Phlebotomy Flashcards
Laboratory Test
Requisitions / Orders
Patient identification (2 unique identifiers)
* Examples:
* Patient’s gender, date of birth or age
* Name of physician or legally authorized person ordering the test
* Tests requested
* Time and date of specimen collection
* Phlebotomist initials or signature*
* Source of specimen
* Other pertinent clinical information when appropriate
* A “STAT” Request
– In cases of emergency
– Document the request appropriately
Labels must include:
– Patient ID (minimum 2 identifiers)
– Date and time of collection
– Phlebotomist’s initials or signature
Blood Tube Draw Order
Blood cultures
Blue - Sodium Citrate
Red
Gold
Mint Green - Lithium Heparin
Green - Sodium Heparin
Lavander - EDTA
Gray - Sodium Floride
Dark Blue - K2EDTA
The patient has the right to
– Impartial access to treatment or accommodations regardless
of race, creed, sex, national origin, or sources of payment.
– Considerate, respectful care
– Confidentiality of all communications and other records
pertaining to patient care
– Reasonable informed participation in care
– Refuse treatment
– Request & receive and itemized bill
– Be informed of hospital rules and regulations regarding
conduct
Legal considerations
Performing venipuncture against a
patient’s will is considered assault and
battery
* Failure to identify a patient, or
misidentifying a patient can also have
legal consequences
* Misidentification of a blood bank
specimen can have lethal results
* Lawsuits have occurred in which a
phlebotomist has been charged with
harming a patient
– Nerve damage can occur if a patient
expresses extreme pain and the draw is
continued
– Always end a draw if asked to by a patient
Anatomy of the Arm for Venipuncture
2nd * Cephalic vein runs
along outside of arm
1st* Median antecubital
runs through center
of inner elbow
last* Basilic vein runs
along inside of arm
Pink top tube
– Contains EDTA
– Used for
confirmatory blood
bank testing
Lavender top tube
– Contains ethylenediamine
-tetraacetic acid (EDTA)
– Chelates/binds calcium to
prevent coagulation
– Used for hematology
(CBC, reticulocytes,
sedimentation rates,)
blood bank, immunology
(cyclosporin or tacrolimus
levels)
Green top tube
– Contains sodium
heparin or lithium
heparin
– Inactivates blood
clotting factor
thrombin
– Used for chemistry
tests
* e.g. complete
metabolic set, renal
function set, ammonia
* Must be placed on ice
for ionized calcium
Dark Blue top tube
– Contains K2EDTA or
no additive
– Used for trace
element testing and
heavy metals (zinc,
lead)
Light Blue Top Tube
- Light blue top
– Contains sodium citrate 3.2%-
anticoagulent
– Must completely fill
– Used for coagulation tests - PT/INR, PTT, fibrinogen,
Factor VIII, Russell Viper
Venom Time (screen for
lupus anticoagulant)
– 1:9 ratio of anticoagulant to
blood required - If short draw- coagulation
time is prolonged
- Yellow Isolator Tube
- Contains lysing and
anticoagulant
agents - Used for detection
of specific
microorganisms
such as yeast,
fungae and
mycobacteria
Blood Culture Bottles
- Contain broth
mixture - Require special
cleaning procedure - Aerobic and
anaerobic bottles
should be drawn - Used to detect
bacterial infections in
the blood
Grey top tube
– Contains sodium
fluoride and
potassium oxalate-
weak anticoagulant
that prevents
glycolysis
– Used for glucose
tolerance tests, lactic
acid test
– Low-filling tubes,
require just 1 mL of
blood
Yellow Top tube
- Contains either-
SPS or Acid Citrate
Dextrose (ACD) - SPS = blood culture
specimens (sodium
polyanethaol sulfonate) - ACD = Used for
tissue typing and
DNA testing
