Methods of Blood Collection Flashcards

(31 cards)

1
Q

What are the two methods of blood collection?

A
  • Capillary Puncture

- Venipuncture method

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2
Q

What is Capillary Puncture?

A
  • Method of blood collection by skin puncture
  • Method of choice in pediatric patients
  • Useful in adults with extreme obesity, severe burns, and thrombotic tendencies
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3
Q

What site is capillary puncture collected?

A
  • Distal phalanx of middle of ring finger
  • Middle finder is first choice
  • Can also be heel, finger, earlobe, or toe
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4
Q

What is the best method of collecting blood?

A

Venipuncture

- Relative ease makes it a primary source of specimen

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5
Q

What is the equipment necessary for Capillary puncture?

A
  • Sterile gauze pads
  • 70% ETOH or Betadine solution
  • Lancet
  • Capillary tubes or QBCstar
  • Bandage
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6
Q

What is the procedure for capillary puncture?

A
  • Arrange equipment
  • Wash hands
  • Identify, greet, reassure Pt
  • Educate Pt
  • Massage finger towards fingertip
  • Clean fingertip
  • Stab using lancet
  • Wipe away first drop of blood
  • Obtain specimen
  • Apply bandage
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7
Q

How many times do you “massage” the finger in preparation for Capillary Puncture?

A

5-6 times

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8
Q

When using the Lancet, what do you keep in mind?

A
  • Max depth of lancet should be 2 mm

- Use lancet against the grains of the fingerprint

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9
Q

Why do you wipe away the first drop of blood when performing capillary puncture?

A

Avoid dilution of the sample with tissue fluid

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10
Q

When obtaining a specimen via capillary puncture, what angle do you want to hold the tube from the finger?

A

15 degrees

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11
Q

How do you want to fill the tube when performing capillary puncture?

A
  • Place tube at 15 degrees
  • Keep tube in contact to avoid air bubbles
  • Fill tube according to manufactures directions
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12
Q

When performing venipuncture, what sites do you not want to use and why?

A
  • IV sites

It can dilute the specimen or alter test results

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13
Q

What is the equipment associated with venipuncture?

A
  • Sterile gauze pads
  • 70% ETOH/betadine solution
  • Tourniquet
  • Vacutainer needle
  • Vacutainer holder
  • Vacutainer tubes
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14
Q

What is the procedure for venipunture?

A
  • Position the Pt
  • Have Pt sitting/lying
  • Use caution so Pt does not fall from chair
  • Wash hands
  • Assemble equipment
  • Identify, great, assure Pt
  • Explain procedure
  • Apply tourniquet 2-3” above site
  • Palpate site
  • Clean site
  • Perform venipuncture
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15
Q

Detailed needle stick portion of venipunture

A
  • Use thumb to pull back skin
  • Insert needle at 15 degree angle, bevel up
  • Insert and fill vacutainer
  • Remove needle
  • Have Pt hold pressure for 3 minutes
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16
Q

What is the anticoagulant used in purple tops?

A
  • Ethylenediaminetetraacetic Acid (EDTA)
17
Q

When is EDTA typically used?

A
  • CBC

- WBC Differential

18
Q

Overview of EDTA?

A
  • Most commonly used anticoagulant
  • Chelating agent that binds calcium so blood cannot clot
  • Does not affect cellular morphology
  • Specimens can be refrigerated for approx. 24 hours
19
Q

What is the powder anticoagulant used in light blue tops?

A

Sodium Citrate

20
Q

What is Sodium Citrate commonly used for?

A
  • Prothrombin Time (PT)
  • Partial Thromboplastin Time (PTT)
  • Chelating agent that binds calcium
21
Q

What liquid or powder anticoagulant is used in green tops?

22
Q

What is Heparin used for?

A
  • Typically used for plasma studies and chemistry testing
  • Ammonia
  • Adrenocorticotropic hormone (ACTH)
23
Q

How does Heparin work?

A
  • It inhibits the clotting enzyme, thrombin, by by creating an antithrombin
  • Antithrombin prevents conversion of prothrombin into thrombin
24
Q

What is special about red tube tops and what are they used for?

A
  • No anticoagulant or additives
  • Commonly used for:
  • Chemistry
  • Serology
  • Blood bank
  • Other tests requiring serum
25
What is a Serum Separator Tube (SST)/Gold/HIV Tube used for?
- No anticoagulant - Contains serum separator gel - Primarily used for chemistry testing
26
What color top is Sodium Fluoride and what is it used for?
- Grey Tube - Used for glucose studies - ETOH analysis - Inhibits Glycolysis
27
What are some common procedural phlebotomy errors?
- Using IV sites - Prolonged application of tourniquet - Using wrong test tube - Wrong draw order - Short fill - Not mixing the tube
28
What is the proper draw order by tops?
- Blood culture tubes - Blue tops - Red tops - SST - Green top - Lavender top - Grey top
29
What are some blood draw complications?
- Syncope - Infection - Continued bleeding
30
What are issues with continued bleeding in blood draw complications?
- Anticoagulation medications - Inadequate pressure - Bending the elbow - Collapsing the vein - Failure to enter the vein - Going through the vein - Hematoma
31
Proper procedure is hematoma occurs during blood draw?
- Integrity of vein is compromised (going through the vein) - Stop procedure and apply pressure with clean gauze - Elevate arm