Specimen Collection And Handling Flashcards
Tube used for finger sticks use tubes with the smallest volume necessary for testing to prevent iatrogenic anemia/hospital acquired anemia
Lancets
Tube used for coagulation studies (PT or PTT)
Light blue or blue
Additives of light blue top
Sodium citrate
Thrombin and soybean trypsin inhibitor
Test affected by additive carry over in light blue top
Citrate
ALP
Calcium
Phosphorus
Tube used in routine chemistries, therapeutic drug levels, immunohematology, and serology
Red (Glass)
Additive of Red (plastic) tube
Clots activator (silica)
Test affected by additive carry over in red (plastic)
Silica
Partial thromboplastin time
Protime
Additive of Red/Black (tiger) Gold Red/Gold tube
Clot activator and gel separator
Additive of Green/Gray Light green tube
Lithium Heparin and Gel separator
Tube used for routine and special chemistry and cytogenetic testing
Green/Gray Light green
Additive of Green tube
Lithium heparin
Sodium Heparin
Test affected by additive carry over
Heparin
Activated clotting time
ACP
Calcium
Sodium
Lithium
Partial thromboplastin
Protime
Best anticoagulant for hemolysis prevention and for STAT sample
Heparin
Tube used in hematology for complete blood count, slide preparation, routine hematology procedures\ immunohematology and some special chemistry assays
Lavender or pink top
Additives of Lavender or pink top
EDTA/thylenediaminetetraacetate
Tests affected by additive carry over
EDTA
ALP
Ca
K
Fe
Sodium
CK
Partial thromboplastin
Protime
EDTA when used in electrolytes will increase:
Sodium and potassium
EDTA when used in electrolytes will decrease:
Calcium and Fe
Tube used to inhibit glycolysis
Gray top
Additive of gray top
Sodium fluoride and Potassium oxalate
Sodium Fluoride and EDTA
Sodium Fluoride
Additives that prevent fermentation of glucose
Sodium fluoride and Potassium oxalate
Sodium Fluoride and EDTA
Sodium Fluoride
Distorts RBC morphology
Oxalates and sodium fluoride
Tests affected by additive carry over
Oxalates
ACP and ALP
Ca
K
LD
Partial thromboplastin
Protime
Sodium Fluoride
Na
Additive of Orange Gray/Yellow top
Thrombin
Tube used in chemistry and toxicology
Royal blue top
Additives of royal blue top
None (red label)
EDTA (Lavender label)
Sodium Heparin (Green label)
Additives of Tan (glass tube) and Tan (plastic)
Yellow tube
Sodium Heparin
EDTA
Additives of yellow tube
Sodium Polyanethol sulfonate (SPS)
Acid Citrate Dextrose (ACD)
Tube used in WBC preservative
Yellow tube
Tubes w/gel are not used for:
ImmunoSero
Blood bank
Trace Metals
TDM
Tube colors with EDTA:
Lavender (glass and plastic)
Pink
White
Royal blue
Tan (plastic)
Tubes that chelates calcium
EDTA
Sodium citrate
All tubes with EDTA + blue, light blue
Tubes that inhibit thrombin formation
Lithium Heparin
Sodium Heparin
Light green
Green
Black
Royal blue
Tubes with clot activator
Red (plastic/hemogard) (Silica)
Red/gray and gold (Silica)
Yellow/Gray and orange
Tube that acts fibrin degradation product
Light blue
Tube used for blood bank, microbiology, HLA phenotyping and Paternity testing
Yellow tube
Order vein choice
Median
Cephalic
Basilic
Anchored and less painful vein
Median
Vein common in obese patients
Cephalic
Vein near cutaneous nerve and brachial artery and painful
Basilic
These are symptoms of nerve puncture:
Electric shock
Arm numbness
Burning
Pain radiating up or down
Problem sites in venipuncture
Burn, scars or tattooed
Damaged veins
Edema
Hematoma
Mastectomy
Lymph removed
It inspects an organ by passing light thru its wall LED or infrared light
Transillumination
If blood pressure cuff used in venipuncture
60 mmHg
Angle in venipuncture
15-30 degrees
Angle of deep vein
High angle
Angle of not too deep vein
Low angle
It introduces a tissue factor then factor 7 activates then PT will shorten. Possible nerve damage.
Probe fishing
Length of needle in venipuncture
1 or 1.5 inches
Antiseptic for ethanol testing
Benzalkonium chloride
Standard needle for venipuncture
21 gauge
Causes of collapse vein
Too much vacuum
Quick pull of plunger
Tight tourniquet or close to the site of puncture
Order of draw of venipuncture
Blood culture
Citrate
Red (glass)
Red (plastic)
Heparin
EDTA
Sodium fluoride
The most common cause of carry over
EDTA
The transfer of one additive/specimen to another thru needle contact causing contamination
Carry over
It means to detect errors and to minimize clerical errors
Bar code labels
Postphlebotomy Neurologic complications
Diaphoresis
Seizure
Pain
Nerve damage
Most common complication in blood
Ecchymosis (Bruise)
In pediatric venipuncture, how many percent of loss of blood that can lead to shock and cardiac arrest
10%
Arterial puncture is used for:
Blood gas and pH
Test conducted prior to collection in arterial puncture
Modified Allen test
Unacceptable sites in arterial puncture
Irritated, edematous, near a wound, or area with fistula
Length of lancet in skin puncture
1.75mm
Depth of incision in skin puncture
<2.0mm in infants
<2.5mm in adults
Preferred sites in skin puncture
Lateral plantar heel (newborn)
3rd and 4th fingers
Earlobes (least site)
Order of filling microtainer
Blood gas analysis
Slides
EDTA
Other tubes with additives
Non-additive tubes
Used for measuring pH and pCO2 but not pO2
Arterialized capillary blood
Preferred site of arterialized capillary blood
Earlobes
In arterialized capillary blood, don’t perform if arterial BP is below:
95 mmHg
Often created when multiple tests are ordered on a single specimen.
Aliquot
In case of delay, most samples are refrigerated at:
4°C for 8 hrs
Cell lysis and slight elevation of LD and K
Excessive centrifugation
Causes of hemolysis
Too small needle
Fast pulling of plunger
Fast transfer of blood to tube
Shaking tube vigorously
Blood collected before alcohol dried
Rimming
Causes hemolysis and aerosol infection
Rimming
Any test used as evidence in legal proceedings; e.g., blood alcohol, drug screens, DNA analysis. Procedure to guarantee integrity of specimens to court, e.g., legal blood alcohol, drug test.
Chain of custody