Module 2 Flashcards
What is the cleaning procedures for collection trays/carts?
Daily- wipe spills with strong bleach, dust, wipe top of needle disposal
Weekly- submersion in weak bleach for 5-10min
What containers are required for sharps disposal?
Puncture resistant containers.
What are the benefits of wearing gloves?
Provide a protective barrier
Reduce vol of blood in the event of a needle stick injury
Reduce microorganism transmission
What are the different kinds of gloves and their pros/cons?
Latex- fit well but breakdown and many are allergic
Vinyl- nonallergenic but don’t fit as well
Nitrile- fit well but designed to tear if perforated
What are the functions of tourniquets?
Briefly inhibit venous return to make the vein more palpable
What is the max time a tourniquet should be left on and why?
1 min
Partial filtration will occur, hemoconcentration.
Falsely elevated protein, hematocrit and other cell count levels.
What are the different types of tourniquets?
Blood pressure cuff
Latex
Nonlatex
Velcro
Buckle cloth elastics
What kinds of alcohol are used to clean collection sites and when?
70% isopropyl alcohol- routine collections
10% povidone iodine- blood cultures or blood alcohol
Chlorhexidine gluconate- blood alcohol
What are the parts of the needle?
Bevel
Shaft
Hub
What are the most common gauges and their colour coding?
23- blue
22- black
21- green
20- yellow
18- pink
How can hemolysis be avoided?
By not using a small needle with a large vacuum tube.
What are the different types of evacuated system needles?
Single sample
Multisample- rubber seal/valve to prevent leakage between tubes
PunctureGuard- self blunting
What are the components of evacuated systems?
Needle
Holder
Evacuated tubes
What are the different types of holders?
Sizes- larger vols, shorter, paediatric
Pronto- quick release
Shielded blood needle adapter- needle is retracted and locked
What are the different kinds of evacuated tubes?
Hemogard- rubber stopper surrounded by plastic shield
UltraSeal stopper- reduces spatter and contamination
What are nonadditive tubes used for?
Serum samples
Red tops
Coated with silicon to prevent blood cells sticking a rupturing
What are the different additives found in tubes?
Anticoagulants
Antiglycolytic agents
Clot activators
Thixotropic gel separators
What are the different anticoagulants and their functions?
EDTA- chelates Ca, inhibits platlet clumping, can’t be used for coag procedures
Heparin- interferes with thrombin formation
NaCit- chelates Ca
K/Na/NH4 oxalate- binds Ca, used with antiglycolytic agents
What is the function of antiglycolytic agents and what is an example of one?
Inhibit glucose metabolism
Na fluoride- glucose testing, inhibits enzymes
How do clot activators enhance coagulation?
Increase the surface area for platlet activation
Enhance the clotting process
- Facilitate full clotting
What is the function of thixotropic gel separators?
Form a physical barrier between the cells and fluid.
Clot and serum or cells and plasma
What is the correct order of drawing tubes?
Blood culture/sterile
Citrate (light blue)
Serum (SST/red)
Heparin (PST/green)
EDTA (lavender)
Fluoride (grey)
What is the function of collection tray/carts?
Used to carry equipment for collections.
Describe a red top tube and its additives.
No additives (unless plastic then clot activator, mix 5x)
Use for serum, chemistry, immunology, toxicology
Coated to prevent cell adherence
Describe a SST/gold tube and its additives.
Polymer barrier and clot activator (mix 5x)
Serum chemistry, serology
Can store after separation
Describe a STAT serum/yellow-black-orange top tube and its additives.
Two units of thrombin (mix 5x)
STAT serum chemistry, anticoagulation
Clots in 5min
Describe a navy blue top tube and its additives.
Can have heparin (8x), sodium EDTA (8x) or no additive
Serum trace elements, toxicology, nutrient analysis
Describe a lavender top tube and its additives.
EDTA or dipotassium EDTA (mix 8-10x)
Hematology, while blood counts and sizing
Inversions prevent clotting
Describe a pink top tube and its additives.
Dipotassium EDTA (mix 8-10x)
Transfusion medicine
Special label
Describe a grey top tube and its additives.
Glycolytic inhibitor- NaF or NaK oxalate (mix 8-10x)
Preserves glucose, whole blood, plasma
If tube is under filled hemolysis occurs
Use for blood alcohol
Describe a light blue top tube and its additives.
3.2% NaCit (mix 3-4x)
Coagulation studies, plasma
Must be 99% filled
Centrifuge 1500G for 15 min
Describe a green top tube and its additives.
Na heparin (mix 8-10x)
STAT electrolytes, plasma
Can be centrifuges immediately
Describe a PST/light green top tube and its additives.
Li heparin and inert polymer (mix 8-10x)
STATs, plasma
Don’t use for Li analysis
Separates as it spins
Describe a yellow top tube and its additives.
SPS (mix 8-10x)
Blood cultures
What are the two ways to describe tube sizes?
Actual measured size
Vol of fluid it can contain
What are the benefits to using standard size tubes to collect various sample sizes?
Only need one size holder
More efficient
Reduced need for balancing
How are partial draw tubes indicated?
Translucent hemogard stopper.
How can we compensated for high altitude effects in small draw tubes?
Mexico City tubes
Suspend a small tube in a larger tube
What is the blood:additive ratio allowed to vary by?
+/- 10%
Why is mixing after collection important?
Unmixed anticoagulants clot
Unmixed clot activators don’t clot
What are the different volume effects?
Over- clotting
Under- not enough sample, dilution effect, cell changes
What is the minimum acceptable full volume/NSQ of all tubes except NaCit?
50% capacity
Why is it important to follow the correct tube fill order?
Otherwise carry over contamination could occur.
What could happen if EDTA is collected first?
Elevated K or falsely low Ca
What should K oxalate and Fluoride tubes always be collected last?
K contamination- false increase
Oxalate damages cell membranes and chelates Ca
Fluoride acts as an enzyme inhibitor
What if Na oxalate is filled instead of K oxalate?
False increase in Na
What if tubes are contaminated with clot activators?
Interfere with coagulation tests
When are discard tubes required?
For special coag testing (VIII)
If drawn with a butterfly needle
Gets right vol, accounts for air drawn from tubing
What are the parts of a syringe?
Barrel
Plunger
What are syringes useful for?
Patients with delicate/damaged veins
Patients with difficult veins
Blood culture specimens
What are the different types of tips used in syringes?
Smooth tips
Leur-lock
Why must blood be transferred as quickly as possible from the syringe to the vacuum tube?
To prevent microclot formation.
Anticoag tubes can be filled first.
What are the three ways to fill a tube from a syringe?
Puncture the stopper
Remove stopper and needle
Use direct draw adapter
When is capillary puncture used?
Paediatric patients Small samples Unsuccessful venipuncture Poor veins Burn victims Obese patients Glucose monitoring Point of care testing
What is the order of capillary draws?
EDTA
Tubes with additives
Tubes without additives
What types of lancets are there?
Metal- not recommended
Automated- recessed blade, automatically retracts
What are the different kinds of automated lancets and their uses?
Purple- 1.5mm, low flow
Pink- 1.8mm, medium flow
Blue- 2.0mm, high flow
What are capillary tubes?
Small glass tubes
Collect blood via capillary action
What are microtainers?
Small, single use tube collection devices
What are unopettes?
Make a dilution of the sample for cell counts
Sample added to diliuent immediately
