U3 LAB: METHODS OF BLOOD COLLECTION Flashcards
Methods of Blood Collection
- Skin puncture
- Venipuncture
- Arterial blood puncture
Oxygenated blood
Arterial blood
Posture
Increase in:
- Protein
- Cholesterol
- Iron
Diurnal rhythm
Increased (morning), Decreased (afternoon)
- Cortisol
- TSH
- Iron
Decreased (morning),
Increased (afternoon)
- Eosinophil count
Exercise
Increase in:
- Creatinine
- TP
- Creatine Kinase
- Myoglobin
- AST
- WBC count
- HDL
Stress
Temporary increase (children)
- WBC Count
Diet
Affects:
- Blood glucose
- Lipid content
Smoking
Increase in:
- WBC count
- Hemoglobin levels (long term smoking)
Decrease in:
- Pulmonary function
T/F: Patient should verbally state name, gender, age, ID number, address, etc
True
Before blood collection, what is being verified and checked?
dietary restrictions, latex sensitivity
Skin Puncture
Equipment
Lancet (feathered or glucometer)
Skin Puncture
Site for adults
3rd (Middle) or 4th (Ring) finger, Earlobe
Skin Puncture
Site for children
Heel (lateral)
This is a combination of venous and arterial blood.
Capillary blood
Skin Puncture
Ideal depth
2 to 3
Skin Puncture
Too much depth will lead to?
Osteomyelitis
This refers to the inflammation of surrounding tissues of bone, and may cause bone defect and cancer.
Osteomyelitis
What must be wiped off during skin puncture?
first drop of blood
Skin Puncture
The first drop of blood must be wiped due to?
contamination with tissue juices or debris (sloughing skin)
Skin Puncture
If obtaining blood is difficult, you may use this equipment.
warm compress
Deoxygenated blood
Venous blood
Venipuncture
Preferred site
Antecubital fossa
Venipuncture
Most preferred veins
- Median Cubital vein
- Cephalic vein
- Basilic vein
Venipuncture
Largest, most anchored, stable vein and no surrounding arteries
Median Cubital vein
Venipuncture
Distal to the body, rolling, thumb is in line with this vein
Cephalic
Venipuncture
Close to the body, has a lot of nerve endings
Basilic vein
Venipuncture
First step
Find / palpate the vein
Venipuncture
Tourniquet must be applied how many inches above the puncture site?
3 to 4
Venipuncture
Maximum time for the tourniquet
1 minute
Venipuncture
More than 1 minute of tourniquet being placed on the arm will result to?
Hemoconcentration
Venipuncture
Manner of applying tourniquet
half-knot
Venipuncture
Finding the vein will be easier if patient will?
open and close hand several times
Venipuncture
Cleanse the puncture site with?
antiseptics (70% alcohol)
In culture, what is used to cleanse puncture site?
iodophores
Venipuncture
Motion of applying antiseptic
up down movement with friction in all directions
Venipuncture
The inner to outer movement for cleansing is disproved by?
Clinical and Laboratory Standards Institute (CLSI)
Venipuncture
Why is the inner to outer movement disproved?
focuses on surrounding tissues instead of actual puncture site
Venipuncture
Placing the tourniquet too low will result to?
contamination (may touch the sterile area)
Venipuncture
Placing the tourniquet too high will result to?
less anchorage to the vein
Venipuncture
Needle gauge
20-23g
Venipuncture
Ideal angle of syringe
15 to 30 deg (depends on the nature of vein)
T/F: If vein is deep, you should decrease the angle.
False
Increase
Venipuncture
Depth of syringe
0.5 to 1 cm
Venipuncture
You may loosen or remove the tourniquet during blood collection if?
vein is well anchored on the sytinge
Venipuncture
What must be removed first before the syringe?
Tourniquet
TOURNIQUET LAGI UNA!!
Venipuncture
Time for applying pressure to stop bleeding
5 to 10 minutes
In arterial puncture, you must apply pressure for?
30 minutes
T/F: Never flex arm after venipuncture.
True
Venipuncture
If bleeding is not arrested, you should apply more pressure and?
elevate the arm
Venipuncture
Inversion of EDTA
8 times with an infinity movement
Venipuncture
Best anticoagulant for hematology
spray-dried EDTA
Venipuncture
Liquid anticoagulant will result in?
dilution of plasma
Venipuncture
Powder anticoagulant will result in?
clumping
Venipuncture
Patient label must include:
- Full name (Last name, First name, middle name)
- Age
- Sex
- Date of birth
- In one line: Date, time of collection, and phlebotomist initials
T/F: Age is a more important patient identifier than date of birth.
True
Venipuncture
How to counter check patient label?
through patient and request form
Venipuncture
2 way
ask anything connected to patient (ID, bracelet) and ask them to state their names and sometimes, date of birth
Venipuncture
3 way
ask attending physician, nurse, guardian (ilagay sa likod ng request form)
These may refer to anticoagulants, antiglycolytic agents, and WBC inhibitors.
Additives
Anticoagulants
- EDTA
- Heparin
- Citrate
- Oxalate
Antiglycolytic agent
Sodium fluoride
WBC inhibitors
Sodium polyanethol sulfonate (SPS)
T/F: SPS is both an anticoagulant and WBC inhibitor.
True
Blood has bacteria, should not be clotted
Also has in vitro effect
Red top (glass)
exposed in surface area (unknown to the platelet activates its function to create clot)
Red top (plastic)
has silica (Activates platelets, converts Fibrinogen to Fibrin)
Silica causes Fibrinogen to convert to?
Fibrin
Complications
Refer to bruising, small blood on clotted tissue, only discoloration
Ecchymosis
Complications
Fainting
Syncope
Complications
Swelling
Hematoma
Complications
Prolonged/tight fitting tourniquet
Petechiae
Complications
Swelling of body fluids
Edema
Complications
Pink or red plasma, caused by wrong needle gauge
Hemolysis
Gauge for difficult collection
23g
Gauge for pediatric collection
25g
Huge gauge, ____ diameter
smaller
A huge gauge causes?
rupture of blood cells in vitro
Complications
Affected lymphatic circulation
Mastectomy
Complications
Allergies in _______ may be present
iodine, latex
Complications
Do not collect from the following:
- IV therapy
- Fistula
- Scarred or burned
Other Complications
- missed hit
- seizures or tremors
- vomiting
