NHA Exam Flashcards
CDC
- Center of disease control
- located in Atlanta Georgia
Which way does blood circulate
left to right
Basilic Vein
- On the inner part (inner medial) of the arm
- This is your last option (but irl we do not do this!!! Go to hand)
- The skin above this vein is very thin -> make sure the skin is tight so you don’t damage blood cells
- Next to the brachial artery
- Rolls more easily and runs directly over an artery (brachial)
- Painful
Median cubital vein
- At the center of the antecubital space
- Your first choice
- Usually larger than the other veins and more stationary
- Veins can move but this vein is well anchored which makes it easier and less likely that the pt. feels pain during the procedure, or develop a hematoma
Cephalic vein
- Second choice vein
- Outer part (lateral) of the arm (thumb side)
- Fairly well anchored
- Only vein that can be palpated in obese pts.
Plasma
- Liquid portion of blood
- 55% of blood
- Golden color
- Contains oxygen, Co2, waste, nutrients
Buffy coat
Leukocytes and Platelets
Formed elements
- Solid cell portion of blood
- Leukocytes and platelets <1% of blood
- Erythrocytes- 45% of blood
- Made in bone marrow
Hematocrit
- Hct.
- measurement of hemoglobin (Hgb)
Straight needle
- Used at the antecubital space
- You cannot use butterfly needle on antecubital space because they’re tiny
- 30-15 degree angle
- If you try to use a butterfly needle at the antecubital it will cause the RBC to try to squeeze in through the tiny needle and burst -> contaminated blood 50% of the time -> hemolysis
Butterfly needle
- Infusion set
- Smallest needle
- Have wings because you go into the metacarpal veins flush (0 degree angle) (hold the needle by the wings)
- Use at metacarpal veins
- Metacarpal vein- Very small, fine veins of the hand
Capillary puncture (dermal puncture)
- Arterioles and venules are in our fingertips; therefore capillaries are present as well
- There is a lot of information here because capillaries carry oxygenated and deoxygenated blood
- use when veins are inaccessible due to IV’s, scarring, or burns
- 3rd and fourth finger on nondominant is best
- usually point of care test
- can be used for people at risk of iatrogenic anemia
- lancet is not bigger than 2mm
Red top tube
- Does not contain an additive unless plastic
- Tests only plasma (serum)
- It only tests plasma bc if the WBC, platelets, and RBC where there they would clot normally, making it impossible to count -> blood parts will separate by density
- tests serology, chemistry blood bank
- Plasma contains chemistry
- No need to invert because no additive -> invert 5x if in plastic
- 60 minutes to clot then centrifuge
- Tests for cholesterol levels, glucose levels, sodium levels, kidney, levels, liver enzymes, cardiac levels, pregnancy test, drug testing, thyroid, HIV, Covid-19, immunities
Gold top, tiger top, speckle top, etc.
- SST (Serum Separator Tube)- Clot activator- makes clot happen faster
- tests plasma (serum)
- once you put the tube in the centrifuge (30 minutes after draw) the formed elements become separated from the plasma by wax so you can test the pure separated plasma
- Testing for chemistries (same as red top tube (same tests))
- More common
- additive: polymer Gel, clot activator
- Must invert at least 5x
Lavender top tube
- Tests complete blood cell count (CBC), sedimentation rate, routine immunohematology testing
- Analyzes whole blood
- Contains the additive known as EDTA (ethylenediaminetetraacetic acid)
- EDTA keeps blood whole (keeps it from clotting) making it possible to count
- Count cells (CBC- complete blood count)
- Checks Inflammation
- invert 8-10x
Light blue top tube
- Sodium Citrate additive
- Tests clotting
- tests plasma
- Coagulation test
- BT- bleeding time
- Testing platelets (if they are working)
- Inverted 3-4x
- must be tested within one hour
- PTT
- INR
Green top tube
- additive- sodium Heparin, lithium heparin, ammonium heparin
- potassium test
- tests stat and routine chemistry tests, ammonia, electrolytes, arterial blood gases (ABG)
- test chemical levels in the blood
- sodium levels
- Tests liver function
- tests plasma
- Heparin is an anticoagulant
- Invert 8x
Gray top tube
- Additive is glucose preservative AKA antiglycolytic agent (antiglycolytic agent)
- tests plasma
- FBS- fasting blood sugar (before you eat)
- GTT- glucose tolerance test (after you eat)
- tests lactic acid measurement, GTT, FBS, blood alcohol levels
- In a diabetic they can’t break down glucose and it remains high glucose levels
- Invert 8x
Yellow top tube
- Used for blood culture
- Additive is nutrient broth or thioglycolate broth or SPS
- tests whole blood
- Used to grow and identify microorganisms that might be growing in blood
- The infection would be identified and the patient is diagnosed with septicemia- blood poisoning, especially caused by bacteria or their toxins
- Blood cultures are done stat
- should withdraw the blood into a sterile safety syringe after obtaining a blood culture specimen from an adult patient
- When you draw blood for blood cultures you draw 20mL total -> 10ml for each two yellow top tubes- #1 for aerobic in one arm and #2 is anaerobic in the other arm or other vein –LABEL THEM #1 and #2
- transfer into anarobic first then aerobic
- Invert three times
Order of draw
- Yellow top tube- blood cultures: Nutrient Broth/thioglycolate
- Light blue top tube- test coagulation/blood clotting time: sodium citrate
- Red top tube- chemistries (blood bank): no additive
- Gold/SST- chemisties (kidney function, liver function, immunities, HIV, etc.): clot activator
- Green top tube- liver function: heparin
- Lavender top tube- CBC (complete blood count): EDTA
- Grey top tube- Glucose (GTT), fasting blood sugar (FBS): oxhemolyalate/fuoride
Fasting specimens
- Requires collection of blood while the patient is in the basal state- patient has fasted and refrained from strenuous exercise for 12 hours prior to the drawing
- It is the phlebotomists responsibility to verify if the patient has been fasting for the required time
- NPO- nothing by mouth
Timed specimens
- These tests are often used to monitor the level of a specific substance or condition in the patients blood at a certain time of day
- The specimen is drawn at a specific time for different reasons:
- To measure blood levels of hormones
- To determine blood levels of medications
- To monitor changes in the patient’s condition
Two hour postprandial
- This test is used to evaluate diabetes
- Fasting glucose levels is compared with the level 2 hours after eating a full meal or ingesting a measured amount of glucose (glucola)
- 3 hour GTT- is used to test hyperglycemia (abnormally high blood sugar level) this will be needed to diagnose diabetes
- draw fasting blood -> patient eats -> every hour for three hours draw a tube = 4 tubes total
- 5 hour GTT- is used to evaluate hypoglycemia (abnormally low blood sugar level) for a possible disorder in metabolism
- draw fasting blood -> person eats -> every hour for five hours draw a tube = 6 tubes
- These tests are done as early as 7:00 AM- 9:00 AM. —-Bloods drawn later in the morning will be rejected by the laboratory
Therapeutic blood monitoring
- Test is used to monitor blood levels of certain medications to ensure patient safety and also maintain a plasma level
- Blood is drawn to coincide with the lowest level or the highest level
- Lowest (trough) levels are collected 15 minutes before the scheduled dose
- Highest level or peak time will vary depending on the medication, and the route of administration (I.V, oral or I.M (intramuscular injection) -> 1-2 hours after oral medication
- communicate with attending nurse ab medication times
Chilled specimens
- Some tests require that the specimen collected be chilled immediately after collecting in crushed ice or ice water mixture
- The specimen must be immediately transported to the laboratory for processing
- ammonia and lactic acid specimen should be placed in ice water slurry
- arterial blood gas should be placed in ice bath
- cold agglutinin must be at body temp (37C)
Light sensitive blood specimen
- These specimens are to be protected from light by wrapping the tubes in aluminum after they are drawn
- Exposure to light could alter the test results for; bilirubin, folate, vitamin A and B6
Battery
you may be charged with battery if you draw from a patient without requisition forms
-intentional touching or force in harmful manner
Consent
- Patient must sign a form that says they cannot leave once they start a GTT because the patient might get hurt or eat something -> (patient comes in fasting and then takes in a lot of glucose -> they may fall and get hurt)
- If patient insist on leaving then call the doctor and ask him to explain or ask him to reschedule
Good samaritan
You save someone’s life but break their rib in the process -> good samaritan law will not allow you to sue them even if they do not survive
Pre-analytical error
- Error that occurs prior to drawing the blood that affects the blood results
- Misidentification
- Using the wrong tube
- Effects the results before the drawing ever occurs
- Improper fast or exercise
- Improper time of collection
- Patient posture
- Improper site preparation- clean the site properly
- Medication interference- if requisition said no morning medicine you must make sure
Analytical error
-Errors made during the collection of blood
-Extended tourniquet time- (band on arm) should not stay on for more than one minute or it will cause hematomas
-Not enough blood drawn, under filing tubes, vacutainers, must be at least ¾ full
-More addictive than blood in tube
-Not waiting 30 minutes to centrifuge after SST draw
Hemolysis
-Failure to invert tube
Post-analytical error
- Failure to separate plasma from cells
- Improper use of serum separator
- Processing delays- timed collections
- Improper storage conditions
Libel
written defamation
Slander
when you speak defamation
Sputum specimen
-phlebotomist should instruct to breathe deeply and cough up the specimen into container
Cleaning station with blood
use a 1:10 ratio of water and sodium hypochlorite (chlorine bleach) in order to clean station properly
- let it sit for 20 mins
- wear goggles and face mask if spill is large
use as antiseptic for the skin
- hydrogen peroxide
- isopropyl alcohol
- benzalkonium chloride- use when allergic to isopropyl
Povidone iodine
- do not use on potassium, bilirubin, uric acid, phosphorous test bc can affect test results
- can cause false elevation of potassium in pt.
- should be used to decontaminate the site for ABG and blood culture collection
- use this to clean the site for blood alcohol levels test
- can be used for blood culture
what temperature should semen samples be stored
36-38C
- 6F
- pt abstains from ejaculation for 2-7 days
- must be given to lab within one hour
implied consent
- rolling up sleeve
- putting arm out
- patient can be unconscious and in an emergency situation
transporting specimens
- put specimens in a locker container to avoid spills
- if it is hot transport samples in a box with cold packs and a biohazard label
capillary blood drops on filter paper
- you should apply the blood drops to the printed side of the filter paper
- must dry for min 4 hours
- if the first blood circle is not full, create a separate second larger circle
- puncture site should not touch the filter paper
WBC count point of care test
- expected range is 4.4-11/mm^3
- anything outside this range must be immediately reported to provider
capillary blood draw
- select the third or fourth finger
- use the second drop of blood
- position puncture device so its perpendicular to the fingerprint ridges
- you should touch the slide to the blood at 1.3 to 2.5cm from the end of the slide
what needle do you use on an older adult with fragile, easy to collapse veins
- syringe and butterfly assembly and transfer to an ETS tube
- syringe minimizes pressure on fragile veins
- using a regular ETS tube would cause too much pressure
- using a pediatric tube may not provide enough blood
Glucometer
-quality control testing should be done every day it is used
Clinical and Laboratory Standards Institute (CLSI) clinical laboratory workflow pathway
- pre examination phase- processing the specimen, provide post puncture care
- examination phase- review and verify results
- post examination phase- entering critical laboratory data
dermal samples
- because hematology tests are most affected by clotting lavender should be used first
- it minimizes platelet clumping and microclot formation
- red top would be collected last bc it is necessary for it to clot
mastectomy
-if a pt has a mastectomy on one side you should draw from the arm on the opposite side to prevent lymphedema and infection
before leaving a pt room
-mark each specimen with the date, time and initials on each tube was drawn
health hazard
blue
heel
-site for any pt under 1 year old
cholesterol point of care test
- expected ranges from 140 to 200 mg/dL
- anything outside of this is reported to provider
OSHA vaccine
-hepatitis B vaccine must be provider to employees for free at least 10 days after hire
fainting
- pts prone to fainting should be laying in a reclined position
- supine position
N95
worn with pts that have airbone conditions (tuberculosis, measles, vericella)
-a regular mask if worn for pts with droplet contagious conditions (rubella, meningitis, diphtheria, mumps, pertussis, influenza)
contact precautions
- wear goggles, gloves and gown
- diphtheria, herpes, simplex, scabies, hepatitis A, respiratory syncytial virus, wound and skin infections
Petechiae
- microcapillary bleeds that are associated with coagulation abnormalities
- appear as small tiny red dots below the tourniquet
- you do not have to stop
Hemoconcentration
elevated blood levels
Edema
accumulation of fluid in one area of the body
Urticaria
-raised welts, often called hives
nerve injury
-a sharp, painful, and tingling sensation that radiates down the patient’s arm.
Accession number
- identifies specimens in the laboratory
- should not be on requisition form
chemical exposure
- remove clothes
- wash for minimum 15 minutes
order of draw for capillaries
- different that regular order of draw
- increased rate of coagulation affects it
- release of thromboplastin causes blood to clot quickly
- blood gas collection
- purple, lavender, pink, pearl tubes containing EDTA
- green
- any other additive
- serum
hemolysis
-to avoid hemolysis make sure the alcohol at the site is completely dried
EDTA
- hematology
- yields only plasma
PT/PTT test
-anticoagulant sodium citrate is used
potassium oxalate
-additive used for chemistry tests
anticoagulants
EDTA, sodium fluoride, sodium citrate, heparin, potassium oxalate
troponin T levels
- expected range is 0 to .2 ng/mL
- anything outside this range is to be reported to the provider
warming technique
- wrap warm towel in plastic bag
- rising hand in warm water for maximum 1 minute
heparin
- anticoagulant
- produces a plasma specimen for chromosome analysis
- aids in determining sodium levels
tourniquet
- should be 7.5 to 10 cm (3 to 4 inch) above venipuncture
- tuck partial loop under the tourniquet
glucose point of care test
- external liquid controls for quality control should be done when a new lot number or kit is opened
- expected fasting blood glucose range is 70 to 126 mg/dL
- using too much blood can cause high results
- using too little blood, the strips is left open, or the first drop is used it can cause low results
- low results can cause fast heart rate
hand immobilizer
-The technician should use a hand immobilizer to access difficult veins in the patient’s hand. A hand immobilizer uses straps to keep the patient’s hand still during the collection procedure.
phlebotomy wedge
stabilizes the patients arm
requisition
- The technician should check the requisition form for duplicate test orders, discrepancies, and missing information prior to performing the venipuncture.
- should not have the accession number
- patients name, date of birth, sex, ID #, specific precautions
- you must fill out date and time of puncture, billing info, diagnostic coding
urine culture and sensitivity test
- should use clean-catch midstream collection of urine
- first morning is preferred for pregnancy tests
- timed urine is preferred for hormone tests
- random urine is preferred for routine testing
chain of custody guidlines
-apply to drug screenings, forensic studies, blood alcohol tests, and paternity tests
3kg newborn
- 1% as maximum allowable volume
- 3 x 100= 300mL
- 300 x .01= 3mL
- 3mL allowable amount of blood draw
pre-employment drug testing
- cannot flush toilet after to ensure there is no tampering
- must contain at least 45mL of urine
- take the temperature of the specimen within 4 min of collection to ensure the urine is within the expected temperature range and tampering has not occurred
- The technician should ensure that the specimen is within a temperature range of 32° to 38° C (90° to 100° F).
IV
- if a pt has an IV in one arm and a masectomy on the other ask the nurse to shut off the IV flow and draw below the IV site
- ask the nurse to turn off all IVs for 2 minutes before starting puncture
order of PPE removal
-gloves, goggles, gown, mask
chloramine
used to disinfect wounds
informed consent
- must be conscious to receive information about the procedure
- often for high risk, invasive, surgical procedure
expressed consent
-pt must be conscious to provide written or verbal consent
explicit consent
-pt must be conscious to dictate how their personal information is disclosed
blood cultures
- Blood cultures are done stat
- must swab the site twice once with isopropyl or chlorhexidine and once with povidone or chlorhexidine
- scrub the site with isopropyl alcohol for 60 seconds with a back and forth motion in a 6.35cm diameter range
- allow 30 seconds to dry when using povidone or chlorhexidine gluconate
- do not use evacuated tube
- should withdraw the blood into a sterile safety syringe after obtaining a blood culture specimen from an adult patient
- When you draw blood for blood cultures you draw 20mL total -> 10ml for each two yellow top tubes- #1 for aerobic and #2 is anaerobic -LABEL THEM #1 and #2
- transfer into anearobic first then aerobic
- Invert three times
sharps container
-replace once 2/3 full
18-gauge
-18-gauge for collection of donor units of blood
21-23-gauge
-for laboratory assays
insufficient blood
-try a different tube first
washing hands
- use dry paper towel to turn off faucet
- use enough soap to form a lather
- rub hands together for at least 15 seconds
- hold hands in downward position when rinsing
chlorhexidine
- antiseptic used for pts allergic to alcohol or latex
- use for blood alcohol test
- nitrile gloves are good for people with latex allergy
what to do when you cant see a vein with the touniquet on
-ask the pt to dangle their arm for 1 to 2 min
role of phlebotomist
- cardiovascular anatomy and physiology
- fundamentals of communication and infection control
5 phases of coagulation
- vascular phase- vessel constricts
- platelet phase- cells clump to plug leak
- coagulation phase- blood clot forms
- clot retraction- clot shrinks as tear heals
- fibrinolysis- clot dissolves
- vascular phase- vessel constricts
six links in the chain of infection
- infectious agent
- reservior
- portal of exit
- mode of transmission
- portal of entry
- susceptible host
analytical communicators
-prefer to work with numbers and data, very little emphasis on emotions and feelings
Intuitive communicators
- prefer to look at the big picture
- can result in more questions than answers when it is so broad
functional communicators
- prefer an organized approach with timelines and detailed plans
- step by step method
- can be overwhelming with details
personal communicators
-focuses on the patients emotions and feelings
steps of communication style
- sender develops the message
- sender encodes message into transmittable format
- sender transmits message
- receiver decodes the message
- receiver interprets the message
- receiver provides feedback
conduction system of the heart
- SA node and AV node transmit signal to the bundle of His cells following atrial contraction
- nerves between atria and ventricles send signal to perkinje fibers in the ventricular muscle to trigger ventricular contraction
antiplatelet
- delay blood clotting
- different from anticoagulant because it affects arterial as well as venous blood
what to do if patient shows signs of syncope
- syncope- fainting
- immediately remove tourniquet and needle
- apply pressure
- move patient to floor or reclining position
- if they do pass out monitor breathing, note how long the patient was unconscious
CPR on adult
- place the heel of one hand on patients sternum (between nipples)
- place other hand over the first, interlacing fingers
- give at least 100 chest pumps per minute, at least 3.8 to 5 cm in depth
- allow the chest to fully recoil between compression
- on child- 5 cm on chest, 30 times at about 100-120 chest pumps per minute, allow time for two rescue breathes and repeat
CPR on infant
- use two fingers
- 30 pumps on chest
- 3.8 cm deep
- 100-120 compression a minute
- two rescue breaths
Accidental needle poke procedure
- immediately disinfect using antiseptic or soap and water
- notify immediate supervisor
- document information in sharps injury log and facility incident report- do not include names, do include location, type of device involved, and how it happened
- get a medical exam
- get tested for HIV, hepatitis B and C
PHI
-protected health information
quality assurance
- makes sure the test is accurate as can be
- adhering to standard operating procedures
- conducting quality control testing- how well a instrument is working
- ensuring equipment is receiving maintenance
when do you perform quality control procedures
- daily
- when there are wide range errors
- never reuse
- record controls in log
- if centrifuge is making noise balance it
- CLIA-waived test
cleansing the site
- use antiseptic
- allow to dry- could cause hemolysis
- clean outward in circular motion
fires
Class A- involves wood, paper, cloth
Class B- involves liquids like paint, oil, gasoline
Class C- involves electrical equipment
Class D- involves metals like sodium, magnesium`, titanium
Hepatitis B
- HBV
- most common spread by needle stick injury
- HIV is least
- Hepatitis A is spread by food and water
Hematology
-blood count
Microbiology
-processes tests related to bacteria growth
Pathology
-processes tests related to tissue samples
aliquot
- wear gloves, mask, and goggles
- use a disposable pipette to transfer serum into aliquot tube after centrifuging blood specimen
refusal of blood draw
- pt does not have to tell you why
- must get written proof refusal
Patient interview
- any allergies?
- do you ever feel faint during blood collection? if yes lock the arm to the chair to prevent sliding
- do they have a preferred spot to puncture?
places you may not draw
- above an IV
- an arm with a arteriovenous fistula or shunt
- an arm with a central venous access device
- anticubital space on a arm that had a recent mastectomy
- site that has edema
- site that has scarring
- site that has hematoma
- avoid site with tattoos
- sclerosed veins
tortuous veins
- aka varicose veins
- twisted
- dialated
- lack elasticity
- easy to go through
thrombotic veins
- vein with a blood blood clot
- hard
- not flexible
fragile veins
- common in old, newborn, pediacterics
- thin
- weak
- difficult to puncture
phlebitic veins
- tender
- warm
- red area around them
- can have clots
sclerotic veins
- as people age they get this
- hard
- inflexible
- narrow
- develops after repeated blood draw from here
urine test: culture
- prepare for growth and identification of microorganisms
- sensitivity usually follows to see which antibotics will kill it
- must be clean catch or from catheter
random urine specimen
- put label on after pee
- do not put label on lid
- can be done at home and kept in refrigerator
- label date and time
fasting urine specimen (first urine)
- pt must pee before sleeping
- more concentrated than random
- first void of the morning
- used for pregnancy, glucose
- urine deteriorate after 30 mins without refrigeration
- detects human chorionic gonadotropin (hCG)
Clean catch urine specimen
- midstream
- wash hands before and after test
- do not let anything touch the inside of cup and lid
- tests for bacteria
- genitalia should be washed before the test too
timed urine specimen
- pt pees and then records the time
- everything after that for the next 24 hours must be collected
- after each pee mix it a little
- start collecting at the second void of the day
- all specimens must be kept on ice or refrigerator
urine reagent testing
- CLIA-wasived test
- point of care
- placing strip into urine
- note color, clarity, odor
- use key
- can test pH, specific gravity, WBC, hemoglobin, ketones, bilirubin, protein, nitrites, and glucose
Fecal occult blood test (FOBT)
- identifies nonvisable blood in stool
- diagnoses gastrointestinal lesions (ulcers) and colorectal cancer
- detects bacteria, virus, fungi, parasites
sputum
-material coughed from lungs
-usually for people with terberculosis, pnemonia
-confirms microorganism
-best in morning before eating and drinking
-
outpatient verification
- must have name, DOB, and photo ID
- billing information
- test status
lipemic
- indicates the pt has eaten fatty foods
- will appear cloudy
warfarin
anticoagulant
-will affect PT/INR results
Fatty foods
-can affect LDL and HDL results
levothyroxine
-can affect thyroid stimulating hormone TSH
evacuated tube system (ETS)
includes
- gloves
- isoproyl alcohol swab
- gauze
- tape/bandaid
- tourniquet
- needles- double sided
- hub
- tube
alternative to tourniquet
-blood pressure cuff at 40mmhg
tube label
- includes expiration date
- additive
- amount of blood it can hold
- after draw you label pts name, DOB, date, time, medical number
anticoagulant tubes
- plasma tubes
- blood culture
- light yellow
- light blue
- green
- lavendar
- royal blue
- gray
royal blue top tube
- clot activator or EDTA
- trace element testing
light yellow top tube
- acid citrate dextrose (ACD)
- blood bank studies
- DNA testing
- invert 8-10x
orange top tue
- thrombin-based clot activator
- stat chemistries
syringe
- for pt with fragile easy to collapse veins
- manually adjust the rate the blood is taken
- evacuated tubes are not used in the blood collection
- blood is first taken and transferred into tube using transfer device
hub
- adapter
- use only once
vein preferance
- median cubital
- cephalic
- hand
- basilic
anchoring veins
- use nondominant
- 2 inches below site
- use thumb to pull down
hand draw
-10 degree angle
angle on needle
- 10 degree on hands
- 30-15 on arm
- deeper the vein bigger the angle
complication that can occur
- nerve damage
- hematoma
- phlebitis- inflammation of blood vessle
- thrombosis- clot that can block
- petechiae
- hemocencentration
- syncope
- diaphoresis- sweat
leaving tourniquet on too long
- may elevate the levels of potassium
- causes hemolysis
- can cause low CBC
- can cause high iron level
blood smear
- can be venous or capillary blood
- can be done by finger to slide
- microscopically examine blood
- must be prepared at least one hour after drawing
- wedge method using two glass slides at 30-35 degree angle
- frosted side up
thermolabile specimens
- use heat or a heat block to to regulate temperature
- use ice slurries, refrigerator, or freezer for chilling purposes. do not use cold or ice packs
- avoid fluctuating temperatures
photosensitive
protect from light
packaging and shipping
- include patients identification, specimen identification, shipping paperwork, and test information
- biohazard identification
- pack with:
- absorbent materials
- watertight primary containers
- watertight secondary containers
- stronger outer packaging
- coolants
steps of packaging tube
- first make sure the tube is labeling with patient ID, date and time of collection, source and type of specimen
- place tube into biohazard bag
- then place into primary container with absorbent material surrounding and any coolants if necessary
- put this all in the secondary container and place specimen documentation above
- then place these into shipping container
steps in handling and transporting specimens
- mixing the sample
- aliquoting
- adding dilutents
- centrifuge
- package
- follow procedures
transporting urine
- use evacuated transport tubes with preservatives when sending urine to a reference lab
- transfer sample into tube with disposable pipette
- keep at room temp
- must be tested within 72 hours
what to include on the lab requisition form for transporting
- patient name, ID #
- date
- type of test
- ordering providers name
- ICD-10-CM code for diagnosis
- and a place for the provider to sign after getting results
pneumatic tube system
- sends tubes to departments
- fast
- inpatients
chain of custody
- maintains control and accountability of specimen from the draw to disposal
- any who handles the specimen must document their name and identifying information of the patient, body, subject, or object the specimen came from
- name of the person who obtained and processed the specimen
- date, location, and signature of the person attesting the specimen is correct and matches the documentation
- signature and date from anyone who handled the specimen for any amount of time
informatics
- QR code, radio frequency identification, bar codes
- these are to be scanned after receiving the specimen
tamper-evident containers
- drug testing
- forensics
reference rage for hemoglobin
male- 13-18
female- 11.5-16.5
how to access patients medical records
-patients ID number
LH/FSH
- hormone tests
- would be used for reproductive specialists
LDL/HDL
cholesterol tests
CRP/BNP
cardiac tests
