Specimen Collection Flashcards by Loui Mojica

GENERAL PRECAUTIONS IN
COLLECTION OF BLOOD SAMPLES:

Never remove syringe without removing the tourniquet first because it can cause hematoma

Avoid prolonged tourniquet because it can cause hemaconcentration

Blood specimen must obtain in the appropriate containers in each specific test

Blood specimen collected in anticoagulant must well mixed to prevent coagulation

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are usually collected early in the morning but can
be collected throughout the day during scheduled “sweeps”
(collection times) on the floors or from outpatients.

Routine sample

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means “as soon as possible.” The response time for
the collection of this test sample is determined by each hospital or
clinic and may vary by laboratory tests.

ASAP SAMPLES

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sample is to be collected, analyzed, and results
reported immediately.

Stat samples

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Types of
Sample

Fasting samples
Timed sample
Blood cultures

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Collection priorities

Routine sample
Asap sample
Stat sample

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Fasting samples other called

Non per orem

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Non per orem means

Nothing by mouth

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Fasting sample example

Fasting blood sugar
Lipid profile

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Timed samples example

Glucose tolerance test
2 hour oral glucose tolerance test
Lactose tolerance test

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has Plasma and formed elements
(unclotted)

Whole blood

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Formed elements are

Rbc
Wbc
Platelets

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Buffy coat has

Wbc
Platelets

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Plasma contain such as

Albumin
Globulin
Fibrinogen

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Liquid portion of unclotted
blood

Plasma

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Liquid portion With anticoagulant

Plasma

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Liquid portion Without anticoagulant

Serum

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Liquid portion of clotted blood

Serum

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Serum contain such as

Albumin
Globulin

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is collected directly into the
evacuated tube, eliminating the need for
transfer of specimens and minimizing the
risk of biohazard exposure

Blood

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Blood is collected directly into the
evacuated tube, eliminating the need for
transfer of specimens and minimizing the
risk of biohazard exposure

Evacuated tube system

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Evacuated tube system include

Double pointed needle
Needle holder
Color coded evacuated tube

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refers to the diameter
of the needle bore.

Needle gauge

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The smaller the gauge number the
___________the diameter of the needle.

Bigger

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Needles should be visually examined before use to determine if any structural defects, such as

Nonbevel point Bent shaft

made of rigid plastic and may be designed to act as a safety shield for the used needle

Needle holder

To protect phlebotomists from accidental needlesticks by contaminated needles

Needle disposal system

Needle disposal system should be

Leak proof Puncture resistant Labeled biohazard Easily sealed lock when full

also known as Vacutainers and are available in glass and plastic

Evacuated tube

Evacuated tube also known as

Vacutainers

Contain a premeasured amount of vacuum for blood collection

Evacuated tube

The amount of blood collected in an evacuated tube ranges from ______________ and is determined by the size of the tube and the amount of vacuum present.

1.8 to 15 mL

Order of draw

Blood cultures (yellow stopper tubes, culture bottles) Light blue stopper tubes (sodium citrate) Red/gray, gold stopper tubes (serum separator tubes), red stopper plastic tubes (clot activator), and red stopper glass tubes Green stopper tubes and light green (plasma separator tubes) (heparin) Lavender stopper tubes (EDTA) Gray stopper tubes (potassium oxalate/sodium fluoride) Yellow/gray or orange stopper tubes (thrombin clot activator)

For single draw

Syringe

Syringe Routinely used for venipuncture range from _____ to ______ mL

2 to 20 ml

For drawing blood from patients with small or fragile veins.

Syringe

Parts of a Syringe

Plunger Barrel Plain tip needle Hub Needle Shaft Lumen Bevel

for performing venipuncture from very small or very fragile veins often seen in children and in the geriatric population

Winged blood collection set

Has powdered and powder-free, and latex and nonlatex

Gloves

Example of nonlatex

Vinyl, nitrile, neoprene and polyethylene

can be worn under latex gloves for persons that develop an allergic dermatitis to gloves

Cotton gloves liners

use high-intensity LED lights that shine through the patient’s subcutaneous tissue

Venoscope II and neonatal transilluminator

Cotton glove liners can be worn under latex gloves for persons that develop an ____________ to gloves

allergic dermatitis

highlight the veins by absorbing the light rather than reflecting it

Venoscope II & Neonatal Transilluminator

Requisition

Thru phone Doctor’s requisition

Checking Requisition forms

- Patient’s name, age and gender - Patient’s date of birth - Patient’s location - Ordering health-care provider’s name - Tests requested - Requested date and time of sample collection

Ideal time

Basal state

Positioning the Patient

Supine Sitting upright

Position of the Phlebotomist

Standing position

Tourniquet application -maximum amount of time

1 min

The preferred site for venipuncture and is located anterior and below the bend of the elbow.

Antecubital fossa

vein of choice because it is large and does not tend to move when the needle is inserted

Median cubital vein

Usually more difficult to locate, except possibly in larger patient and has more tendencies to move

Cephalic cubital vein

the least firmly anchored; has a tendency to "roll" and hematoma formation is more likely to occur.

Basilic vein

3 major vein

Median Cephalic Basilic

includes the cephalic, median cubital, and basilic veins in a pattern that looks like a slanted H.

H - shaped pattern

Includes the cephalic, median cephalic, median basilic, and basilic veins.

M shaped pattern

Areas to Be Avoided

• Damaged Vein • Hematoma • Edema • Burns, Scars and Tattoos • Mastectomy • Obesity • IV Therapy • Heparin and Saline Locks • Cannulas and Fistulas

Angle needle

15-30 degree

Labeling the tubes

- Patient’s name and identification number - Age and Gender of the Patient - Date and time of collection - Phlebotomist’s initials

Reasons for sample rejection:

• Unlabeled or mislabeled samples • Inadequate volume • Collection in the wrong tube • Hemolysis • Lipemia • Clotted blood in an anticoagulant tube • Improper handling during transport, such as not chilling the sample • Samples without a requisition form • Contaminated sample containers • Delays in processing the sample • Use of outdated blood collection tubes

Remedy: One minute application of tourniquet

localized hemaconcentration or Venous stasis

Remedy: Let the patient lie down

Fainting or syncope

Failure to obtain blood

Needle Position Bevel Against the Wall of the Vein Needle Too Deep/ Too Shallow Collapsed Vein Needle Beside the Vein Faulty Evacuated Tube

Formation of blood clots inside the lumen of the vein due to trauma

Thrombosis in vein

Inflammation of the vein due to thrombus as manifested by an inflammatory reaction on the outer skin surface

Thrombophlebitis

Blue or black skin discoloration commonly due to repeated trauma or puncture of the veins

Hematomas

Hematoma error

Failure to remove the tourniquet before removing the needle Applying inadequate pressure to the site after removal of the needle Bending the arm while applying pressure Excessive probing to obtain blood Failure to insert the needle far enough into the vein Inserting the needle through the vein Selecting a needle too large for the vein Using veins that are small and fragile Accidentally puncturing the brachial artery

Hemolysis: Errors

• Applying the tourniquet too close to the puncture site or for too long • Using fragile hand veins • Performing venipuncture before the alcohol is allowed to dry • Collecting blood through different internal diameters of catheter and connectors • Partially filling sodium fluoride tubes • Readjusting the needle in the vein

Generally used for the determination of blood oxygen, carbon dioxide tension and blood pH

Arterial puncture

Blood collected is called in blood gas analysis

Arterial blood or oxygenated blood

Specimen Collection Flashcards

(71 cards)