PMLS LAB Flashcards
1
Q
Basis for classifying microorganisms into risk groups and biosafety levels
A
RISK MANAGEMENT PROCESS
2
Q
What are the components of Risk Management Process
A
> IDENTIFICATION OF RISKS
RISK ASSESSMENT
RISK MITIGATION PLAN
IMPLEMENTATION AND MONITORING
REVIEW AND UPDATE RISK PLAN
3
Q
No or Low Individual or community risk. Unlikely to cause disease.
A
RISK GROUP 1
4
Q
Laccaria bicolor, Saccharomyces cerevisiae, Lactobacillus acidophilus, Baculoviruses, adeno-associated virus
A
RISK GROUP 1
5
Q
Moderate individual risk, Low Community risk. With treatments available
A
RISK GROUP 2
6
Q
Human blood, Streptococcus pyogenes, Giarda spp., Microsporum canis, Human adenoviruses, Hepatitis virus
A
RISK GROUP 2
7
Q
High Individual Risk. Low Community risk. Effective and preventive treatments are available
A
RISK GROUP 3
8
Q
Yersinia pestis, Francisella tularensis, Coccidioides immitis, Prions, Hantavirus, Influenza viruses A H1N1 (1918), H2N2 (57-68), and H5N1 (Bird flu)
A
RISK GROUP 3
9
Q
High Individual and High Community Risk. Effective and preventive treatments are NOT USUALLY available.
A
RISK GROUP 4
10
Q
Small pox Virus, Ebola Virus
A
RISK GROUP 4
11
Q
Usually no bacteria, parasites, and fungi are observed in this group
A
RISK GROUP 4
12
Q
Term used to describe the containment principles, the technologies, practices that are implemented to prevent unintentional exposure to pathogens and toxins, or their accidental release
A
BIOSAFETY
13
Q
- LABORATORY TYPE: Basic teaching, research
- LABORATORY PRACTICES: Good Microbiological Techniques (Examples: Aseptic Techniques, PPE)
- SAFETY EQUIPMENT: None, Open bench
A
BIOSAFETY LEVEL 1 (RISK GROUP 1)
14
Q
- LABORATORY TYPE: Primary health services, Diagnostic Services, Research
- LABORATORY PRACTICES: GMT, Protective Clothing, Biohazard signs
- SAFETY EQUIPMENT: Open bench plus Biosafety Cabinet for potential aerosols
A
BIOSAFETY LEVEL 2 (RISK GROUP 2)
15
Q
- LABORATORY TYPE: Special diagnostic services, Research
- LABORATORY PRACTICES: GMT, Protective Clothing, Biohazard signs, plus special clothing, controlled access, directional airflow.
- SAFETY EQUIPMENT: BSC and other primary devices for all activities
A
BIOSAFETY LEVEL 3, CONTAINMENT (RISK GROUP 3)
16
Q
- LABORATORY TYPE: Dangerous pathogen units
- LABORATORY PRACTICES: GMT, Protective Clothing, Biohazard signs, plus special clothing, controlled access, directional airflow, plus airlock entry, shower exit, special waste disposal
- SAFETY EQUIPMENT: Class III BSC or positive pressure suits with Class II BSCs, double ended autoclave
A
BIOSAFETY LEVEL 4, MAXIMUM CONTAINMENT (RISK GROUP 4)
17
Q
Institutional and personal security measures designed to prevent the loss, theft, misuse, diversion, and intentional release of pathogens to the environment
A
BIOSECURITY
18
Q
COMPONENTS OF CHAIN OF INFECTION
A
> INFECTIOUS AGENT
RESEVOIR
PORTAL OF EXIT
MODE OF TRANSMISSION
PORTAL OF ENTRY
SUSCEPTIBLE HOST
19
Q
Pathogenic microbes, Virus, Bacteria, Fungi, Protozoa
A
INFECTIOUS AGENT
20
Q
Source of agent, a place a microbe can grow, survive, or multiply (human, animals, food, water, others)
A
RESEVOIR
21
Q
Airborne Transmission, Direct Contact, Vector Borne Transmission, Droplets
A
MODE OF TRANSMISSION
22
Q
Orifices of the body, also through the mucus membranes and breaks in the skin
A
PORTAL OF ENTRY
23
Q
Immunocompromised Adults, Elderly, Newborns, Unvaccinated, Those with acute and chronic diseases
A
SUSCEPTIBLE HOST
24
Q
- Safe handling of specimens in the laboratory
- Biohazard Signs, Universal Precautions
A
LABORATORY MEASURES
25
Complete destruction of all forms of microbial life
STERILIZATION
26
Complete elimination of vegetative forms except the bacterial forms, spores
DISINFECTION
27
Used for eliminating microorganisms from inanimate objects
DISINFECTANTS
28
Disinfection of living tissue or skin
ANTISEPSIS
29
Chemical substance used for the purpose of non-selective killing or inhibiting groups of microbes
CHEMICAL GERMICIDE
30
Chemical compound or biological product used to kill, control the growth, or repel a specific microogranism
BIOCIDES
31
Proper Order of DONNING
Gown
Mask
Headcap
Gloves
32
Proper order of DOFFING
Gloves
Headcap
Gown
Mask
33
PHLEBOTOMY/ VENIPUNCTURE MATERIALS
1. PPE
2. Cleaning Agent
3. Cotton/ Gauze
4. Bandage/ Tape
5. Sharps Container
6. Tourniquet
7. Needle
8. Tube Holder/ Vacutainer Adapter
9. Syringe
10. Blood Collection Tubes
34
Lab Gown, Mask, Headcap, Gloves
Personal Protective Equipment
35
For Disinfection or Antiseptic
Cleaning Agent
36
- Alcohol Pads are commonly used
- 70% Isopropyl alcohol are best used to disinfect the skin
For Routine Use
37
Povidone Iodine
For Blood Culture and Blood Gas
38
Water and Soap
For Alcohol Testing, Allergies
39
- To be used to disinfecting
- To cover the wound
Cotton/ Gauze
40
- Called as micropore
- To cover the wound
Bandage/ Tape
41
- To discard the needles, Lancets
- Has a biohazard marking, color red
- Puncture resistant, leak proof
- NEVER recap, bend- break needles
- Has a cutter for cutting the needle of the syringe
Sharps Container
42
- For constriction
- Slow venous blood flow
- Makes veins more prominent
Tourniquet
43
NEVER leave tourniquet for _____________
1 minute
44
AVOID rigorous fist clenching or hand pumping, ___________, _____________, _____________
Increase potassium, Lactic Acid, Lactate dehydrogenase
45
if allergic to latex can use __________________
Synthetic Fiber
46
When vein cant be located
Blind- Shooting
47
_____________ can be done at maximum of 2-3 times
Probing
48
chemical constituents to be tested
Analytes
49
for Obese, use _____________________________________ for ___________________
Blood Pressure cuff/ Sphygmomanometer, > 60mmHg
50
if there are no tourniquet or BP cuff, _______________ can be used as a tourniquet
used gloves
51
Don'ts in Needles
- NEVER reuse needles
- NEVER use if shield/ cap is broken
- NEVER recap, bend or break
52
The size of the needle is indicated by its ___________
GAUGE
53
Larger Gauge number, ___________________ the needle diameter
the smaller
54
Method of fishing out the cap using the needle to close the cap onto the needle without possibly hurting yourself
FISH OUT METHOD
55
Blue Needle
0.6 OD, 23G
56
Black Needle
0.7 OD, 22G
57
Green Needle
0.8 OD, 21G
58
Yellow Needle
0.9 OD, 20G
59
Pink Needle
1.2 OD, 18G
60
_________ needle is used for children and adults
23G
61
- Most used often with syringe
- Expensive, thus not used for routine draws
- Increased risk of needlestick injury
- Has a wing-like appendage
- For those with very fragile veins or very thin veins or
babies
Butterfly Needle
62
Parts of Needle
Bevel, Bore, Shaft, Barrel, Plunger
63
Indicates the volume of syringe
Barrel
64
- Contain a vacuum
- Made out of glass or plastic
- Used w/ vacutainer & syringe systems
- Stoppers universal color, indicates contents
- Has an expiration date
Blood Collection Tubes
65
Order of Draw
> Yellow
> Blue
> Red
> Green
> Lavender
> Gray
66
- Contains sodium polyanethole sulfate
- Used for blood culture
- Invert 8-10x
Yellow Cap Tube
67
- Contains Thixotropic Gel Separator
- Separate RBC and Formed elements from supernatant
- Used for clinical chemistry
- Invert 5x
Gold Cap Tube
68
- Contains Sodium citrate
- Used for coagulation studies
- Invert 3-4x
Light Blue Cap Tube (1:9 Blood to coagulant ratio)
Black Cap Tube (1:4 Blood to coagulant ratio)
69
- NO additives
- If plastic Invert 5 times
- If glass no inversion
- used for serum examination
Red Cap Tube
70
- Contains Heparin
- Used for chemistry exam
- Invert 8-10x
Green Cap Tube
71
- Contains EDTA (Ethylenediamine tetra acetic acid)
- Used for Hematology (CBC, Platelet Count)
- Invert 8-10x
Lavender Cap Tube
72
- Contains Sodium Fluoride
- Used Glucose Monitoring
- Invert 8-10x
Gray Cap Tube
73
- Serum Tube (5 mins coagulation)
- Contains Thrombin
- Used for Stat Exams
- Invert 5-6x
Orange Cap Tube
74
Required Information
- Patient name
- Identification number, room number
- Date of draw (mm, dd, yyyy)
- Time of draw (military time)
- Phlebotomists signature, first initial, last name
- Sex or gender
75
- Most often used
- Most economical
- Quick
- Least risk of accidental needle stick injury
Vacutainer Tube
76
- Most control
- Can reposition easily
- Will see ‘flash’ of blood in syringe when vein is
successfully entered
Syringe
77
STEPS OF VENIPUNCTURE PROCEDURE
Step 1: Review and Accession on Test Requisition
Step 2: The Patient
Step 3: Selecting the Site
Step 4: Clean and Air Dry the Site
Step 5: Prepare the Equipment
Step 6: Anchor the Vein and Insert the Needle
Step 7: Establish Blood Flow and Fill Tube or Syringe
Step 8: Fill, Remove, Mix Tubes or Fill Syringe
Step 9: Remove The Needle
Step 10: Label the Tube
78
- Check the completeness of the required information.
- Verify the test to be collected
- Take note of any dietary restriction or special condition
- Determine the test status
Step 1: REVIEW AND ACCESSION ON TEST REQUISITION
79
- Approach the patient
- Communication and empathy
- Handling special situation
- Patient Identification
> Arm Band
> Legal Document
- Prepare patient for blood draw
> Check for Latex Allergy
Step 2: THE PATIENT
80
- Antecubital area most often accessed
- Median, Cephalic, Basilic
- Hand or wrist
- Remember: 2 Arms
- Ask permission
- Apply tourniquet 3 to 4 inches or 4-5 fingers length from the puncture site.
- Using the finger. Trace the path to determine a possible puncture site
- Palpate or press the vein to determine the depth and patency
Step 3: SELECTING THE SITE
81
Vein inline with the 5th Digit (Pinky)
Basilic Vein
82
Vein inline with the 1st Digit (Thumb)
Cephalic Vein
83
- Apply tourniquet ______ inches or _______ fingers width from the puncture site.
3 to 4 Inches, 4-5 Finger width
84
2nd choice for selecting the Site
Hand or Wrist
85
Palpate or press the vein to determine the _____ and ________
Depth, Patency
86
- The selected puncture site should be cleaned using an antiseptic
- The area to be cleaned should be 2-3 inches in diameter
- Clean the site in an up and down motion with friction
- Air dry, never fan, blow or touch
Step 4: CLEAN AND AIR DRY THE SITE
87
The area to be cleaned should be _______ inches in diameter
2-3 inches
88
- Prepare equipment based on the chosen venipuncture procedure (syringe, evacuated tube system, winged infusion set)
- Size depends on:
Age of the patient
Volume of the blood needed
Size and condition of vein
Step 5: PREPARE THE EQUIPMENT
89
Size of the Equipment is based on:
- Age of the Patient
- Volume of the Blood Needed
- Size and condition of the Vein
90
- Reapply tourniquet
- Taut the skin using the thumb at least 1-2 in below to stabilize
- Position the needle at 15- 30 degrees angle or depending on the depth of the vein then insert the needle using a forward motion.
Step 6: ANCHOR VEIN AND INSERT NEEDLE
91
Taut the skin using the thumb at least _____ in below to stabilize
1-2 Inches
92
Position the needle at _____ degrees angle or depending on the depth of the vein then insert the needle using a forward motion.
15- 30 Degrees Angle
93
- When the vein is punctured, a “flash” of blood will be seen in the hub then you may pull the plunger until the desired volume is reached.
- When using the evacuated tube system, make sure to properly hold the tube holder to stabilize the needle hen press on the collection tube to penetrate the needle and collect blood.
Step 7: ESTABLISH BLOOD FLOW AND FILL TUBE OR SYRINGE
94
- Make sure to collect the required volume
- Follow the order of draw when collecting samples in ETS
- The tourniquet should be released before removing the needle
Step 8; FILL, REMOVE, MIX TUBES OR FILL SYRINGE
95
- First remove the tourniquet
- Disengage the tube
- Place cotton directly over the needle without pressing down
- Remove needle in swift, smooth motion
- Immediately apply pressure to puncture site
- Do not bend arm
Step 9: REMOVE THE NEEDLE
96
- In sight of the patient (beside)
Patient name
Identification Number
Date of Draw
Time of Draw
Initials of Phlebotomist
Step 10: LABEL THE TUBE
97
What needs to be seen in the Label
- Patient Name
- Identification Number
- Date of Draw (mm/dd/yyyy)
- Time of Draw (Military TIme)
- Initials of Phlebotomist
98
THINGS TO REMEMBER AFTER DRAWING BLOOD
- Recheck the Draw Site
- Dispose contaminated material
- Thank the Patient, remove gloves and sanitize hands
99
THINGS TO DO AFTER FAILURE
1. Look at the alternative sites
2. Use a Clean, Sterile needle
3. Only try Twice
4. After 2nd try and you fail, endorse to a different MedTech
100
POOR COLLECTION TECHNIQUES
1. Venous Stasis
2. Hemodilution
3. Clotted Sample
4. Hemolysis
5. Partially filled tube
6. Specimen Contamination
7. Specimen Handling
8. Use of Wrong Anticoagulant
101
o Prolonged application of tourniquet <1 min
Venous Stasis
102
o Drawing above IV line
o Short Draw (unbalanced blood to coagulant ratio)
Hemodilution
103
o Inadequate mixing
o Traumatic stick
Clotted Sample
104
o Traumatic stick
o To vigorous mixing
o Alcohol is wet
o Using of too small needle
o Forcing blood into syringe
Hemolysis
105
o Short draw
o Sodium citrate tube draw critical volume
Partially Filled Tube
106
o Using incorrect cleaner
o Alcohol is still wet
o Powder from gloves
o Drawing above IV
Specimen Contamination
107
o Exposure to light
o Pre- chilled tube
Specimen Handling
108
Specimen/ Procedure that is sensitive to Light Exposure
BILIRUBIN
109
Specimen/ Procedure that must be placed in a Pre-chilled Tube
Arterial Blood Gas
110
111
112
