Specimen Preparation, Handling, Transport & Storage Flashcards
Preanalytical Variable in Px. Preparation
Age & Gender
Diurnal Variation
Posture
Fasting
Diet
Drugs
Stress
Exercise - Transient Increase
Lactate, FA, Ammonia
Fasting Specimens
FBS
GTT
Lipid Profile
Gastrin
Insulin
Aldoterone/Renin
Over fasting - 72 hrs
Increased in Males: TAG
Decreased in Females: 45mg/dl of Glucose
Increased during standing
Albumin
Cholesterol
Aldosterone
Calcium
Increased - From Supine to Sitting
Albumin
Enzymes
Calcium
Increased - From Sitting to Supine
Proteins
Lipids
BUN
Iron
Calcium
Increased - Prolonged tourniquet application
Potassium
Proteins
Enzymes
Lactate
Cholesterol
Ammonia
Increased - Fist Clenching
Potassium
Phosphate
Lactate
Analytes Increased in AM
ACTH
Iron
Cortisol
Analytes Increased in PM
GH
ACP
Calcium is ___& decrease supine
4%
Iron decreases up to ___% during the day.
30%
Decreased cortisol level by 8:00 pm
50%
Uric acid levels peak in men in their
20s
Increase of Cholesterol/TAG per year
TG - 2mg/dL (0.02 mmol/L)
TC - 2 md/dL (0.05 mg/dL)
Sleeping patients
Should be awakened
Outpatient/Ambulatory Patient is counterchecked with:
Driver’s License or Valid ID with photo
3 ways of ID
Positive ID: Verbal ID statement
Passive ID: Check ID band
Comparison of labeled specimen with px. ID before leaving
Average human blood
5 quartz (4.73 L)
Venous Blood
Deoxygenated, Dark Red Color
Most Common Site for Venipuncture
Antecubital fossa - (1) Median (2) Cephalic (3) Basilic
CLSI Recommended site for Venipuncture
Median Cubital Vein
international Standard - A backflow is first seen in the ______________
Flash window of the Needle hub
Note: If no flash window in the choices, answer - needle hub
Most common Antiseptic
70% Alcohol
Used for Ethanol Testing
Benzalkonium chloride/Zephiran Chloride (1:750)
CLSI recommended - blood culture, Infants, Iodine Sensitivity
Chlorhexidine gluconate
Tourniquet Application
3-4 (7.5-10 cm) inches ABOVE the site for <1 minute
CLSI - Tourniquet Reapplication
2 minutes
Bacteria transmitted due to Reusable tourniquets
MRSA - Methicillin-resistant Staphylococcus aureus
10% contamination of 5% glucose increase glucose by _____ mg/dL
500 mg/dL
Needle Angle (Veni)
<30 degrees
15-30 degree
Needle - Yellow Cap gauge
20 gauge
Needle - Green Cap Gauge
21 gauge
Needle - Black Cap Gauge
22 gauge
Standard gauge for Venipuncture
21 gauge
Pediatric/Small veins needle gauge
23 gauge
Blood Letting Gauge
16-G
Lumbar puncture needle gauge
18-G
25-G
Infants/Neonates/Blood from Scalp needle Gauge
Routine Needle Length
1-1.5 inches
Butterfly Needle Length
1/2 - 3/4 (0.5-0.75) inch
Cause of Hemolysis
Prolong tourniquet application
Alcohol contamination
Small needle bore
Agitation
Frothing/Bubbling
Lancet Length
Disposable: ________
Non-disposable: ______
Rodriguez - _____
NCBI - _____
Lancet Length
Disposable: 0.75 mm
Non-disposable:
1.75 mm (Rodriguez)
2.8 - 3.2 mm (NCBI)
Most Routine Site for Capillary Puncture
4th Finger
Sites to avoid in Capillary Puncture
Thumb
5th Finger
Depth of Puncture
Children/Adults
<2.0/2-2.5 mm
Detected analytes in Arterialized Capillary Blood
pH
pCO2
Preferred site for Arterialized Capillary Blood
Earlobe
First microcollection tube to be filled in Skin puncture
EDTA/Lavander
Order of Draw - Skin Puncture
(B)lood gases
(S)lides
(ED)TA
(O)ther microcollection tubes
(S)erum container