
- when specimens are mishandled because the membrane is fragile and easily damaged
- when the red cell membrane breaks other cellular components (enzymes, electrolytes are released, etc.)
What causes hemolysis?
1- using force to transfer blood through a needle using a syringe into tubes
2- mixing the sample in a not very gentle way after collection
3- puncturing the vein before the alcohol dries which might get the alcohol mixed with the sample
4- Really old specimens
QNS means:
quantity not sufficient; not enough blood in tube required for testing
True or False: You should never under-fill a tube but it is fine to over-fill it just in case you needed extra samples.
False; you should never over or under-fill a tube
What would happen if a tube contains additives and it is underfilled?
It can have a high concentration of additives, giving inaccurate results (erroneous)
True or False: different tube = different additive.
True
How many blood collection tubes are there?
Over 9
What would happen if a shuffle in the order of collection tubes happened?
cross-contamination may occur
give the order of draw (tubes)
1- Black (culture)
2- Blue (sodium citrate / no citrate)
3- Gold (serum (SST))
4- Red (serum)
5- Green (Heparin)
6- Tan/Pink/Lav (EDTA)
7- Grey (Na Flouride/glycolytic inhibitor)
What is the most important step in specimen collection?
Patient identification
How many identifiers are usually used for each patient?
2 unique identifiers
True or False: The number of the hospital room can be used as an identifier.
False; this should never be used as an identifier.
True or False: The number of the hospital room can be used as an identifier.
False; this should never be used as an identifier.
What is the first choice of venipuncture site collection?
Median Cubital vein
Why is the median cubital vein picked first?
- least painful
- anchors really well
- large
- least likely to bruise
The second choice after the median cubital vein is:
Cephalic vein
Reasons for picking the cephalic vein after the median cubital vein
-more painful than the median cubital vein
-not as well anchored as the median cubital vein
When are the hand or wrist veins picked?
you cant find both the median cubital vein and the cephalic vein
the hand or wrist veins are known to have:
narrow diameter and needs small gauge needles and small volume evacuation tubes
For safe puncturing:
1- avoid hitting a nerve
2- avoid puncturing the arteries
3- avoid excessive or blind needle probing
How do you control the infection?,
Wash your hands with soap and water
Or
Use a waterless sanitizer
Put your gloves on both hands
How do you clean the venipuncture site?
- Use an antiseptic to clean the venipuncture site
- never forget to start at the center the move outward to prevent re-introducing dirt & bacteria
- never apply or use over-pressure
- before venipuncturing let the site dry and don’t wipe or fan the site
Why should you never wipe or fan the site for it to dry faster?
To prevent introducing or reintroducing contaminants
What would happen if you used the wrong needle gauge?
You will increase the chances of hemolysis
State the steps of the proper insertion of the needle.
Step 1: hold the patient’s arm (thumb on top and the rest of the fingers below )
Step 2: pull the skin below the intended venipunctured site with your thumb
Step 3: smoothly and quickly insert the needle (the bevel must be up)
* if the resistance decreased = you must stop since that indicates entry into the vein
How are the samples mixed?
They are inverted (mostly 180 degrees and back) for 5-10 time (mostly around 8)
What cat happen if the specimen is not mixed properly?
Blood clot & will need to be redrawn
Hemolysis
What could happen if you removed the gauze too soon?
You may disturb the clot and bleeding may restart
State the common causes of needle stick injuries.
1) safety device is not activated
2) improper disposal
3) hand-off of needle device is often used
4) manipulating needle in the patient
5) patient moving throughout the process
How do you avoid possible needle stick injuries?
1) plan the disposal of needle before you start the procedure
2) do one thing at a time
3) always activate safety device
4) work in good lighting
5) explain the procedure to the patient
6) immediately dispose needles after the procedure
State 2 other ways to draw blood
1) finger stick
2) heel stick
