Phlebotomy Flashcards
Phlebos
incision
-otomy
making an incision into a vein
Arterial punture
Performed in a hospital to assess the oxygen levels, Co2, and acid-base balance in arterial blood
Venipunture
The puncturing of a vein for the removal of a venous blood sample.
- Most common method: vacuum tube and butterfly
Vacuum tube
Fasted and most convenient. Relies on evacuated tube
- Collection needle, plastic holder, and evacuated tube
Butterfly method or winged infusion method
Used for more difficult draws, like the hand or small sclerosed (hardened) veins
- Recommended for adults with small veins and children
- Gauge: 21-23 G
- Length: 0.5 to 0.75
Guidlines for Venipuncture
Review specimen collection Identifying the patient Reassuring the patient Assembling equipment and supplies Positioning the patient Applying the tourniquet Select the site Obtain the type of blood specimen required
Patient Position
Sit down, palm facing up, elbow supported by armrest
Venous reflux
Blood to flow from the evacuated tube back into the patients vein. Can cause patient to have adverse reaction due to the additive in the tube. ex EDTA
- Prevented by keeping the patients arm in the downward position
Tourniquet
Should be applied with enough tension to blow the venous flow without affecting the arterial flow
Hematoma
A swelling or mass of coagulated blood caused by a break in a blood vessels
- Caused by a needle that is inserted too far, a bevel opening that is partially in the vain, or insufficient pressure applied
Antecubical space
Have wide lumen and are closed to the surface of the skin.
Thick walls making them less likely to collapse
Median cubital
A prominent vein in the middle of the antecubital space and does not roll
Cephalic vein
Thumb side of the antecubital space
Basilic vein
Located on the little finger side of the antecuital space
Clotted blood Specimens
Obtained from a tube that does not contain an anticoagulant
Serum
From clotted blood by allowing the specimen to stand and then centrifuging it
- Top layer: serum (clear/ light yellow in color)
- Bottom layer: clotted blood cells
- Contains: glucose, cholesterol, sodium. potassium, antibodies, hormones, and enzymes
Whole blood
Obtained using a tube that contains an anticoagulant. Must be inverted 8-10 times
Plasma
Obtained from whole blood that has been centrifuged
- Top layer: plasma
- Middle layer: buffy coat
- Bottom layer: red blood cells
Buffy coat
Contains white blood cells and platelets
Anterior Needle
Longer and has a beveled point designed to facility entry into the skin and vein
Posterioer needle
Shorter and its purpose it to pierce the rubber stopper
Needle
- Coated in silicon
- Sizes: 20- 22, with 21 being the most common for venipuncture. 22 For children and small veins
- Length: 1-1.5 inches. 1 inch most used but 1.5 allows for more room to stabilizing the vein
Flange
On the plastic holder it assist in the insertion and removal of evacuated tubes and prevents the plastic holder from rolling when it is placed on a flat surface
Red tube
Does not contain anticoagulant. Used to obtain clotted blood or serum
- need to lets stand upright at room temp for 30 to 45 minutes before centrifuging
Red/gray-speckled tube
Gold stopper for Hemogard tubes. Used to obtain serum but does have an additive that is a clot activator
Lavender tube
Contains EDTA and used to obtain whole blood plasma. Most common used to collect for a CBC. Also used for sedimentation of blood
Light blue tube
Contain anticoagulant sodium citrate and used to obtain whole blood or plasma. Most common used for prothrombin time
Green tube
Contains anticoagulant heparin and used fro blood specimen to perform gas determination and pH assays
Gray tube
Contains sodium fluoride and potassium oxalate (anticoagulant) and used for whole blood or plasma. Most used for drug and alcohol tests or oral glucose tolerance test (OGTT)
Royal blue tube
Contains EDAT or no additive. Used for the detection of trace elements like lead, zinc, arsenic and copper
Order of draw
Yellow, light blue, red, gold, light green, green, lavender, gray
Failure to obtain blood
- Not inserting the needle far enough
- Insertion of the needle to far
- The bevel opening becoming lodge against the wall of the vein
Fibrin clot
A spongy substance that occupies space interfering with serum collection.
- Blood that does not sit long enough cell layer does not form a whole blood clot.
- Sits too long and leaching of substances form cell layer into serum
Serum Separator Tubes (SST)
Also known as gel barrier tube. Is an evacuated tube specially designed to facilitate the collection of a serum specimen
- Red/gray stopper or gold
- Contains thixotropic gel
Skin Puncture
Used to obtain a capillary blood specimen, usually in small children
Skin Puncture Site
The lateral part of the tip of the 3rd or 4th finger
Osteochondritis
Inflammation of bone and cartliage
Osteomyelitis
Inflammation of the one or bone marrow caused by bacterial infection
Hemoconcentration
An increase in the concentration of the nonfilterable blood components in the blood vessels as a result of a decrease in the fluid content of the blood.
Hemolysis
The breakdown of blood cells
