PPPHLEBOTOMY EQUIPMENT Flashcards
1
Q
- Patients who have their blood drawn while in a seated position
- Most have adjustable are rests to allow proper positioning
A
Phlebotomy Chairs
2
Q
- Hold all necessary equipment for proper sample collection
- In variety of styles and sizes designed to be easily carried by the phlebotomist
- Convenient for STAT or emergency, situations or when relatively few patients need blood work
A
Handheld Carriers
3
Q
- Made of stainless steel or synthetic material, usually with swivel wheels that allows smooth gliding
- Has several shelves to carry adequate supplies
A
Phlebotomy Carts
4
Q
- Used to clean the site prior to blood collection
- Prevent or inhibit the growth and development of microorganisms but do not necessarily kill them
- Considered safe to use on human skin
A
Antiseptics
5
Q
Examples of Antiseptics
A
70% ethyl alcohol
70% isopropyl alcohol (isoproраnol)
Benzalkonium chloride (e.g., Zephiran chloride)
Chlorhexidine gluconate
Hydrogen peroxide
Povidone-iodine (0.1% to 1% available iodine)
Tincture of iodine
6
Q
- Used to remove or kill microorganisms on surfaces and instruments
- Stronger, more toxic, and typically more corrosive than antiseptics and are not safe to use on human skin
- At least 10 minutes of contact time is required for bleach-based
A
DISINFECTANTS
7
Q
- Use of alcohol-based hand sanitizers for routine decontamination of hands as a substitute for handwashing
- Should not be used when hands are visibly soiled
A
HAND SANITIZERS
8
Q
- used to hold pressure over the site following blood collection procedures
- Bandages are used to cover a blood collection site after the bleeding has stopped
A
GAUZE PADS, BANDAGES & COTTON
9
Q
- Precleaned 25 x 75-mm (1 x 3-in) glass microscope slides are used to make blood films for hematology determinations
- either plain or with a frosted area at one end where the patient’s name or other information can be written in pencil
LABELING materials like pen with permanent, non-smear ink is also needed
A
SLIDES
10
Q
- Used needles, lancets, and other sharp objects must be disposed of immediately in special containers
- Most are red for easy identification
- Must be marked with biohazard symbol
- Characteristics:
✓ Rigid
✓ Puncture resistant
✓ Leakproof
✓ Disposable
✓ Locking lids
A
NEEDLE AND SHARPS DISPOSAL CONTAINERS
11
Q
- Leakproof plastic bags that are commonly used to transport blood and other specimens
- Marked with a biohazard label
- Has an outside pocket where requisitions can be placed
A
BIOHAZARD BAGS
12
Q
- Tend to be expensive
- Utilizes transillumination to make it easier to locate veins that are difficult to see or feel
- Shine high-intensity LED or infrared red light through the patient’s skin to highlight veins
- The hemoglobin in the blood within the veins absorbs the light, causing the veins to stand out as dark lines
A
VEIN-LOCATING DEVICES
13
Q
- Applied or tied around a patient’s arm prior to venipuncture
- Compresses veins to restrict blood flow
- Restriction of venous flow distends or inflates the veins, making them larger and easier to find
- Restriction of blood flow can change blood components if the tourniquet is left in place for more than one minute
A
TORNIQUET
14
Q
- Approx. 1 inch wide by 15-18 inches long
- Flat strip type are commonly used
- Should be non-latex to prevent latex allergy
- Re-using of torniquets may be prone to contamination concerns
A
TORNIQUET
15
Q
- Must be applied 3-4 inches above puncture site
- Should be applied tight enough
- Pumping of hands can result to elevated potassium levels
- Prolonged tourniquet causes hemoconcentration
A
TORNIQUET
16
Q
- Sterile, disposable, and designed for a single use only
✓ Multisample needles (ETS)
✓ Hypodermic needles (Syringe System)
✓ Winged infusion (butterfly)
A
NEEDLES
17
Q
PARTS OF A NEEDLE
A
BEVEL
SHAFT
HUB
LUMEN
18
Q
- End that pierces the vein
- Allows needle to easily slip into the skin and vein w/o coring
A
BEVEL
19
Q
Long cylindrical portion
A
SHAFT
20
Q
- End that attaches to the blood collection device
A
HUB
21
Q
- Internal space of the needle
A
LUMEN
22
Q
- Indicated by a number that is related to the diameter of the lumen
- Inversely proportional to the needle’s diameter
** the higher the gauge number the smaller the diameter of the needle - Needle gauge is selected accordingly to the size and condition of px’s vein
- 21-gauge-standard and most routine
A
GAUGE
23
Q
Collection of donor units,
autologous blood donation, and therapeutic phlebotomy
A
15-17 / Special needle attached to collection bag
23
Q
Sometimes used when large-volume tubes are collected, or large-volume syringes are used on patients with normal-size veins
A
20 Multisample
20 Hypodermic
24
Considered the standard venipuncture needle for routine venipuncture on patients with normal veins or for syringe blood culture collection
21 Multisample
21 Hypodermic
25
Used on older children and adult patients with small veins or for syringe draws on difficult veins
22 Multisample
22 Hypodermic
26
Used on the veins of infants and children and on difficult or hand veins of adults
23 Blood collection set
27
Used on the veins of infants and children and on difficult or hand veins of adults
25 Blood collection set (Thin- wall needle)
28
LENGTH (needles)
Most needles come in _____
Butterfly needles: _____
Most needles come in 1- or 1.5-in lengths
Butterfly needles: 0.5-0.75 in
29
- Provide immediate permanent needle containment
- Activated using one hand
- Resheathing devices, blunting devices, retractable needles
NEEDLE SAFETY FEATURES
30
- Used for patients with small or difficult veins
- Consist of a (1) hypodermic needle, (2) sterile plastic syringe with a Luer-lock tip
SYRINGE SYSTEM
31
- Used for collecting blood from small or difficult veins such as hand veins and veins of elderly and pediatric patients
- Allow much more flexibility and precision
- Most sets have removable Luer adapters that allow them to be used with either ETS holders or syringes
INFUSION SETS
32
_____ commonly referred as butterfly, which contains plastic extensions that resemble butterfly wings
WINGED INFUSION SET
33
- Most common, efficient, and CLSI-preferred system for collecting blood samples
- System allows numerous tubes to be collected with a single venipuncture
EVACUATED TUBE SYSTEM
34
- Allows multiple tubes of blood to be collected during a single venipuncture
- Threaded in the middle and have a beveled point on each end
- Threaded portion screws into a tube holder
Covered by a sleeve that retracts as the needle goes through the tube stopper
EVACUATED TUBE SYSTEM MULTISAMPLE NEEDLES
35
- Clear, plastic, disposable cylinder with a small threaded opening at one end
- Attaches to the needle and holds the tube for
EVACUATED TUBE SYSTEM TUBE HOLDERS
36
_____ are available permanently attached as a single unit or as both devices preassembled
Needle and tube-holder devices
37
- Collection tubes for obtaining blood
- VACUUM
*Allows automatic filling of blood due to the negative pressure
*Amount of vacuum is measured precisely by manufacturer
*Able to draw exact volume of blood indicated on the label
*Tube that has prematurely lost all or part of its vacuum will fail to properly fill blood
EVACUATED TUBE SYSTEM EVACUATED TUBES
38
EVACUATED TUBES
CAUSES OF PREMATURE LOSS OF VACUUM:
-Improper storage
-Opening the tube
-Dropping the tube
-Advancing the tube too far onto the needle before
puncture
-Bevel becomes partially out of the skin during
puncture
39
a result of premature loss of vacuum resulting to underfilled tube
SHORT DRAW
40
- Commonly used for clearing and discarding purposes
- Yield serum samples
Ex. Vacuette® gray top, BD clear top
NON-ADDITIVE TUBES
40
- Any substance placed within a tube
- Have one or more specific functions:
a. Preventing clotting
b. Preserving blood components
c. Clot activator
- Additive amount is pre-calibrated
ADDITIVE TUBES
41
- Tube caps, tops, or closures are made of a type of rubber
- Some are covered by a plastic shield
- Designed to:
✔ Prevent blood drops
✔ Prevent aerosols (mists)
✔ Prevent blood on the stopper or rim
✔ Prevents removal of stopper using a "thumb-roll" or "pop-off"
STOPPERS
42
- Identifies the type of additive placed in tube
- Indicates a special property of the tube
- Color coding is generally universal, although there might be a slight variation by the manufacturer
COLOR CODING
43
- Guarantee reliability of additives and tube vacuum until an expiration date
EXPIRATION DATES
44
- Liquid, spray-dried, and powder forms
- Powdered additive should be lightly tapped prior to use
- Must be inverted upon addition of blood sample
- Number of inversions are dependent on type of additive and manufacturer
BLOOD COLLECTION ADDITIVES
45
a specimen as this can cause hemolysis, which makes most specimens unsuitable for testing.
!! Never shake or otherwise vigorously mix
46
- Substances that prevent blood from clotting (coagulating)
1. By binding (chelating) calcium
2. Precipitating calcium
3. Inhibiting formation of thrombin
4. Preventing fibrinogen to fibrin in coagulation process
- Must be mixed immediately after collection to prevent microclot formation
ANTICOAGULANTS
47
Precipitates calcium
Potassium oxalate
48
Inhibits glycolysis
Sodium fluoride
49
Binds calcium and allows bacteria to grow for culture
Sodium polyanethol sulfonate (SPS)
50
Binds calcium
Sodium citrate / Solutions A and B (ACD) / EDTA
51
Inhibits prothrombin to thrombin
Lithium heparin / Sodium heparin / Ammonium heparin
52
Accelerates clotting
Silica/glass particles / Thrombin
53
Promotes faster centrifugation and a sample with fewer cells
Silicon
54
Natural formed clot
No additive
55
- PRINCIPLE: prevents clotting by cheating calcium
✓ Phosphate stabilizes pH
✓ Dextrose provides cells with energy
CITRATE PHOSPHATE DEXTROSE
56
- substance that enhances coagulation in tubes
- Include substances that provide surface for platelet activation
*Glass (silica)
- clot activators in SSTs (serum-
separator tubes)
- Plastic red top
*Thrombin
CLOT ACTIVATORS
57
_____ should still be mixed to avoid particles interfering with test
Tubes with clot activators
58
- provide a physical barrier between the serum or plasma in the tube and the cells
- prevents the cells from continuing to metabolize substances such as glucose in the serum or plasma
- Thixotropic Gel Separator
✓ inert (nonreacting) synthetic substance
✓ density of the gel is between that of the cells and the serum or plasma
Serum or Plasma Separator Tubes
59
- Refers to the order in which tubes are collected during a multiple-tube ETS draw
- Intended to prevent contamination of blood specimens by carryover of additives that can interfere with some tests
ORDER OF DRAW
60
ORDER OF DRAW
Yellow (sterile)
Blue (citrate)
Red (serum)
Green (heparin)
Lavender (EDTA)
Grey (oxalate)
Black
