Module 2 - Phlebotomy Equipment

Question 1

Collection tray

Answer 1

A tray that phlebotomists carry that has all of the equipment that is required for a number of collections, without having to return to the lab for supplies. Most hospitals require that it is carried in a closed and concealed container.

Question 2

Collection Carts

Answer 2

Carts containing all of the equipment needed for a phlebotomist. Benefits include: No need to place collection tray on surfaces in patient’s room, surface for writing, carry a wide variety of supplies, ergonomically friendly (trays can be awkward to carry.)

Question 3

Cleaning

Answer 3

Done weekly. Trays and carts should be kept dust free and tidy at all times.

Question 4

Carts/Trays include:

Answer 4

Gloves, tourniquets, alcohol swabs, cotton balls, gauze, tape and or bandaids, pen, needles in various gauges, butterfly needles, lancets, tubes, tube holders, syringes, capillaries, slides, lab procedure reference manual, a container of alcohol and disinfectant wipes, sharps container (on carts.)

Question 5

Sharps disposal

Answer 5

Needles and other sharps such as lancets, most be disposed of in thick plastic puncture resistant containers that are labelled with a biohazard symbol. Once the fill line has been reached, permanently close the contained before discarding in the appropriate biohazard bin.

Question 6

Gloves

Answer 6

Always wear gloves when collecting blood. New blood-borne pathogens such as Hep B, Hep C and HIV has made the wearing of gloves important to the protection of the healthcare worker.

Question 7

Types of gloves

Answer 7

Latex, Vinyl, Nitrile

Question 8

Tourniquets

Answer 8

Used on the upper arm to aid in the location of the veins.

Question 9

Types of tourniquets

Answer 9

Velcro, Non-latex, Latex, Blood pressure cuff, Buckle cloth elastics

Question 10

Alcohol wipes, cotton swabs

Answer 10

70% isopropyl alcohol is commonly used as a disinfectant. If the site on a patient is touched more than once, it must be disinfected again before puncture.

Question 11

Tape/Adhesive bandages

Answer 11

Before leaving the patient, inspect the puncture site and apply an adhesive bandage or tape over the cotton ball or gauze to secure it.

Question 12

Safety goggles/Glasses

Answer 12

Must be worn when drawing blood incase blood splashes it will not get into your eyes.

Question 13

Basic needle

Answer 13

Has a bevel (tip), shaft (middle) and hub (where it connects to the vacutainer.)

Question 14

Needle gauge

Answer 14

The larger the gauge, the SMALLER the needle. Becton-Dickinson colour codes: Blue = 23 gauge, Black = 22 gauge, Green = 21 gauge, Yellow = 20 gauge, Pink = 18 gauge.

Question 15

Puncture guard

Answer 15

A type of needle. It is self-blunting (protective covering) which provides additional bio-safety protection against needle stick injuries.)

Question 16

Needle holder

Answer 16

Is a plastic semi-disposable device. It is reusable and not very expensive so it can be discarded if contaminated or if the threads securing the needle become worn. Some labs discard them after each use, others disinfect them after each use or daily.

Question 17

Unthreading a needle from a needle holder

Answer 17

Invert the holder and insert the needle into the large end of the teardrop unwinder in the top of the disposal container lid. Slide the needle toward the smaller end of the teardrop until the hub is gripped. Unwind the needle in a counter-clockwise rotation. Needle will drop off. Some have a button that will dislodge the needle from the holder into the sharps container.

Question 18

Evacuated tubes

Answer 18

Are the receptacles for the blood specimen. Vacutainer tubes are glass or plastic.

Question 19

Hemogard

Answer 19

A rubber stopper surrounded by a plastic shield on top of tubes. Protects lab personnel when opening the tube, from contact with blood on the stopper or around the outer rim of the tube, as well as from blood splattering (aerosols.)

Question 20

Colour coded stoppers and labels

Answer 20

Provides information on the exact type of additive in the tube, lot control number and expiration date.

Question 21

Non-additive tubes

Answer 21

Are plain red tops and the inside is coated with silicon to keep blood cells from sticking to the sides of the tube, preventing rupture.

Question 22

Additive tubes

Answer 22

An additive is any substance placed in a tube other than the silicon acting of the tube or tube stopper. Additives have specific functions: Anticoagulants, cell preservatives, clot activators, separation devices.

Question 23

Anticoagulants

Answer 23

When blood is removed from the body, the clotting process is activated. This process can be inhibited by the addition of an anticoagulant immediately following collection

Question 24

EDTA

Answer 24

Ethylenediaminetetraacetic acid in a dipotassium or tripotassium base. Prevents coagulation by chelating (binding) with calcium in the form of a potassium or sodium salt. Complete blood counts are done from EDTA tubes.

Question 25

Heparins

Answer 25

There are three heparin formulations: ammonium, lithium and sodium heparin. Inhibits coagulation by interfering with thrombin formation which is required in the clotting process.

Question 26

Sodium citrate

Answer 26

Prevents coagulation by chelating (binding) calcium. Light blue stopper.

Question 27

Potassium, sodium or ammonium oxalate

Answer 27

Prevents coagulation by binding calcium. Oxalates are usually used in conjunction with antiglycolytic agents.

Question 28

Antiglycolytic Agents

Answer 28

Inhibits the metabolism of glucose in a sample.

Question 29

Sodium fluoride

Answer 29

Is an antiglycolytic agent that inhibits the metabolism of glucose by the cells in the blood. May be combined with an anticoagulant such as disodium EDTA or potassium oxalate. Sodium fluoride inactivates the enzyme systems that are required for glucose metabolism.

Question 30

Clot activators

Answer 30

Substances that initiate or enhance coagulation. Provide increased surface areas for platelet activation. Enhance the clotting process, including thromboplastin and thrombin.

Question 31

Thixotrophic Gel Separators

Answer 31

Separators are substances that form a physical barrier between a clot and serum or between cells and plasma, following centrifugation. Commonly used tubes: Hematology - Lavender EDTA, Coagulation - light blue sodium citrate.

Question 32

SST (serum separator tubes)

Answer 32

Contain a clot activator to speed up the clotting as well as a gel that will migrate during centrifugation, separating the clot from the serum. Invert times, let clot for 30 minutes, spin for 15 minutes. Plain red top tubes can always be used in place of SST tubes.

Question 33

PST tubes (plasma separator tubes)

Answer 33

Mint green in colour. Contain heparin anticoagulant and a gel separation device. Their advantage is that you do not have to wait 30 minutes for the specimen to clot. The tube can be centrifuged immediately following collection.

Question 34

Stop Buying Roses, Girls Love Gold

Answer 34

Order of draw: Sterile, light Blue, Red, Gold, Lavender, Grey (rarely used.)

Question 35

Syringes

Answer 35

Are not used extensively for blood collection, but do remain an important option. They are useful for patients with damaged or difficult veins and combined with a butterfly needle. Consist of a barrel and plunger.

Question 36

Capillary puncture

Answer 36

Of the heel or finger when the patient is: a baby, a small amount of blood is required, when venipuncture was unsuccessful, on patients with poor veins, burn patients, obese patients, glucose monitoring, point of care testing.

Question 37

Order of draw for capillary collection

Answer 37

Lavender EDTA, Other tubes with additives, Tubes without additives.

Question 38

Lancets

Answer 38

Are small, sterile, disposable devices. They come in a variety of models, but all are designed to penetrate a predetermined distance into the skin.

Question 39

Metal lancets

Answer 39

A traditional lancet with a metal point. Cheap and easy to use.

Question 40

Automated lancets

Answer 40

Safe to use, less traumatic for the patient. The recessed blade allows for precise placement of the lancet prior to use.

Question 41

Capillary tubes

Answer 41

Small glass tubes (about 1mm in diameter.) Blood flows into them by capillary action. Some contain anticoagulants, while others do not. One or both ends must be covered by a plastic stopper to prevent blood from flowing back out.

Question 42

Microtainers

Answer 42

Are small single tube collection devices. Available with or without additives. Vacuum tubes that are colour coded. The sample is collected directly into the tube via a “scoop.:

Question 43

Unopettes

Answer 43

Designed to make a dilution of the blood sample for cell counts. The microsample is collected and added to the dilutent immediately. Minimizes the amount of sample that must be collected.