Specimen Collection Flashcards
GENERAL PRECAUTIONS IN
COLLECTION OF BLOOD SAMPLES:
Never remove syringe without removing the tourniquet first because it can cause hematoma
Avoid prolonged tourniquet because it can cause hemaconcentration
Blood specimen must obtain in the appropriate containers in each specific test
Blood specimen collected in anticoagulant must well mixed to prevent coagulation
are usually collected early in the morning but can
be collected throughout the day during scheduled “sweeps”
(collection times) on the floors or from outpatients.
Routine sample
means “as soon as possible.” The response time for
the collection of this test sample is determined by each hospital or
clinic and may vary by laboratory tests.
ASAP SAMPLES
sample is to be collected, analyzed, and results
reported immediately.
Stat samples
Types of
Sample
Fasting samples
Timed sample
Blood cultures
Collection priorities
Routine sample
Asap sample
Stat sample
Fasting samples other called
Non per orem
Non per orem means
Nothing by mouth
Fasting sample example
Fasting blood sugar
Lipid profile
Timed samples example
Glucose tolerance test
2 hour oral glucose tolerance test
Lactose tolerance test
has Plasma and formed elements
(unclotted)
Whole blood
Formed elements are
Rbc
Wbc
Platelets
Buffy coat has
Wbc
Platelets
Plasma contain such as
Albumin
Globulin
Fibrinogen
Liquid portion of unclotted
blood
Plasma
Liquid portion With anticoagulant
Plasma
Liquid portion Without anticoagulant
Serum
Liquid portion of clotted blood
Serum
Serum contain such as
Albumin
Globulin
is collected directly into the
evacuated tube, eliminating the need for
transfer of specimens and minimizing the
risk of biohazard exposure
Blood
Blood is collected directly into the
evacuated tube, eliminating the need for
transfer of specimens and minimizing the
risk of biohazard exposure
Evacuated tube system
Evacuated tube system include
Double pointed needle
Needle holder
Color coded evacuated tube
refers to the diameter
of the needle bore.
Needle gauge
The smaller the gauge number the
___________the diameter of the needle.
Bigger
Needles should be visually examined
before use to determine if any
structural defects, such as
Nonbevel point
Bent shaft
made of rigid plastic and may be designed to act as a safety shield for
the used needle
Needle holder
To protect phlebotomists from
accidental needlesticks by
contaminated needles
Needle disposal system
Needle disposal system should be
Leak proof
Puncture resistant
Labeled biohazard
Easily sealed lock when full
also known as Vacutainers and are
available in glass and plastic
Evacuated tube
Evacuated tube also known as
Vacutainers
Contain a premeasured amount of vacuum
for blood collection
Evacuated tube
The amount of blood collected in an
evacuated tube ranges from ______________
and is determined by the size of the tube
and the amount of vacuum present.
1.8 to 15 mL
Order of draw
Blood cultures (yellow stopper tubes, culture bottles)
Light blue stopper tubes (sodium citrate)
Red/gray, gold stopper tubes (serum separator tubes), red stopper plastic tubes (clot
activator), and red stopper glass tubes
Green stopper tubes and light green (plasma separator tubes) (heparin)
Lavender stopper tubes (EDTA)
Gray stopper tubes (potassium oxalate/sodium fluoride)
Yellow/gray or orange stopper tubes (thrombin clot activator)
For single draw
Syringe
Syringe Routinely used for venipuncture range
from _____ to ______ mL
2 to 20 ml
For drawing blood from patients with
small or fragile veins.
Syringe
Parts of a
Syringe
Plunger
Barrel
Plain tip needle
Hub
Needle
Shaft
Lumen
Bevel
for performing venipuncture from
very small or very fragile veins
often seen in children and in the
geriatric population
Winged blood collection set
Has powdered and powder-free,
and latex and nonlatex
Gloves
Example of nonlatex
Vinyl, nitrile, neoprene and polyethylene
can be
worn under latex gloves for
persons that develop an
allergic dermatitis to gloves
Cotton gloves liners
use high-intensity
LED lights that shine
through the patient’s
subcutaneous tissue
Venoscope II and neonatal transilluminator
Cotton glove liners can be
worn under latex gloves for
persons that develop an
____________ to gloves
allergic dermatitis
highlight the veins
by absorbing the
light rather than
reflecting it
Venoscope II & Neonatal
Transilluminator
Requisition
Thru phone
Doctor’s requisition
Checking Requisition forms
- Patient’s name, age and gender
- Patient’s date of birth
- Patient’s location
- Ordering health-care provider’s name
- Tests requested
- Requested date and time of sample collection
Ideal time
Basal state
Positioning the Patient
Supine
Sitting upright
Position of the Phlebotomist
Standing position
Tourniquet application -maximum amount of time
1 min
The preferred site for venipuncture and is located anterior and below the bend of the elbow.
Antecubital fossa
vein of choice because it is large and does not tend to move when the needle is inserted
Median cubital vein
Usually more difficult to locate, except possibly in larger patient and has more tendencies to move
Cephalic cubital vein
the least firmly anchored; has a tendency to “roll” and hematoma formation is more likely to occur.
Basilic vein
3 major vein
Median
Cephalic
Basilic
includes the cephalic, median
cubital, and basilic veins in a pattern
that looks like a slanted H.
H - shaped pattern
Includes the cephalic, median
cephalic, median basilic, and basilic
veins.
M shaped pattern
Areas to Be Avoided
• Damaged Vein
• Hematoma
• Edema
• Burns, Scars and Tattoos
• Mastectomy
• Obesity
• IV Therapy
• Heparin and Saline Locks
• Cannulas and Fistulas
Angle needle
15-30 degree
Labeling the tubes
- Patient’s name and identification number
- Age and Gender of the Patient
- Date and time of collection
- Phlebotomist’s initials
Reasons for sample rejection:
• Unlabeled or mislabeled samples
• Inadequate volume
• Collection in the wrong tube
• Hemolysis
• Lipemia
• Clotted blood in an anticoagulant tube
• Improper handling during transport, such as not chilling the
sample
• Samples without a requisition form
• Contaminated sample containers
• Delays in processing the sample
• Use of outdated blood collection tubes
Remedy: One minute application of tourniquet
localized hemaconcentration or Venous stasis
Remedy: Let the patient lie down
Fainting or syncope
Failure to obtain blood
Needle Position
Bevel Against the Wall of the Vein
Needle Too Deep/ Too Shallow
Collapsed Vein
Needle Beside the Vein
Faulty Evacuated Tube
Formation of blood clots
inside the lumen of the vein due to trauma
Thrombosis in vein
Inflammation of the vein due
to thrombus as manifested by an inflammatory
reaction on the outer skin surface
Thrombophlebitis
Blue or black skin discoloration
commonly due to repeated trauma or puncture
of the veins
Hematomas
Hematoma error
Failure to remove
the tourniquet
before removing the
needle
Applying inadequate
pressure to the site
after removal of the
needle
Bending the arm
while applying
pressure
Excessive probing to
obtain blood
Failure to insert the
needle far enough
into the vein
Inserting the needle
through the vein
Selecting a needle
too large for the
vein
Using veins that are
small and fragile
Accidentally
puncturing the
brachial artery
Hemolysis: Errors
• Applying the tourniquet too close to the
puncture site or for too long
• Using fragile hand veins
• Performing venipuncture before the alcohol
is allowed to dry
• Collecting blood through different internal
diameters of catheter and connectors
• Partially filling sodium fluoride tubes
• Readjusting the needle in the vein
Generally used for the determination of blood oxygen, carbon dioxide
tension and blood pH
Arterial puncture
Blood collected is called in blood gas analysis
Arterial blood or oxygenated blood
