- Point of care testing - Glucose monitoring (glucometer)

EQUIPMENT Flashcards by test knowledge

Capillary Puncture

Skin puncture
Dermal puncture
Microsampling

How well did you know this?

Not at all

Perfectly

Obtaining drips of blood from puncturing or maming an incision in the capillary bed

Capillary puncture

How well did you know this?

Not at all

Perfectly

Capillary puncture preferred sites

Lateral plantar heel surface
Palmar surface of the fingers (3rd and 4th)
Plantar surface of the big toe
Earlobes - least site

How well did you know this?

Not at all

Perfectly

Capillary puncture sites not recommended or should be avoided

Central arch area of an infants heel

Fingers of newborn or infant, 1 y.o

Thumb, index and 5th fingers

Fingers on the side of masectomy

With scarred areas

How well did you know this?

Not at all

Perfectly

Capillary Puncture
Obtaining drops of blood from puncture or making an incision in ___

the capillary bed

How well did you know this?

Not at all

Perfectly

Capillary Puncture

Indications for Capillary Puncture:

Small amounts of blood are acceptable to be use for
testing

How well did you know this?

Not at all

Perfectly

Capillary puncture
Suitable for adult and older children:

Fragile veins/ for chemo

Unsuccessful venipuncture

Patient has thrombotic or clot forming tendencies

 Patient is apprehensive or has fear of needles

 No accesible veins (IV, SCARRED, BURNED)

 POCT procedures

How well did you know this?

Not at all

Perfectly

fluid in tissues

interstitial fluid

How well did you know this?

Not at all

Perfectly

fluid in cells

intracellular fluid

How well did you know this?

Not at all

Perfectly

Capillary blood has a ____ of ____ than ________

CAPLLARY
BLOOD HAS A
HIGHER PROPORTION
OF ARTERIAL BLOOD
THAN VENOUS BLOOD

How well did you know this?

Not at all

Perfectly

Capillary puncture

A mixture of ___,____, and ____ with ____ and _____

arterial, venous, and capillary blood with interstitial fluid and intracellular fluid

How well did you know this?

Not at all

Perfectly

Capillary puncture

Reference value of ___ is different from ____

Reference value of capillary is different from venous blood

How well did you know this?

Not at all

Perfectly

PREFERED SITES IN NEWBORN

● Lateral plantar heel surface

How well did you know this?

Not at all

Perfectly

PREFERED SITES IN ADULTS

● Palmar surfaces of the fingers (3rd and
4th)

How well did you know this?

Not at all

Perfectly

LAST OPTION IN THE PREFERED SITES

Earlobes

How well did you know this?

Not at all

Perfectly

COMMONLY LOW
IN CAPILLARY
BLOOD

TOTAL PROTEIN
CALCIUM
POTASSIUM

How well did you know this?

Not at all

Perfectly

COMMONLY HIGH IN
CAPLLARY
BLOOD

GLUCOSE

How well did you know this?

Not at all

Perfectly

avoided because of Pulse

Thumb

How well did you know this?

Not at all

Perfectly

POCT procedures

Point of care testing
Glucose monitoring (glucometer)

How well did you know this?

Not at all

Perfectly

avoided because of Bone fracture

5th finger

How well did you know this?

Not at all

Perfectly

avoided because of Callus

Index

How well did you know this?

Not at all

Perfectly

Preferred method for infants and very young children

● Infants have a small blood volume
(anemia) (bc of veni)
● Large quantities of blood removed can
result to cardiac arrest
● Venipuncture may damage veins and
surrounding tissues
● Puncturing deep veins can result to
hemorrhage, venous thrombosis,
infection, and gangrene
● Restraining method can injure an infant
or child
● Preferred specimen for some tests
(NBS)

How well did you know this?

Not at all

Perfectly

Large quantities of blood removed can
result to

cardiac arrest

How well did you know this?

Not at all

Perfectly

Venipuncture may

damage veins and
surrounding tissues

How well did you know this?

Not at all

Perfectly

Infants have ___

a small blood volume

Puncturing deep veins can result to

hemorrhage, venous thrombosis, infection, gangrene

can injure an infant or child

Restraining method

Preferred specimen for some tests

Newborn screening test

Order of filling microsampling

● EDTA → Other additive tubes → Serum tubes

CAPILLARY PUNCTURE IS NOT APPROPRIATE FOR PATIENTS WHO ARE

DEHYDRATED OR HAVE POOR CIRCULATION TO THE EXTREMITIES

Person who can benefit CAPILLARY PUNCTURE

● Pediatric children- sample volume limited ● Obese patients ● Chemotherapeutic patients ● Burn patients

TEST THAT CANNOT BE PERFORMED BY CAPILLARY PUNCTURE

● ESR ● Coagulation studies (CITRATE TUBE) ● Blood cultures (NEED OF HIGH BLOOD VOLUME = HUGH DETECTION) ● Tests that require large volumes of serum or plasma

EQUIPMENTS FOR CAPILLARY PUNCTURE (7)

● Blood collection supplies and equipment (general) ● Lancets/Incision device/Laser lancets ● Microcollection containers ● Microhematocrit tubes and sealants ● Capillary Blood Gas equipment ● Microscope Slides ● Warming devices

(CITRATE TUBE)

Coagulation studies

Laser/Incision devices: Length of lancet:

1.75 mm

Lancets/Incision devices

● Sterile and disposable ● Sharp pointed or bladed instrument ● Purpose: PUNCTURE/INCISION TO COLLECT BLOOD ● How to select what lancet to use: AGE, SITE, VOLUME, PUNCTURE DEPT ● Finger puncture or heel puncture

WHO REQUIRED LANCET SAFETY FEATURE THAT SHOULD HAVE A PERMANENTLY RETRACTABLE BLADE OR NEEDLE POINT TO REDUCE RISK OF SHARPS INJURY?

Occupational Safety and Health Administration (OSHA)

Laser/Incision devices: Depth of incision:

 Infants and children: <2.0 mm  Adults: <2.5 mm

Laser/Incision devices: Distance from skin surface to bone or cartilage:

1.5 - 2.4 mm.

LASER LANCETS

Perforating skin with a laser instead of sharp instrument

PUNCTURES SHOULD NOT BE MADE MORE THAN ____ DEEP FOR INFANTS; FOR ADULTS _______ DEEP

2.5 mm ; 2-3 mm

how laser lancets work?

vaporates water in the skin to produce a small hole in the capillary bed without destrying delicate capilaries

Microtubes

MICROCOLLECTION LANCETS

advantages of laser lancets

no sharps injury and disposal

laser lancets are usually used on?

on fingers for adults and children 5 years of age and older

Special small plastic tubes used to collect the tiny amounts of blood obtained from capillary puncture

MICROCOLLECTION LANCETS

“Bullets”

MICROCOLLECTION LANCETS

Markings for minimum and maximum fill levels (uL)

MICROCOLLECTION LANCETS

Color coded bodies or stopper with additives present

MICROCOLLECTION LANCETS

Lot numbers and expiration date on tubes

MICROCOLLECTION LANCETS

MICROCOLLECTION LANCETS Markings for minimum and maximum fill levels (uL)

250 uL - 500uL

true or false ORDER OF DRAW IS NOT THE SAME AS FOR VENIPUNCTURE

TRUE

you can use microcollection container instead of tubes if you have ______ and label as ______

short draw vein venous blood

ORDER OF DRAW

● Skin releases Tissue thromboplastin (Activates coagulation process in the blood) ● Hematology specimen first (unclotted sample) ● Serum specimen last (clotted sample)

Activates coagulation process in the blood

Skin releases Tissue thromboplastin

Hematology specimen first

SAMPLE ACTIVATES THE COAGULATION NEEDS TO BE UNCLOTTED

Serum specimen last

SAMPLE NEEDS TO CLOT

Order of draw quick collection minimizes __________

minimizes platelet clamping and microclot formation

Order of draw right collected amount before site stops ______

bleeding

CLSI

Clinical Laboratory Standards Institute

CLSI ORDER OF DRAW for CAPILLARY SPECIMEN

Blood gas specimen (Heparin tubes) EDTA specimen (Hematology) Other additives specimens Serum Specimens Newborn Screening Test ( collected separately)

capillary blood collection order

blood gas EDTA Lithium heparin Lithium heparin with gel separator Sodium Flouride/ Potassium Oxalate Serum - Clot activator Serum (No additive) NBS

MIx Blood gas

Cap ends between palms to mix

mix EDTA

MIX LITHIUM HEPARIN WITH GEL SEPARATOR

MIX LITHIUM HEPARIN

MIX SODIUM FLOURIDE/ POTASSIUM OXALATE

MIX SERUM - CLOT ACTIVATOR

SERUM NO ADDITIVES

COLLECTED SEPARATELY

NEWBORN BLOOD SPOT CARD

Disposable, narrow-bore plastic or plastic-clad glass capillary tubes

microhematocrit tube

capilet

microhematocrit tube

use of microhematocrit tube

measure hematocrit measurement

microhematocrit tube red or green

blood collected directly to capillary

microhematocrit tube plain or blue

collect from EDTA

Microhematocrit tubes can hold ______ of blood to infant & child anemia screening and pediatric patients

9 uL

microhematocrit sealants

plasticor clay seal one end of microhematocrit tube and the side you didnt touch dry end of tube was inserted into the clay to plug it

Capillary blood gas equipment

CBG COLLECTION TUBES STIRRERS MAGNET PLASTIC CAPS

Long thin narrow-bore capillary tubes

CBG COLLECTION TUBES

heparin ammonium

red and green

CBG COLLECTION TUBES

● 100 mm in length, 100uL capacity (plastic made) ● Color coded band (green for sodium heparin) ● Long thin narrow-bore capillary tubes

AID IN MIXING ANTICOAGULANTS

STIRRERS

SMALL METAL FILINGS/BARS

STIRRERS

FLEA

STIRRERS

MAGNET

BACK AND FORTH MOVEMENT MIXING THE SPECIMEN (STICKS TO THE STIRRER)

PLASTIC CAPS

Sealing of CBG tubes and maintaining anaerobic condition

MICROSCOPE SLIDES

FROSTED /NON FROSTED Making blood films for hematology determination

WARMING DEVICES purpose

increase blood flow as much as 7 times on the site

WARMING DEVICES Temperature that does not exceed

42C

WARMING DEVICE ● _______ OR ______ dampened with warm tap water

Towel or diaper

Capillary Puncture: Equipment

Laser Lancets Microcollection lancets Order of draw Microhematocrit tube and sealants Capillary blood gas equipment Microscope slides Warming device

EQUIPMENT Flashcards

(91 cards)