Mod 4 Flashcards by Aubs Ganda

presence of microorganisms or their toxic products with the bloodstream

sepsis

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Prevent or inhibit the growth and development of microorganisms but do not necessarily kill them

Antiseptics

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Consideredsafetouseonhuman skin and are used to clean the site prior to blood collection

Antiseptics

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Antiseptics Used in Blood Collection

› 70% ethyl alcohol
› 70% isopropyl alcohol (isopropanol)
› Benzalkonium chloride (e.g. Zephiran
chloride)
› Chlorhexidine gluconate
› Hydrogen peroxide
› Povidone-iodine (0.1%-1% available
iodine)
› Tincture of iodine

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most commonly used antiseptic in routine blood collection

70% isopropyl alcohol (isopropanol)

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has higher degree of antisepsis; used for blood culture collection,
blood gas collection

Povidone-iodine

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Chemical substances or solutions that are used to remove or kill microorganisms on surfaces and instruments

Disinfectants

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Typically corrosive and are not safe to use on human skin

Disinfectants

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for decontaminating nonporous surfaces after
cleaning up blood or other body fluid spills in patient-care settings

1:100 dilution of sodium hypochlorite

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For spills involving large amounts of blood or other
body fluids or those that occur in the laboratory prior to cleanup

1:10 dilution of sodium hypochlorite

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If hands are heavily contaminated with organic material and hand-washing facilities are not available, it is recommended that hands be cleaned with

detergent-containing wipes followed by the use of an alcohol-based hand cleanser

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It is a device that is applied or tied around a patient’s arm prior to venipuncture to restrict blood flow

TOURNIQUET

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sterile, disposable, and designed for a single use only.

Phlebotomy needles

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• Comes in wide range of
needle lengths and
gauges
• Does not require special
training
• Can be used for blood
drawing in pediatric
population
• For patient with small or
difficult veins, blood drawing can be easier than an evacuated tube system
• If heparinized, can be used for arterial blood drawing

Hypodermic single-use needle and syringe

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• Safer than using hypodermic needle and syringe
• Eliminates blood transfer
• Allows numerous blood samples to be collected through single venipuncture

Vacuum-tube systems
Multisample needles

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• Good for blood drawing • from pediatric population or patient with small or difficult veins
• Allows better precision • than hypodermic needle or evacuated tube needle

Winged steel needles (butterfly)

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Retractable; prevent needle-stick injuries

Lancet

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indicated by a number that is related to the diameter of the
lumen.

Needle gauge

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needle’s diameter and gauge relationship

the higher the gauge number, the smaller the actual diameter of the needle

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Collection of donor units, autologous blood donation, and therapeutic phlebotomy

15-17
Special needle attached to collection bag

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Used primarily as a transfer needle rather than for blood collection; safety issues have diminished use

18
Hypodermic

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Sometimes used when large-volume tubes are
collected or large-volume syringes are used on patients with normal-size veins

20
Multisample
Hypodermic

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Considered the standard venipuncture needle for routine venipuncture on patients with normal veins or for syringe blood culture collection

21
Multisample
Hypodermic

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Used on older children and adult patients with small veins or for syringe draws on difficult veins

22
Multisample
Hypodermic

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Used on the veins of infants and on difficult or hand veins of adults

23 Butterfly

20-gauge color

Yellow

21 gauge color

Green

22 gauge color

Black

Length of most multisample needles come in

1-or 1.5-inch lengths

come in many lengths, however, 1- and 1.5-inch ones are most commonly used for venipuncture

Syringe needles

typically1⁄2 to 3⁄4 inch long

Butterfly needles

most common and efficient system and that preferred by the CLSI for collecting blood samples

evacuated tube system (ETS)

closed system in which the patient’s blood flows through a needle inserted into a vein and then directly into a collection tube without being exposed to the air or outside contaminants

EVACUATED TUBE SYSTEM

Three basic components of evacuated tube system

1) A special blood-drawing needle 2) A tube holder 3) Various types of evacuated tubes

Allow multiple tubes of blood to be collected during a single venipuncture.

Multisample needles

They are threaded in the middle and have a beveled point on each end.

Multisample Needles

A clear, plastic, disposable cylinder with a small threaded opening at one end (often also called a hub) where the needle is screwed into it and a large opening at the other end where the collection tube is placed.

Tube Holders

Used with both the ETS and the syringe method of obtaining blood specimens

BLOOD COLLECTION (EVACUATED) TUBES

amount of air removed and negative pressure created

vacuum

Evacuated tubes fill with blood automatically because there is a

Vacuum

used for clearing or discard purposes only

nonadditive plastic tubes

Has one or more specific functions, such as preventing clotting or preserving certain blood components

ADDITIVE TUBES

Tube stoppers (tops or closures) are typically made of

Rubbers

identifies a type of additive placed in the tube by the manufacturer for a specific purpose; for some tubes, it indicates a special property of the tube

stopper color

Tubes are handled properly and stored between

4 and 25°C.

Light blue

Sodium citrate Coagulation

Red

None Chemistry, Blood Bank, Serology/Immunology

Red

Clot activator Chemistry

Red/light gray

None NA (discard tube only)

Clear

Red/black (tiger) Gold Red/gold

Clot activator and gel separator Chemistry

Green/gray Light green

Lithium heparin and gel separator Chemistry

Green

Lithium heparin Sodium heparin Ammonium heparin Chemistry

Lavender (purple)

EDTA Hematology

Pink

EDTA Blood bank

Gray

Sodium fluoride and potassium oxalate Sodium fluoride and EDTA Sodium fluoride Chemistry

Orange Gray/yellow

Thrombin Chemistry

Royal blue

None EDTA Sodium heparin Chemistry

Tan

EDTA

Yellow

Sodium polyanethol sulfonate (SPS) Microbiology

Yellow

Acid citrate dextrose (ACD) Blood Bank/Immunohematology

1. Liquid 2. Spray-dried 3. Powder forms

ADDITIVE FORMS

prevents blood from clotting through chelating (or binding) or precipitating calcium so it is unavailable to the coagulation process

ANTICOAGULANTS

Common anticoagulants

Ethylenediaminetetraacetic acid (EDTA), Citrates, Heparin and Oxalates

These are combined with other additives and have additional properties for special-use situations

SPECIAL-USE ANTICOAGULANTS

SPECIAL-USE ANTICOAGULANTS examples

Acid Citrate Dextrose (ACD); Citrate Phosphate Dextrose (CPD); Sodium Polyanethol Sulfonate (SPS)

Substance that prevents glycolysis

ANTIGLYCOLYTIC AGENTS

breakdown or metabolism of glucose/blood sugar by blood cells

glycolysis

If glycolysis is not prevented, the glucose concentration in a blood specimen decreases at a rate of

10 mg/dl per hour

Antiglcolytic agent exampls

Sodium fluoride

Enhances coagulation in tubes used to collect serum specimens

CLOT ACTIVATORS

CLOT ACTIVATORS example

Silica (glass) particles, Thrombin

Inert (non-reacting) synthetic substance initially contained in or near the bottom of certain blood collection tubes

THIXOTROPIC GEL SEPARATOR

Made of materials that are as free of trace element contamination as possible

TRACE ELEMENT-FREE TUBES

This system consists of a sterile syringe needle called a hypodermic needle and a sterile plastic syringe with a Luer-lock tip

Syringe system

a special tip that allows the needle to attach more securely than a slip tip

Luer-lock tip

Come in wide range of gauges and lengths for many different uses

Syringe needles

Appropriate for phlebotomy procedures: gauges and inches

21 to 23 1- to 1.5-inch

Come in sterile pull-apart packages and are available in various sizes or volumes

SYRINGES

Most commonly used for phlebotomy syringe

2,5,and10mL

a cylinder with graduated markings in either milliliters (mL) or cubic centimeters (cc)

Barrel

a rod-like device that fits tightly into the barrel

Plunger

Allows the safe transfer of blood into the tubes without using the syringe needle or removing the tube stopper

SYRINGE TRANSFER DEVICE

Also known as butterfly

WINGED INFUSION SET

indispensable tool for collecting blood from small or difficult veins such as veins and veins of elderly and pediatric patients as it allows much more flexibility and precision than a needle and syringe

WINGED INFUSION SET

Commonly used butterfly needle gauge for phleb

23-gauge

refers to the order in which tubes are collected during a multiple tube draw ro are filled from a syringe

Order of draw

1. Sterile tube (blood culture) 2. Blue-top coagulation tube 3. Serum tube with or without clot activator, with or without gel 4. Heparin tube with or without gel plasma separator 5. EDTA tube 6. Glycolytic inhibitor tube

Order of draw color

Sterile (yellow) Light blue Red SST (yellow) PST (light green) Green lavender Gray

Minimizes chance of microbial contamination

Blood cultures (sterile collections) Yellow SPS Sterile media bottles

The first additive tube in the order because all other additive tubes affect coagulation tests

Coagulation tubes Light blue

Prevents contamination by additives in other tubes

Glass nonadditive tubes Red

Filled after coagulation tests because silica particles activate clotting and affect coagulation tests (carryover of silica into subsequent tubes can be overridden by anticoagulant in them)

Plastic clot activator tubes Red Serum separator tubes (SSTs) Red and gray rubber Gold plastic

Heparin affects coagulation tests and interferes in collection of serum specimens; it causes the least interference in tests other than coagulation tests

Plasma separator tubes (PSTs) Heparin tube Green and gray rubber Light green plastic Green

Responsible for more carryover problems than any other additive; elevates Na and K levels, chelates and decreases calcium and iron levels, elevates PT and PTT results

EDTA tubes Lavender, pink, or purple Plasma preparation tubes (PPTs) Pearl top

Sodium fluoride and potassium oxalate affect sodium and potassium levels, respectively. Filled after hematology tubes because oxalate damages cell membranes and causes abnormal RBC morphology. Oxalate interferes in enzyme reactions

Oxalate/fluoride tubes Gray

Mod 4 Flashcards

(96 cards)