(P) Lesson 4: Blood Collection Equipment, Additives, and Order of Draw Flashcards
What is the primary duty of a phlebotomist?
To collect blood specimen of samples
What are the methods of blood collection?
Venipuncture
Capillary Puncture or Skin Puncture
Arterial Puncture
Most commonly used method for blood collection
Venipuncture
collect the blood of the patient using
his or her vein
Venipuncture
collect blood from the capillaries; combination of blood from veins and arteries
Capillary Puncture/Skin Puncture
collects blood from the arteries
Arterial Puncture
Who can only perform arterial puncture?
Respiratory therapist
Physicians
where phlebotomy procedures are
performed
Blood Drawing Station
Other name that refers to blood drawing section
Phlebotomy section/area
T or F; Phlebotomists are common in PH
False (they are not common here because Medtech and other medpractitioners perform phlebotomy)
These are eeded for the proper positioning of the patient because sudden position change could the result of whatever you’re going to test from what you’ve collected
Phlebotomy chairs
Makes blood collection equipment portable
Equipment carriers
Two types of equipment carriers
Handheld carriers
Phlebotomy carts
Easily carried; Contain enough equipment for
numerous blood draw
Handheld carriers
Gliding carts made up of steel or
synthetic material; Shelves carrying adequate supplies for many patients
Phlebotomy carts
Tackle box is an example of what equipment carrier
Handheld carriers
Tackle box is an example of what equipment carrier
Handheld carriers
T or F; you can bring phlebotomy carts inside the patient room
False (Not in the room, hallway only, to
prevent nosocomial infection)
These are used as a hand barrier to prevent contamination during the phlebotomy
Gloves and glove liners
T or F; gloves should only be one pair for each patient
True
These are nonsterile, disposable latex, nitrile,
neoprene, polyethylene and vinyl
Gloves and glove liners
available for person with
allergies or dermatitis (glove liner)
Special gloves
T or F; Gloves with powder are recommended to use
False (not recommended
because the powder inside the gloves can be
a source of contamination and at the same,
that could be the cause of allergy)
Substances that are used to prevent sepsis
Antiseptics
T or F; Antiseptics dont just prevent or inhibit growth and development but also kill them
False (They dont kill them)
most commonly used antiseptic
70% Isopropyl alcohol
Antiseptic used for routine blood collection
70% Isopropyl alcohol
Antiseptic that refers to traditional iodine
Povidone Iodine
Antiseptic most commonly used for culture and sensitivity
Povidone Iodine
Chemical substances used to remove or kill
microorganisms on surface and instruments
Disinfectants
T or F; Disinfectants are commended to use in the body because they are not corrosive and they are safe for human skin
False (they are corrosive and not sfae)
Commonly used disinfectant found in household
Sodium hypochlorite
Ratio of sodium hypochlorite dilution for nonporous surface
1:100
Ratio of sodium hypochlorite dilution for large amount of blood
1:10
Contact time for sodium hypochlorite
10 minutes
T or F; Fresh bleach solution
should be made daily or as needed
True
Refers to two methods of hand sanitizing
Routine decontamination and usage of Detergent containing wipes
Refers to alcohol based sanitizers as a substitute for handwashing, provided that your hand is not visibly soiled
Routine decontamination
Hand sanitizer used for visibly soiled hand and there’s no hand washing facilities
Detergent containing wipes
Size of gauze pad
2x2 inches
T or F; Gauze pads are more recommended than cotton balls
True
These are applied to hold the pressure at the puncture site
Gauze pads
Used to cover a blood collection site after the
bleeding has stopped
Bandages
T or F; Adhesive bandages should be used on babies younger than 2 years old
False (They shouldnt; causes aspiration and suffocation)
in PH, we don’t have bandages, but rather we
have the so-called ___________
Micropore tapes
This is where you place used needles, lancets, and other sharp objects
Needles and Sharps Disposal Containers
These should be leakproof plastic bags and has a biohazard symbol and outside pocket
Biohazard bags
used to make blood films and is commonly
used for hematology determination/section
Slides
phlebotomist should always carry an this to label the
tubes
indelible or
permanent non-smear ink pen
Used to accurately determine specimen collection time and time certain tests
Watch
Three different methods of venipuncture
Syringe method
Butterfly infusion method
Vacutainer/ETS method
Inspecting organ by passing light through its
wall; it shines a red or an infrared red light to the patient’s subcutaneous tissue to highlight
the veins
Portable transilluminaton devices
Constrict the flow of blood; Makes the vein more prominent
Torniquet
What is the torniquet site relative to the puncture site
3 - 4 inches above it
T or F; Torniquet application can be more than 1 min
False mhie
T or F; Blood pressure cuff can be an alternative for torniquet
True (for obese, pediatric, and geriatric patients)
Type of needle used in syringe system
Hypodermic
Refers to opening of the upper
part of the needle
Bevel
Refers to long cylindrical portion of
the needle
Shaft
Refers to end of the needle that
attaches to the blood collection
or to the syringe
Hub
Refers to the internal
space of the needle
Lumen
Refers to diameter of the lumen of the needle
Cage
Commonly used gauge for syringe
20 - 21 g
Syringe needle gauge for blood collection
21 and 22
Gauge used for children
23 g
Gauge used for butterfly infusion/needle
21 - 23 g and 25
Color coding for needle gauges; yellow is for?
20
Color coding for needle gauges; green is for?
21
Color coding for needle gauges; black is for?
22
Color coding for needle gauges; blue is for?
23
Color coding for needle gauges; orange is for?
25
Color coding for needle gauges; brown is for?
26
performed just in case the needle
has no safety cap or safety feature
Fishing out
Parts of syringe
Graduated barrel and plunger
Used for fragile, thin, or “rolly” veins that tend
to collapse
Syringe
used for transferring blood from syringe going to the tube safely
Transfer device
Short needle with a thin tube with attached
plastic wings
Butterfly method system (Winged infusion sets)
Used for infants and children and patients
with fragile veins (cancer patients)
Butterfly method/system
The plastic wings allow us to insert the
needle in a shallow angle with _______
degrees only
10 to 15 degrees
What gauge is the most commonly used gauge for butterfly method?
23 guage
What gauge is used when doing a butterfly method in the scalp or tiny veins of premature infants and
neonates?
25 gauge
Of all the venipuncture method, this is the preferred method of blood collection
Evacuated Tube System
Allows one to collect numerous blood sample in the tube with a single venipuncture
ETS
The three materials needed in the ETS are?
Needle (Multi-sample aka Double-pointed)
Tube holder/needle adapter/plastic holder
Evacuated tubes
Length of multi-sample needles
1 to 1.5 inches
T or F; In ETS, the bevel of the multi-sample needle should be facing downward
False (upward)
Help place and remove tubes through
its flanges in ETS
Tube Holder/Needle Adapter
Two sizes of tube holder/needle adapter in ETS
Pediatric and Adult
These are made up by Sodalime, Borosilicate glass or plastic
Evacuated collection tubes
Refers to the ability of the evacuated tubes to pull air from the tube
Vacuum
T or F: Tubes fill blood all the way to the stopper
False
Component in evacuated tubes that preserve a specific blood constituent
Tube additives
Four types of tube additives
Anticoagulants
Anti-glycolytic
Clot activators
Thixotropic gel separators
Interrupts the process of coagulation
Anticoagulants
Additive that prevents glycolysis
Anti-glycolytic
Additives that activate clot formation
Clot activators
Additives that have presence of a certain gel that aids in the separation of serum from the cell
Thixotropic gel separators
Actiosn that anticoagulant do
Chelatetes or precipitates Calcium
Inhibits thrombin activity
Most common anticoagulants used are:
EDTA
Citrate
Heparin
Oxalate
Anticoagulant; purple or pink stopper
EDTA
EDTA; how many inversions?
8 to 10 (8 minimum)
EDTA is used in?
Hematology test and Blood Bank
Anticoagulant; combines calcium in a non-ionized form
Citrate
Ratio concentration of citrate per parts of blood
1:9
Anticoagulant used in coagulation studies
Citrate
Sodium citate in black stoppers are used for
ESR
Ideal unioversal anticoagulant
Heparin
Heparin is also called?
Mucoitin Polysulfuric acid
Anticoagulant; Acts as antithrombin and
antithromboplastin
Heparin
Naturally occurring anticoagulant
Heparin
Anticoagulant; light blue stopper
Citrate
Anticoagulant; green stopper
Heparin
Heparin; how many inversions?
8 - 10 (8 minimum)
Anticoagulant; Used in Blood Gas Analysis, Chemistry test (Stat request e.g., Electrolytes), situation that needs a fast turnaround time
Heparin
Anticoagulant: Combines with Calcium to
form an insoluble salt.
Oxolates
Temperature sensitive anticoagulant
Oxolates
Anticoagulant; black stopper
Oxolates
edit: flouride can also exist in black used for ESR
Oxolates; how many inversions
8 times
Anticoagulant; used in Hematology (CBC, Hgb and Hct)
Oxolates
Anti-glycolytic; Inhibits the glycolytic enzyme enolase and calcium
Flouride
Antiglycolytic; also considered as weak anticoagulant
Flouride
Antiglycolytic; gray stopper
Flouride
Anti-glyoclytic; for blood culture section, microbio section
Sodium Polyanethol Sulfonate (SPS)
SPS; How many inversions
8
Antiglycolytic; yellow stopper
Sodium Polyanethol Sulfonate
Antiglycolytic;
Action:
▪ Anti-coagulant
▪ Anti-complementary (reducing
action that target the bacteria)
▪ Anti-phagocytic (slows down
the phagocytosis)
▪ Neutralizes aminoglycoside
(antibiotic)
Sodium Polyanethol Sulfonate
Clot activator; help isolate/ separate
the serum to cell composition
Serum Separatior Tube
Clot activator; gold top/stopper
Serum Separator Tube
Clot activator; Helps isolate or separate
plasma to the cell component
Plasma Separator Tube
Clot activator; white top stopper
Plasma Separator Tube
What color is the stopper of nonadditive tubes?
Red
T or F; Nonadditive tubes yield plasma sample
False (Serum)
Recite the order of draw (sorry for this ;P)
“Stop, Light is Red. Green Light, Go. “
“Stop, Light is Red, Stay Put. Green Light, Go.”
- Sterile blood culture tubes – Yellow stopper
- Coagulation tubes – Light blue stopper
- Serum tube / Plain tube – Red stopper
- Heparin tube – Green stopper
- EDTA tube – Lavender / Purple stopper
- Anti-glycolytic tube / Fluoride – Gray stopper
Occurs when:
▪ Blood in additive tube touches the needle
during ETS blood collection
▪ When blood is transferred from a syringe
into ETS tube
Carry Over/Cross contamination
Blood collection tube and collection apparatus
combined in a single unit
Combination system
Aka Capillary puncture or Microsampling or
Microcollection
Skin puncture
Length of lancet in skin puncture
1.75 mm
Deep of incision in infants and children in skin puncture
less than 2mm
Deep of incision in adults in skin puncture
less than 2.5mm
Distance from skin surface to bone or cartilage in skin punctue
1.5 to 2.44 mm
People who can benefit in skin puncture are:
▪ Pediatric children- sample volume limited
▪ Obese patients
▪ Chemotherapeutic patients
▪ Burn patients
Types of lancets in skin puncture
Non-retractable and retractable lancets