Mod 4 Flashcards
presence of microorganisms or their toxic products with the bloodstream
sepsis
Prevent or inhibit the growth and development of microorganisms but do not necessarily kill them
Antiseptics
Consideredsafetouseonhuman skin and are used to clean the site prior to blood collection
Antiseptics
Antiseptics Used in Blood Collection
› 70% ethyl alcohol
› 70% isopropyl alcohol (isopropanol)
› Benzalkonium chloride (e.g. Zephiran
chloride)
› Chlorhexidine gluconate
› Hydrogen peroxide
› Povidone-iodine (0.1%-1% available
iodine)
› Tincture of iodine
most commonly used antiseptic in routine blood collection
70% isopropyl alcohol (isopropanol)
has higher degree of antisepsis; used for blood culture collection,
blood gas collection
Povidone-iodine
Chemical substances or solutions that are used to remove or kill microorganisms on surfaces and instruments
Disinfectants
Typically corrosive and are not safe to use on human skin
Disinfectants
for decontaminating nonporous surfaces after
cleaning up blood or other body fluid spills in patient-care settings
1:100 dilution of sodium hypochlorite
For spills involving large amounts of blood or other
body fluids or those that occur in the laboratory prior to cleanup
1:10 dilution of sodium hypochlorite
If hands are heavily contaminated with organic material and hand-washing facilities are not available, it is recommended that hands be cleaned with
detergent-containing wipes followed by the use of an alcohol-based hand cleanser
It is a device that is applied or tied around a patient’s arm prior to venipuncture to restrict blood flow
TOURNIQUET
sterile, disposable, and designed for a single use only.
Phlebotomy needles
• Comes in wide range of
needle lengths and
gauges
• Does not require special
training
• Can be used for blood
drawing in pediatric
population
• For patient with small or
difficult veins, blood drawing can be easier than an evacuated tube system
• If heparinized, can be used for arterial blood drawing
Hypodermic single-use needle and syringe
• Safer than using hypodermic needle and syringe
• Eliminates blood transfer
• Allows numerous blood samples to be collected through single venipuncture
Vacuum-tube systems
Multisample needles
• Good for blood drawing • from pediatric population or patient with small or difficult veins
• Allows better precision • than hypodermic needle or evacuated tube needle
Winged steel needles (butterfly)
Retractable; prevent needle-stick injuries
Lancet
indicated by a number that is related to the diameter of the
lumen.
Needle gauge
needle’s diameter and gauge relationship
the higher the gauge number, the smaller the actual diameter of the needle
Collection of donor units, autologous blood donation, and therapeutic phlebotomy
15-17
Special needle attached to collection bag
Used primarily as a transfer needle rather than for blood collection; safety issues have diminished use
18
Hypodermic
Sometimes used when large-volume tubes are
collected or large-volume syringes are used on patients with normal-size veins
20
Multisample
Hypodermic
Considered the standard venipuncture needle for routine venipuncture on patients with normal veins or for syringe blood culture collection
21
Multisample
Hypodermic
Used on older children and adult patients with small veins or for syringe draws on difficult veins
22
Multisample
Hypodermic
Used on the veins of infants and on difficult or hand veins of adults
23
Butterfly
20-gauge color
Yellow
21 gauge color
Green
22 gauge color
Black
Length of most multisample needles come in
1-or 1.5-inch lengths
come in many lengths, however, 1- and 1.5-inch ones are most commonly used for venipuncture
Syringe needles
typically1⁄2 to 3⁄4 inch long
Butterfly needles
most common and efficient system and that preferred by the CLSI for collecting blood samples
evacuated tube system (ETS)
closed system in which the patient’s blood flows through a needle inserted into a vein and then directly into a collection tube without being exposed to the air or outside contaminants
EVACUATED TUBE SYSTEM
Three basic components of evacuated tube system
1) A special blood-drawing needle
2) A tube holder
3) Various types of evacuated tubes
Allow multiple tubes of
blood to be collected during a single venipuncture.
Multisample needles
They are threaded in the middle and have a beveled point on each end.
Multisample Needles
A clear, plastic, disposable cylinder with a small threaded opening at one end
(often also called a hub) where the needle is screwed into 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
BLOOD COLLECTION (EVACUATED) TUBES
amount of air removed and negative pressure
created
vacuum
Evacuated tubes fill with blood automatically because there is a
Vacuum
used for clearing or discard
purposes only
nonadditive plastic tubes
Has one or more specific functions, such as preventing clotting or
preserving certain blood components
ADDITIVE TUBES
Tube stoppers (tops or closures) are typically made of
Rubbers
identifies a type of additive placed in the tube by the
manufacturer for a specific purpose; for some tubes, it indicates a special property of the tube
stopper color
Tubes are handled properly and stored between
4 and 25°C.
Light blue
Sodium citrate
Coagulation
Red
None
Chemistry, Blood Bank, Serology/Immunology
Red
Clot activator
Chemistry
Red/light gray
None
NA (discard tube only)
Clear
Red/black (tiger)
Gold
Red/gold
Clot activator and gel separator
Chemistry
Green/gray
Light green
Lithium heparin and gel separator
Chemistry
Green
Lithium heparin
Sodium heparin
Ammonium heparin
Chemistry
Lavender (purple)
EDTA
Hematology
Pink
EDTA
Blood bank
Gray
Sodium fluoride and potassium oxalate
Sodium fluoride and EDTA
Sodium fluoride
Chemistry
Orange
Gray/yellow
Thrombin
Chemistry
Royal blue
None
EDTA
Sodium heparin
Chemistry
Tan
EDTA
Yellow
Sodium polyanethol sulfonate (SPS)
Microbiology
Yellow
Acid citrate dextrose (ACD)
Blood Bank/Immunohematology
- Liquid
- Spray-dried
- Powder forms
ADDITIVE FORMS
prevents blood from clotting through chelating (or binding) or precipitating calcium so it is unavailable to the coagulation process
ANTICOAGULANTS
Common anticoagulants
Ethylenediaminetetraacetic acid (EDTA), Citrates, Heparin and Oxalates
These are combined with other additives and have additional properties for special-use situations
SPECIAL-USE ANTICOAGULANTS
SPECIAL-USE ANTICOAGULANTS examples
Acid Citrate Dextrose (ACD); Citrate Phosphate Dextrose (CPD); Sodium Polyanethol Sulfonate (SPS)
Substance that prevents glycolysis
ANTIGLYCOLYTIC AGENTS
breakdown or metabolism of glucose/blood sugar by blood cells
glycolysis
If glycolysis is not prevented, the glucose concentration in a blood specimen decreases at a rate of
10 mg/dl per hour
Antiglcolytic agent exampls
Sodium fluoride
Enhances coagulation in tubes used to collect serum specimens
CLOT ACTIVATORS
CLOT ACTIVATORS example
Silica (glass) particles, Thrombin
Inert (non-reacting) synthetic substance initially contained in or near the bottom of certain blood collection tubes
THIXOTROPIC GEL SEPARATOR
Made of materials that are as free of trace element contamination as possible
TRACE ELEMENT-FREE TUBES
This system consists of a sterile syringe needle called a hypodermic needle and a sterile plastic syringe with a Luer-lock tip
Syringe system
a special tip that allows the needle to attach more securely than a slip tip
Luer-lock tip
Come in wide range of gauges and lengths for many different uses
Syringe needles
Appropriate for phlebotomy procedures: gauges and inches
21 to 23
1- to 1.5-inch
Come in sterile pull-apart packages and are available in various sizes or volumes
SYRINGES
Most commonly used for phlebotomy syringe
2,5,and10mL
a cylinder with graduated markings in either milliliters (mL) or cubic centimeters (cc)
Barrel
a rod-like device that fits tightly into the barrel
Plunger
Allows the safe transfer of blood into the tubes without using the syringe needle or
removing the tube stopper
SYRINGE TRANSFER DEVICE
Also known as butterfly
WINGED INFUSION SET
indispensable tool for collecting blood
from small or difficult veins such as veins and veins of elderly and pediatric patients as it allows much more flexibility and precision than a needle and syringe
WINGED INFUSION SET
Commonly used butterfly needle gauge for phleb
23-gauge
refers to the order in which tubes are collected during a multiple tube draw ro are filled from a syringe
Order of draw
Order of draw
- Sterile tube (blood culture)
- Blue-top coagulation tube
- Serum tube with or without clot activator, with or without gel
- Heparin tube with or without gel plasma separator
- EDTA tube
- Glycolytic inhibitor tube
Order of draw color
Sterile (yellow)
Light blue
Red
SST (yellow)
PST (light green)
Green
lavender
Gray
Minimizes chance of microbial contamination
Blood cultures (sterile collections)
Yellow SPS
Sterile media bottles
The first additive tube in the order because all other additive tubes affect coagulation tests
Coagulation tubes
Light blue
Prevents contamination by additives in other tubes
Glass nonadditive tubes
Red
Filled after coagulation tests because silica particles activate clotting and affect coagulation tests (carryover of silica into subsequent tubes can be overridden by anticoagulant in them)
Plastic clot activator tubes
Red
Serum separator tubes (SSTs)
Red and gray rubber
Gold plastic
Heparin affects coagulation tests and
interferes in collection of serum specimens; it causes the least interference in tests other than coagulation tests
Plasma separator
tubes (PSTs)
Heparin tube
Green and gray rubber
Light green plastic
Green
Responsible for more carryover problems than any other additive; elevates Na and K levels, chelates and decreases calcium and iron levels, elevates PT and PTT results
EDTA tubes
Lavender, pink, or purple
Plasma preparation tubes (PPTs)
Pearl top
Sodium fluoride and potassium oxalate affect sodium and potassium levels, respectively.
Filled after hematology tubes because oxalate damages cell membranes and causes abnormal RBC morphology. Oxalate interferes in enzyme reactions
Oxalate/fluoride tubes
Gray
