Busy. Please wait.

Forgot Password?

Don't have an account?  Sign up 

show password


Make sure to remember your password. If you forget it there is no way for StudyStack to send you a reset link. You would need to create a new account.

By signing up, I agree to StudyStack's Terms of Service and Privacy Policy.

Already a StudyStack user? Log In

Reset Password
Enter the email address associated with your account, and we'll email you a link to reset your password.

Remove ads
Don't know (0)
Know (0)
remaining cards (0)
To flip the current card, click it or press the Spacebar key.  To move the current card to one of the three colored boxes, click on the box.  You may also press the UP ARROW key to move the card to the "Know" box, the DOWN ARROW key to move the card to the "Don't know" box, or the RIGHT ARROW key to move the card to the Remaining box.  You may also click on the card displayed in any of the three boxes to bring that card back to the center.

Pass complete!

"Know" box contains:
Time elapsed:
restart all cards

Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.

  Normal Size     Small Size show me how

Stack #221113

Phlebotomy Chap 7 Blood Collection Pg218-249

What is the primary duty of the phlebotomist?Pg 218 is to collect blood specimens for laboratory testing.
The blood is collected by several methods name 3. arterial puncture, capillary puncture and venipuncture
Chapter 7: describes general blood collection equipment and supplies commonly needed regardless of the method of collection,as well as blood collection equipment specific to venipuncture. Specific equipment for arterial puncture and skin puncture is described in their respective chapters.
General Blood Collection Equipment&supplies: commonly needed for all methods of collecting blood samples. There are 13 can you name some of them? *Blood Drawing station*phlebotomy chairs *Equipment carriers*Glove &glove liners *antiseptics*disinfectants*hand sanitizers *gauze pads/cotton balls *bandages*slides*pen*watch*needle&sharp disposal containers
What is a dedicated area of a medical laboratory or clinic equipped for performing phlebotomy procedures on patients, primarily outpatients sent by their physicians for laboratory testing called? A Blood-drawing station
A typical blood drawing station includes a _?_ for supplies, a special _?_ where the patient sits during the blood collection procedure and a bed or a _?_ chair for patients with a history of _?_,persons donating blood and other special situations. a table for supplies, special chair,reclining chair,history of fainting
A bed or padded table is also needed if heelsticks or other procedures will be performed on _?_ and small _?_. infants, small children
A phlebotomy chair should be _?_ for the patient and have adjustible armrests to achieve proper _?_ of either arm. should be confortable,proper positioningSpecial phlebotomy chairs are available from a # of manufacturers. Most have adjustible armrests that lock in place to prevent the patient from falling should fainting occur.
Caution: In the absence of a special chair, precautions must be taken to prevent falls and ensure client safety. Caution: In the absence of a special chair, precautions must be taken to prevent falls and ensure client safety.
What help make blood collection equipment portable? Equipment carriers
It is especially important that blood collection equipment is portable in _?_ setting and other instances in which the patient cannot come to the _?_ Hospital setting, cannot come to the labortory
Hand held phlebotomy equipment carriers or trays come in a variety of styles and _?_ designed to be easily _?_ by the phlebotomist and to contain enough equipment for numerous blood draws. sizes,easily carried
The hand held carriers are convenient for "stat" or _?_ situations or when relatively few patients need blood work Emergency
Phlebotomy carts(fig 7-3)are typically made of _?_ _?_ or strong synthetic material. They have _?_ wheels, which glide the carts smoothly and quietly down hospital hallways and in and out of elevators. pg 219 Stainless Steel
The phlebotomy carts normally have several _?_ to carry adequate supplies for obtaining blood specimens for many _?_ shelves,many patients
When are phlebotomy carts commonly used in a hospital setting? They are used for early morning phlebotomy rounds when many patients need lab work and for scheduled "sweep" round that occur at regular intervals throughout the day.
The phlebotomy cart are bulky and a potential source of nosocomial _?_ and are not normally brought into patient rooms. Instead, they are parked where? A tray of _?_ to be taken into the room is often carried on the cart. nosocomial infections, they are parked outside in the hallway. a tray of supplies
In regards to the carts and trays, what is an important duty of the phlebotomist? Keeping carts and trays adequately stocked with supplies is an important duty.
pg 220 CDC.HICPAC _?_ precautions and the OSHA _?_ pathogen standard, require the wearing of _?_ when performing phlebotomy. Standard precautions, OSHA bloodborne, wearing of gloves
A _?_ pair must be used for each _?_ and be _?_ when the procedure is completed. A new pair, each patient, and be removed
Nonsterile, disposable latex, nitrile,neoprene,polyethylene, and vinyl examination gloves are acceptable for most phlebotomy procedures. What is essential to all gloves used? A good fit is essential
Some gloves come lightly dusted with powder to make them more comfortable to wear and easier to slip on and off. However, phlebotomist should be aware that glove powder can be a source of _?_ for some tests(especially those collected by skin puncture) source of contamination
another issue with gloves lightly dusted with powder is it can also cause _?_ in some users Allergies.
Powder in latex gloves can help suspend latex particles in the air and pose a danger to those with _?_ allergy? Latex
Special glove liners (fig 7-4A) are available for persons who develop _?_ or dermatitis from wearing gloves. develop alllergies
Barrier hand creams (fig 7-4B) that help prevent _?_ irritation and are compatible with _?_ gloves are also available. skin irritation, latex gloves
What government entity regulates glove quality? The Food and Drug Administration
_?_ of hands after glove removal is essential. Any type of glove may contain defects and some studies suggest that vinyl gloves may not provide adequate barrier to viruses. Decontamination of hands
pg221 Antiseptics are substances used to prevent _?_, the presence of microorganisms or their toxic products in the bloodstream. prevent sepsis
Antiseptics prevent or inhibit the growth and development or microorganisms, but do not necessarily kill them. They are considered safe to use on human skin and are used to clean the _?_ prior to blood collection. clean the site
the antiseptic most commonly used for routine blood collection is _?_ isopropyl alcohol(isopropanol) in individually wrapped prep pads. 70% isopropyl alcohol
For a higher degree of antisepsis, the traditional antiseptic has been Povidone- _?_ in the form of swabsticks or sponge pads for blood _?_ collection and prep pads for blood _?_ collection. Povidone-Iodine, for blood culture collection,blood gas collection.
The use of alcohol-based preparations for these procedures is increasing because many _?_ are allergic to _?_-iodine. many patients, allergic to povidone-iodine.
see box 7-1 pg 221 Antiseptics used in blood collection: Can you list these 7 antiseptics: 7 Antiseptics used in blood collection:*70 Ethyl alcohol*70% isopropyl alcohol(isopropanol)*Benzalkonium chloride(eg. zephiran chloride)*Chlorhexidine gluconate*hydrogen peroxide *povidone-iodine (0.1-1% available iodine) * tincture of iodine
True or False: Cleaning with antiseptic reduces the number of microorganisms, and sterilizes the site. False! Cleaning with antiseptic reduces the number of microorganisms, but does not sterilize the site.
pg222 Disinfectants are _?_-regulated chemical substances or solutions that are used to remove or _?_ microorganisms on surfaces and _?_. EPS-regulated, remove or kill, surfaces and instruments.
Disinfectants are typically corrosive and are not safe for use on human _?_. human skin
According to _?_ and HICPAC(guidelines for environmental infection control in healthcare facilities, use of EPA-registered sodium hypochlorite products is _?_, but solutions made from generic 5.25% sodium hypochlorite (household bleach) may be used. CDC,products is preferred
solutions made from generic 5.25% sodium hypochlorite (household bleach) may be used.a _?_ dilution is recommended for decontaminating nonporous surfaces after cleaning up blood or other body fluid spills in _?_-care settings 1:100 dilution,patient-care settings
solutions made from generic 5.25% sodium hypochlorite (household bleach): when spills involve large amounts of blood or other body fluids or occur in the laboratory, a _?_ dilution is applied prior to cleanup. 1:10 dilution
At least _?_ minutes of contact time is required for disinfectants to be effective. 10 minutes
How often should fresh bleach solutions be made? be made daily or as needed.
pg222 Hand Sanitizers:A recent _?_ report entitled Guideline for Hand Hygiene in Health care settings recommends use of _?_-based hand sanitizers for routine decontamination of hands as a substitute for hand washing,provided hands are not visibly dirty. CDC report,alcohol-based
If hands are heavily contaminated with organic material and hand washing facilities are not available, it is recommended hands be cleaned with detergent containing wipes followed by use of an _?_-based hand cleaner. alcohol based
Alcohol-based hand cleaners are available in 3 forms name them. rinses, fels, and foams
pg222 Gauze Pads/Cotton Balls: clean 2x2 inch gauze pads folded in _?_ are used to hold _?_ over the site following blood collection procedures. folded in fourths, used to hold pressure,
Special gauze pads with _?_ proof backing are also available to help prevent contamination of gloves from blood at the site. Fluid proof backing,
True or false: Use of cotton balls to hold pressure is not recommended because they tent to stick to the site and reinitiate bleeding when removed. True
Bandages: _?_ bandages are used to cover blood collection site after the bleeding has stopped. Paper,cloth,or knitted tape placed over a folded gauze square can also be used. Adhesive bandages
Self-adhesive gauze placed over the _?_ pad or cotton ball and wrapped aroung the arm is being used increasingly, especially for _?_ who are allergic to _?_ bandages. gauze pad,for patients,adhesive bandages,
Self-adhesive gauze,is also used to form a pressure bandage following _?_ puncture or _?_ in patients with bleeding problems. aterial puncture or venipuncture in patients
_?_-free bandages are available for those with latex allergies. Latex-free
Why should adhesive bandages not be used on babies younger than 2 years of age ? because of the danger of aspiration and suffication.
pg 223 Needle & Sharps Disposal Containers:Why do you use these type of containers? to Dispose of used needles, lancets and other sharp objects even if they contain safety features.
A veriety of styles and sizes are available for "_?_" containers. Most are _?_ color for easy identification, but some are clear or opaque to make it easier to tell when they are _?_. "sharps" containers, Red color, tell when they are full
All "sharps" must be clearly marked with a _?_ symbol and be rigid and puncture _?)_, leak proof and disposable and have _?_lids to seal the contents when full Biohazard symbol,puncture resistant,locking lids
When sharps disposal containers are full they must be properly disposed of as _?_ waste. Biohazardous waste.
All Needle & "sharps" containers have 1 most common color,2 colors that make it easier to tell when full. Most common color is Red, 2 that make it easier to tell if full are clear or opaque.
Fig 7-6 pg 224 All Needle & "sharps" containers,no matter what style or size has these requirements name the 6 requirements *clearly marked biohazard symbol *rigid*puncture resistant*leak proof*disposable *locking lids to seal contents when full.
What is the proper way to dispose of all "Sharps" containers? To be properly disposed of as biohazardous waste.
Pg 224 Slides: Precleaned 25x75-mm (1x3-inch) glass _?_ slides are used to make _?_ films for hematology determinations. Slides are available either _?_ or with a _?_ area at one end where the _?_ name or other information can be written in _?_. microscope slides,blood films,either plain, frosted area,patient name, written in pencil.
Pen: A phlebotomist should always carry a pen with Indelible (_?_) nonsmear ink to label tubes and record other patient information. (permanent)nonsmear ink,
Watch: A watch, preferably with a _?_ _?_ hand or timer, is needed to accurately determine _?_ collection times and time certain tests. with a sweep second hand,determine specimen collection
Arterial Puncture Equipment See Chap 12Capillary Puncture Equipment See Chap 10 Arterial Puncture Equipment See Chap 12Capillary Puncture Equipment See Chap 10
pg 224 Venipuncture Equipment:The following equipment is used for venipuncture procedures in addition to the general blood collection supplies and equipment previously described: Pg224 Venipuncture equipment:*Vein locating Devices*Tourniquet*Needles*Evacuated tube System(ETS)*Tube holders*evacuated tubes*syringe system*winged infusion set*combination systems
pg225 Vein Locating Devices:there are a number of optional,portable devices to make it easier to locate veins that are difficult to see or feel. Most devices can be used on all ages. see next card for examples Vein Locating devices:* transillumination devices such as venoscopeII (fig7-7)Neonatal transilluminator and transillumination vein locator(VL-U) *Vein entry indicator(VEID)
Name the vein-locating device that use high intensity LED lights to shine through the patients subcutaneous tissue and highlight veins, which absorb the light rather than reflecting it and stand out as dark lines? Vein Locating devices:*transillumination devices such as venoscopeII (fig7-7)Neonatal transilluminator and transillumination vein locator(VL-U)
Name vein-locating device uses pressure-sensing technology that attaches to catheter needle insertion unit. When needle penetrates blood vessel the devices senses the change in pressure and emits a beeping signal that stops when the needle exits the vein. Vein entry indicator(VEID)
Tourniquet(fig7-8)a device that is applied or tied aroung patient's arm prior to venipuncture to restrict blood flow.If properly applied is tight enough to restrict _?_ flow out of the area but no so tight as to restrict _?_ flow into the area. Venous Flow out of the area, Arterial flow into the area
What vein locating device: restricts venous flow distends or inflates the veins making them larger and easier to find,stretches the vein walls so they are thinner and easier to pierce with a needle. Tourniquet is a device
Restriction of blood flow can change blood components if the tourniquet left in place for more than 1 min.it must fasten in a way that is easy to release with one hand during _?_ collection procedures or emergency situations. blood collection procedures
Why does a tourniquet need to fasten in such a way that it easy to release with one hand during blood collection procedures, emergency situations,when patient starts to faint or needle accidently backs out of arm during venipuncture.
there are a number of different types of tourniquets most are available in both adult and pediatric sizes. Name the most common type that is fairly cheap and disposable?It can be used more than once,normally thrown away if it get contaminated with _?_ a flat strip of stretchable material such as latex of vinyl. contaminated with blood it is thrown away
List 4 types of tourniquets and advantage or disadvantage or using them. *velcro closure&Buckle closure:stay on arm when released & be tightened again if necessary=require reg.cleaning w/disinfectant or autoclaved.some will not fit extremely obese patients, not easy to clean*latex strap *nonlatex strap:cheap and disposable
Sometimes a _?_ _?_ _?_ may be used in place of a tourniquet. The patient's BP is taken and the pressure is maintained below the patient's _?_ pressure. Blood pressure cuff, below the patient's diastolic pressure.
PPG227 Phlebotomy needles are sterile, disposable,single use only.include multisample needles(evacuated tube system),hypodermic needles(syringe system) and winged infusion(butterfly)needles used with both the evacuated tube system and the syringe system. Multisample needles are commonly enclosed in sealed twist off shields or covers. Hypodermic needles and butterfly needles are typically sealed in sterile pull-apart packages.
why is it important to examine the packaging or seal of a needle before use? If the packaging is open or the seal is broken, the needle is no longer sterile and should not be used.
Specific terminology is used to refer to the parts of the a needle. The end that pierces the vein is called the _?_ because it is cut on a slant. bevel "beveled" or cut on a slant
The bevel allows the needle to easily to slip into the skin and vein without _?_ (removal of a portion of the skin or vein) Coring (removal of a portion of the skin or vein)
The long cylindrical portion is called the _?_ of the parts of a needle. Shaft
the end that attaches to the blood collection device is called the _?_ of the parts of a needle. Hub
the internal space of the needle is called the _?_ parts of a needle. lumen
Needles are available in various sizes indicated by _?_ and _?_ length and gauge
It is important to visually inspect a needle prior to venipuncture. Needles are mass produced, Please explain why you need to visually inspect the needle. Needles are mass produced and on rare occasions contain defects such as blocked,blunt,or bent tips or rough bevels or shafts that could injure a patient's vein, cause unnecessary pain, or result in veinpuncture failure.
Needle gauge is a number that relates to the _?_ of the lumen. diameter
The needle diameter and the gauge have an inverse (opposite)relationship that is , the larger the gauge number, the _?_ the actual diameter of the needle. the smaller
although blood typically flows more quickly through _?_ diameter needles, needle gauge is selected according to the _?_ and condition of the patient's vein, the type of procedure,the equipment being used. large, size
Appropriate Needles for the collection of most blood specimens for laboratory testing include gauges _?_ through _?_, however a 21 gauge needle is considered the standard for most routine phlebotomy situations. gauges 20 through 23
pg 228 see table 7-1 Common venipuncture needle gauges with needle type and typical use pg 228 see table 7-1 Common venipuncture needle gauges with needle type and typical use
Why is it important to select the appropriate needle for the situation? A needle too large? A needle too small? needle too large:may damage a vein needlessly needle too small:may hemolyze the specimen
pg228 what gauges is this needle? Use: is collection of donor units, autologous blood donation and therapeutic phlebotomy.Needle type: is special needle attached to a collection bag. gauges is 15-17 size needles
what gauge is this needle? Type:syringe Use: used primarily as a transfer needle rather than for blood collection, safety issues have diminished use gauge 18
what gauge is this needle? Type:multisample syringe Use:Sometimes when large volume tubes are collected or large volume syringes are used on patients with normal size veins Guage 20
what gauge is this needle? Type:Multisample syringe Use:considered the standard venipuncture needle for routine venipuncture on patients with normal veins or syringe blood culture collection Guage 21
what gauge is this needle? Type:Multisample syringe Use:Used on older children and adult patients with small veins or syringe draws on difficult veins Guage 22
what gauge is this needle? Type:Butterfly Use:veins of infants and children and difficult or hand veins of adults Guage 23
pg228 fig:7-9 Manufacturers typically color code needles by gauge for easy identification. Generally multisample needles have color coded caps and hubs and syringe needles have color coded hubs.Butterfly needles often have color coded wings. Syringe and butterfly needle packaging may also contain color coding. Needle color codes vary among manufacturers.
Length: most multisample needles come in _?_ or _?_ lengths. 1 inch or 1.5 inch lengths
Syringe needles come in many lengths, however the most commonly used for venipuncture are _?_ and _?_ inch lengths 1 inch or 1.5 inch lengths
Butterfly needles are typically 1/2 to _?_ of an inch long. Some of the new safety needles come in slightly longer lengths to accommodate resheathing features. 1/2 to 3/4 of inch long
Length selection depends primarily upon user preference and the _?_ of the vein. depth
Many phlebotomists prefer to use _?_ -inch needles in routine situations because it is less intimidating to the patient. Other's especially those with larger hands feel that 1.5 inch needle makes it easier to achieve proper angle for entering the vein. 1-inch needles
pg229 Needles are available with or without safety features. Safety features must provide immediate permanent containment and be activated using one hand, which must stay behind the needle at all times. Safety features include resheathing devices such as shields that cover the needle after use, blunting devices, and equipment with devices that retract the needle after use.
_?_ is responsible for clearing medical devices for marketing. see fig 7-2 pg229 FDA
According to _?_ regulations, if the needle does not have a safety feature, the equipment it is used with(such as tube holder or syringe) must have a safety feature to minimize the chance of accidental needlesticks. OSHA
Can you name 4 desirable safety features that the FDA considers important in preventing percutaneous injury? *safety feature is a fixed safety feature that provides a barrier between the hands and the needle after use,should allow or require the worker's hands to remain behind the needle at all times *is an integral part of the device and not an accessory
Can you name 4 desirable safety features that the FDA considers important in preventing percutaneous injury? *is in effect before disassembly and remains in effect after disposal to protect users and trash handlers for environmental safety *is as simple as possible, requiring little or no training to use effectively
Evacuated Tube system(ETS) most common, effecient, and CLSI preferred system for collecting blood samples is this system. See fig 7-10 pg230. Evacuated Tube system(ETS) most common, effecient, and CLSI preferred system for collecting blood samples is this system. See fig 7-10 pg230.
It is a _?_ system in which the patient's blood flows through a needle inserted into a vein, directly into a collection tube without being exposed to the air or outside contaminants. Closed
the ETS system allows numerous _?_ to be collected with a single venipuncture. ETS are available from several manufacturerss. tubes
Although the design of individual elements may vary slightly by manufacturer all ETS systems have three basic components. Name the 3 components. *special blood-drawing needle *a needle and tube holder * various types of evacuated tubes
True or False. Unless components are specifically designed for use with multiple systems, it is recommended that all ETS components come from the same manufacturer. True. Mixing components from different manufacturers can lead to problems such as needles coming unscrewed and tubes popping off the needle during venipuncture.
pg230 ETS needles are called _?_ needles because they allow multiple tubes of blood to be collected during a single venipuncture.They are threaded in the middle and have a beveled point on each end. The threaded portion screws into a tube holder. Multisample
The end of the needle that pierces the vein is longer and has a longer bevel. shorter end penetrates the tube stopper during specimen collection. It is covered by a sleeve that retracts as The needle goes through the tube stopper so blood can flow into the tube.
When the tube is removed, the sleeve slides back over the needle to prevent _?_ of blood. Leakage
ETS needles are available with or without safety features. An ETS needle with a safety feature is shown attached to a tube holder. See fig 7-11 Pg 231
True or False. ETS needles without safety features must be used with holders that do not have safety features. False. ETS needles without safety features must be used with holders that have safety features.
pg231 A _?_ holder is 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. A Tube holder
The large en has flages or extensions on the sides that aid in tube placement and removal._?_ regulations require that the tube holder with needle attached be disposed of as a unit after use and never removed from the needle and reused. OSHA regulations
Holders are typically available in several sizes to accommodate different sized tubes, including special sizes for large diameter blood culture bottles, some of which have adapter inserts to narrow the diameter of the holder and allow collection of evacuated tubes after the blood culture specimens.
Adapter inserts are also available so small diameter tubes can be collected in _?_-sized tube holders. Holders are available with and without safety features. regular-size tube holders
True or False: if the tube holder does not have a safety feature, the needle used with it must have a safety feature. True
pg233 fig 7-13 Safety features include shields that cover the needle and devices that manually or automatically retract the needle into the holder either before or after it is removed from the vein. Pg 233 fig 7-13. Several types of holders with safety features are shown
see fig 7-14 pg 234 Evacuated tubes are the type of tube used with both the ETS and the syringe method of obtaining blood specimens. (With the syringe method, blood is collected in a syringe and must be immediately transferred into the tubes) Evacuated tubes come in various sizes and volumes ranging from 1.8 to 15 mL.
Evacuated tubes selection is based on 3 things. Name them. *age of the patient *amount of blood needed for the test *the size and condition of the patient's vein.
Most laboratories stock several sizes of each type of tuve to accommodate various needs. Presently tubes are available in _?_ and _?_. available in plastic and glass.
for safety reasons, it is strongly recommened that _?_ tubes be used if at all possible. Local, state, and federal safety regulatory agencies should be consulted for current applicable regulations. Plastic tubes
pg233 Evacuated tubes fill with blood automatically because there is a _?_ (negative pressure, or artificially created absence of air)in them. Vacuum
the vacumn is premeasured by the manufacturer so that the tube will draw the precise volume of blood indicated. To reach it's stated volume,a tube must be allowed to fill with blood until the normal vacuum is exhausted. A tube that is prematurely lost all or part of its vacuum will fail to properly fill with blood.
True or False. Tubes do not fill with blood all the way to the stopper. When filled properly, there is always a consistent amount of headspace between the level of blood in the tube and the tube stopper. True
What can cause premature loss of vacuum in evacuated tubes? 6 causes. *improper storage*opening the tube*dropping the tube*advancing the tube too far onto the needle before venipuncture*pulling the needle bevel partially out of the skin during venipuncture.
Define what a partial draw or "short draw" is? Premature loss of vacuum, removing the tube before the vacuum is exhausted, or stoppage of blood flow during the blood draw can result in an underfilled tube.
Some manufacturers offer special"short draw" tubes designed to partially fill without compromising test results. These tubes are used in situations in which it is difficult or inadvisable to draw larger _?_ of blood. quantities of blood
True or False. Manufacturer partial draw tubes are often the same size as standard-volume tubes but do not fill to the same level and may fill more quickly. False. Manufacturer partial draw tubes are often the same size as standard-volume tubes but do not fill to the same level and may fill more SLOWLY.
Pg234 Most ETS tubes contain some type of _?_ Additive
Any substance placed within a tube other than the tube stopper or the coating of the tube is called what? Additive
Blood collected in additive tuves may or may not clot, depending on the additive type. For example, if the additive prevents clotting, the result is a _?_ _?_ specimen. Whole blood specimen
some whole blood specimens are used directly for testing; others are centrifuged to separate the cells from the _?_ portion called _?_. fluid portion, called plasma.
If the additive is a clot activator, the blood will clot and the specimen must be _?_ to obtain the fluid portion called _?_. must be centrifuged,called serum
The amount of additive in a tube will function optimally with the amount of _?_ it takes to fill the tube to the capacity or volume indicated. blood
_?_ quality can be compromised if the tube is underfilled, so it is important to allow additive tubes to fill with blood until the normal vacuum is exhausted. Specimen,
True or False: An underfilled tube that contains an additive will have an incorrect additive-to-blood ratio,which can cause inaccurate test results. True.
pg 234 nonadditive tubes: With the advent of plastic tubes, very few tubes are additive free. Even serum tuves need and additive to promote _?_ if they are plastic. promote clotting
pg235 fig 7-15. Any nonadditive plastic tubes that do exist are to be used for clearing or _?_ purposes only. discard purposes only
A few glass nonadditive _?_ top tubes are still in existence, but most are in the process of being discontinued for safety reasons. Red top tubes
Blood collected in a tube will clot when there is _?_ in the tube to prevent it. Consequently, nonadditive tubes yield serum samples. nothing in the tube
Tube stoppers (tops or closures) are typically made of _?_. made of rubber
Some tubes have a _?_ stopper covered by plastic shield designed to protect _?_ personnel from blood drops remaining on stopper after the tube is removed from the needle, and from aerosols(mists)sprays of specimen when the stopper is removed from tube. rubber stopper,lab personnel,
The rigidity of the plastic also prevents removal of the stopper using a "thumb roll", a technique that has been shown to cause _?_ formation. aerosol formation
Tube stoppers are color-_?_.It is not unusual for evacuated tubes to be referred to as red tops,green tops and so forth. For most tubes, the stopper color identifies a type of _?_ placed in the tube by the manufacturer for a specific purpose. color-coded. type of additive place in the tube
True or False: For some tubes, the stopper color indicates a special property of the tube. True.
A royal-blue stopper color indicates a _?_-_?_ free tube. trace-element-free tube.
Occasionally, there may be more than one stopper _?_ for the same additive. stopper color
Although color-coding is generally universal, it may vary slightly by manufacturer. Common stopper colors, what they indicate, and what departments use them are shown in Table 7-2 pg 236 Study pg 236 tab 7-2
Manufacturers guarantee reliability of _?_ and tube vacuum until an expiration date printed on the label, provided the tubes are _?_ properly and stored between 4 and _?_C. of additives,are handled properly, 25*C
Improper handling or storage can affect _?_ integrity and _?_ vacuum, which can lead to compromised test results or improper filling. additive integrity, tube vacuum,
True or False: it is okay to use a tube that has expired or has been dropped. False, Always check the expiration date on a tube before using it, and never use a tube that has expired or has been dropped. Discard it instead.
pg236 Table 7-2 Common stopper colors, additives and departments pg236 Table 7-2 Common stopper colors, additives and departments
Name the stopper color for this additive:Sodium citrate department:Coagulation Stopper Color:Light blue
Name the stopper color for this additive:None department:Chemistry, blood bank, serology/immunology Stopper Color:Red (glass)
Name the stopper color for this additive:Clot activator department:Chemistry Stopper Color:Red (plastic)
Name the stopper color for this additive:nonadditive department:NA (discard tuve only) Stopper Color:Red/light gray (plastic)
Name the stopper color for this additive:clot activator and gel separator department:Chemistry Stopper Color:Red/black(tiger) Gold Red/gold
Name the stopper color for this additive:Lithium heparin and gel separator department:Chemistry Stopper Color:Green/gray Light green
Name the stopper color for this additive:Lithium heparin, sodium heparin department:Chemistry Stopper Color:Green
Name the stopper color for this additive:EDTA department:Hematology blood bank Stopper Color:Lavender, Pink
Name the stopper color for this additive:Sodium fluoride and potassium oxalate, sodium fluoride and EDTA, sodium fluoridedepartment:Chemistry Stopper Color:Gray
Name the stopper color for this additive:Thrombindepartment:Chemistry Stopper Color:Orange, gray/yellow
Name the stopper color for this additive:None(red label),EDTA (lavender label),Sodium heparin(green label)department:Chemistry Stopper Color:Royal Blue
Name the stopper color for this additive:Sodium heparin,EDTA department:Chemistry Stopper Color:Tan(glass tube), Tan (plastic)
Name the stopper color for this additive:Sodium polyanethol sulfonate (SPS)department:Microbiology Stopper Color:Yellow
Name the stopper color for this additive:Acid citrate dextrose (ACD)department:Blood bank/immunohematology Stopper Color:Yellow
pg237 fig 7-16 Although the evacuated tube system is the preferred method of blood collection a syringe _?_ is sometimes used for patients with _?_ or difficult veins. syringe system, with small
Can you name the traditional syringe system 7 components? *bevel*shaft*hub*needle*graduated barrel*plunger*syringe
This System consists of a _?_ syringe needle called a _?_ needle and a sterile plastic syringe with a Luer lock tip (a special tip that allows the needle to attach more securely than a slip tip) Sterile syringe needle, called hypodermic needle
A relatively new syringe system component is an OSHA required syringe transfer device.(fig7-17 pg 238) a piece of equipment used to transfer _?_ from the syringe into ETS tubes. transfer blood
syringe needles come in a wide range of _?_ and lengths for many different uses. Those appropriate for Phlebotomy procedures are generally gauges _?_ to _?_ and in _?_" pr _?_"inch lengths. range of gauges, 21-23 gauges in 1 or 1.5 inch lengths
When used to draw blood, a syringe needle must have a _?_ feature to allow it to be safely covered and removed so that a transfer device can be attached to the syringe to fill the evacuated tubes. must have a resheathing feature
An example of a safety needle attached to a syringe is shown in fig7-18A pg239 A syringe that has a built in safety device to cover the needle is show in fig 7-18b pg239
True or False: syringe needles used for phlebotomy must have resheathing devices to minimize chance of accidental needlesticks. True
True or false:Needles used for intradermal skin tests must have resheathing devices or be used with plungers that have devices that cover or retract the syringe after use. False:Needles used for intradermal skin tests must have resheathing devices or be used with SYRINGES THAT HAVE DEVICES THAT COVER OR RETRACT THE NEEDLE AFTER USE.
Syringes typically come in sterile pull apart packages and are available in various sizes or volumes. The most common volumes used for phlebotomy are _?_._?_,and _?_ mL. are 2,5,and 10mL
Syringe volume is selected according to the size and condition of the patient's _?_ and the amount of blood to be collected. patient's vein
see pg239 Syringes have two parts: name them *barrel-a cylinder with graduated markings in either milliliters(mL) or cubic centimeters(cc)* a Plunger-rodlike ddevice that fits tightly into the barrel see fig7-16
When drawing venous blood by syringe, the phlebotomist slowly pulls back on the plunger, creating a _?_ that causes the barrel to fill with blood. creating a vacumn
Blood collected in a syringe must be transferred into _?_ _?_. In the past blood was transferred by poking the syringe needle through the tube stopper or by removing the tube stopper and ejecting blood from the syringe into the tube. into ETS tubes. Both practices are now considered unsafe.
A syringe transfer device allows the safe transfer of blood into the tubes with out using the syringe needle or removing the tube stopper. The device is similar to an ETS _?_ holder, but has a permanently attached needle inside tube holder
After completing the draw and exiting the vein, the needle safety device is activated and the needle removed and discarded into the sharps. The transfers device is them attached to the hub of the syringe.An ETS tube is placed inside it and advanced onto the needle until blood flows into the tube.
Additional _?_ can be filled as long as there is enough blood in the syringe. additional tubes
The transfer device greatly reduces the chance of accident needlesticks and confines any aerosol or spraying of the specimen that may be generated as _?_ are removed from it. tubes removed
What is another name for a winged infusion blood collection set? butterfly
a Butterfly is an indispensible tool for collecting blood from small or difficult veins such as _?_ veins of elderly and _?_ patients. hand veins of elderly and pediatric patients
pg240 fig 7-19 Winged infusion sets attached to a syringe and an evacuated tube holder by means of _?_ adapter. Luer adapter
the butterfly allows much more flexibility and precision than a needle and _?_. and syringe
a Winged infusion set consists of a 1/? to 1/? inch stainless steel needle permanently connected to a 5-12 inch length of _?_ with either a _?_ attachment for syringe use or a multisample _?_ adapter for use with the evacuated tube system. 1/2 to 1/4 inch stainless steel needle. length of tubing with eithera Luer attachment for syringe use, or a multisample luer adapter
True or False: The first tube collected with a butterfly will underfill because of the air in the tubing. True.
True or False:If the tube contains an additive and is the first tube used in a butterfly draw, the blood-to-additive ratio will be affected. True.
True or False; If an additive tube is the first tube to be collected in a butterfly draw, it is important to draw a few milliliters of blood into a nonadditive tube or another additive tube of the same type, and keep with the collection of the first tube. False. If an additive tube is the first tube to be collected in a butterfly draw, it is important to draw a few milliliters of blood into a nonadditive tube or another additive tube of the same type, and DISCARD IT PRIOR TO COLLECTING THE FIRST TUBE.
If an additive tube is the first tube to be collected in a butterfly draw, it is important to draw a few milliliters of blood into a nonadditive tube or another additive tube of the same type, This is referred to as collecting a "_?_" or discard tube. Clear or discard tube and is especially critical when collecting coagulation tubes using a butterfly.
Plastic extensions that resemble butterfly wings (thus the name butterfly) are attached to the needle where it is joined to the _?_. tubing
During use, the needle may be held from above by gripping the wings together between the thumb and _?_, allowing the user to achieve the shallow angle of needle insertion required to access small veins. thumb and index finger
Butterfly needles come in various gauges although a _?_ gauge is most commonly used for phlebotomy. In rare situations, a _?_ gauge is used to collect blood from scalp or other tiny veins of premature infants and other neonates. 23 gauge most common and rare situations 25 gauge
Using a needle smaller than 23 gauge increases the chance of _?_ the specimen. Hemolyzing the specimen.
As with other blood collection needles, butterfly needles are required to contain safety devices to reduce the possibility of accidental needlesticks. See fig 7-20 pg241 Butterfly safety devices include locking shields that slide over the needle,blunting devices,needle retracting devices.
Combination systems:S-Monovette Blood collection system fig 7-21 is a complete system for blood collection in which the blood collection tube and collection apparatus are bombined into a _?_ unit. single unit. The unit allow the specimen to be collected by evacuated tube or syringe system technique.
pg242 blood collection tubes and other collection devices often contain one or more additives. There are a number of different types of additives, and each has a specific function. The type required for blood collection depends upon the rest ordered. In most cases no substitutions or combining of tubes with different additives is allowed.
True or False: You can transfer blood collected in an additive tube into another additive tube. False. Never transfer, as different types of additives may interfere with each other or the testing process. Even if additives same mixing them together creates excess additive and intererence in testing.
Name 3 forms additives are available in? *liquid *spray dried *powder forms
A tube with a powdered additive form should be _?_ _?_ prior to use to settle it to the bottom of the tube. slightly tapped
An additive tube must be gently _?_ 3 to 8 times, depending on the type, immediately after collection to adequately mix the additive with the specimen. The most common additives are categorized by function. gently inverted
True or False: It is important to shake or other wise vigorously mix a specimen. False. NEVER SHAKE,OR VIGOROUSLY MIX,it can cause hemolysis, which makes most specimens unsuitable for testing.
_?_are substances that prevent blood from clotting(coagulation)? Anticoagulants
Anticoagulants prevent blood from clotting by two methods:*chelating(binding)or precipitating calcium so it's unavailable to coagulation _?_ needed to convert fibrinogen to fibrin in the coagulation process. Thrombin
If a test requires whole blood or plasma, the specimen must be collected in a tube that contains an _?_ Anticoagulant
Anticoagulant specimens must be mixed immediately after collection to prevent _?_ formation Micrclot Gently mixing is essential to prevent hemolysis
True or False: Because the cells are free flowing and not clotted, a specimen collected in anticoagulant will separate thru settling or centrifugation and can be resuspended by intentional or inadvertent mixing of the specimen. TRUE.
pg243 There are different types of anticoagulants each designed for use in certain types of testing. It is imporatant to use the correct anticoagulant for the type of test collected. Name the 4 most common anticoagulants. *Ethylenediaminetetraacetic acid (EDTA) *citrates *heparin *oxalatesMemory joggers to help learn the most common see table 7-3 Pg 243
Acronym,Mnemonic or Acrostic: ECHO An Easy way to remember: the most common Anticoagulants: E (EDTA) C(citrate) H (heparin) O (oxalate)
Acronym,Mnemonic or Acrostic: phEDTA (pronounced like fajita) An Easy way to remember: Purple tubes go to hematology and contain EDTA P(purple)H (hematology) EDTA
Acronym,Mnemonic or Acrostic: Spring Creates Colorful Light-Blue Pansies An Easy way to remember: Sodium citrate tubes go to coagulation, have light blue stoppers and yield plasma S(sodium) C(citrate) C(coagulation) L(light) B(blue) P (plasma)
Acronym,Mnemonic or Acrostic: HH: Heparin inhibits An Easy way to remember: Heparin inhibits thrombin formation
Acronym,Mnemonic or Acrostic: In-in: Heparin inhibits An Easy way to remember: H in heparin and H in inhibits Heparin ends with "in" and inhibits starts with "in"
Acronym,Mnemonic or Acrostic: Greenhouses Have Colorful Plants An Easy way to remember: Green tubes contain heparin for chemistry tests on plasmaG (green) H(heparin) C(chemistry) P(plasma)
Acronym,Mnemonic or Acrostic: GO (gray oxalate) An Easy way to remember:Gray tubes typically contain oxalate
Acronym,Mnemonic or Acrostic: Gray ox (gray oxalate) An Easy way to remember: G (gray) O (oxalate)
Acronym,Mnemonic or Acrostic: LL(lavender last, except for gray) An Easy way to remember: Lavender is drawn last unless a gray top is ordered. Gray tops are rarely ordered, so lavender is often last.
Name the anticoagulant? commonly available in a sodium or potassium based salt, prevents coagulation by binding or chelating calcium. Although it is increasingly being used for blood bank tests. EDTA (Ethylenediaminetetraacetic acid) also, it is primarily used to provide whole blood specimens for hematology tests because it preserves cell morphology and inhibits platelet aggregation or clumping.
How may inversions are required for proper mixing of EDTA specimen? 8 inversions
True or False: if microclots are detected in a hematology specimen it cannot be used for testing and must be recollected? True
Why is it important that EDTA specimens be mixed immediately after collection? To prevent platelet clumping and microclot formation, which can negatively affect test results.
CLSI recommends spray-dried EDTA for most hematology test because liquid EDTA _?_ the specimen and results in lower _?_ values, red and white blood cell counts, _?_ counts, and _?_ _?_ volumes it dilutes the specimen, results in lower hemoglobin values, platelet counts, packed cell volumes.
True or False: The dilution effect of liquid EDTA is even more pronounced if the tubes are not completely filled, so it is important to have the tubes filled until their vacumn is exhausted. True
Whether you use spray-dried EDTA or Liquid EDTA. Either type of tube should be properly _?_ to maintain the correct blood-to-anticoagulant ratio. Properly filled
True or False: Excess EDTA that results when tubes are underfilled causes RBCs to expand and changes the complete blood count (CBC) results. False: Excess EDTA that results when tubes are underfilled causes RBCs to SHRINK and changes the complete blood count (CBC) results.
What anticoagulant is contained in: Lavender (purple) top tubes EDTA
What anticoagulant is contained in: Microcollection containers with lavender tops EDTA
What anticoagulant is contained in: Pink Plastic top tubes with a special blood bank patient ID label EDTA
What anticoagulant is contained in: Pearl-top tubes thixotropic gel separator EDTA
What anticoagulant is contained in: Royal-blue top tubes with lavender color coding on the label EDTA
pr244 Citrates prevent coagulation by binding or chelating _?_. Sodium citrate in light blue top tubes is used for _?_ tests because it does the best job of preserving the coagulation factors. chelating calcium, for coagulation tests,
Coagulation tests are performed on _?_, so specimens must first be centrifuged to separate the _?_ from the cells. Performed on plasma, separate the plasma
During Plasma testing, _?_ is added back to the specimen so the clotting process can be initiated and timed. Calcium is added back
There is a critical 9:1 ratio of blood to anticoagulant in light-_?_ sodium citrate tubes,it is important to fill them to stated capacity.Underfilled tubes cause artificially prolonged_?_ times and will not be accepted for testing by most laboratories. Light-blue, prolonged clotting times
_?_ specimens require immediate mixing after collection to prevent activation of the coagulation process and microclot formation, ehich invalidates test results. Coagulation specimens
Coagulations specimens require _?_ to _?_ gentle inversions for proper mixing. 3 to 4 gentle inversions
Coagulation tests: when vigorous mixing or an excessive number of inversions are done what can activate and shorten clotting times? activate platelets and shorten clotting times.
_?_ prevents clotting by inhibiting thrombin formation. Heparin
What is Thrombin? It is an enzyme needed to convert fibrinogen into the fibrin necessary for clot formation.
Heparinized _?_ ften used for stat chemistry test and other rapid response situations when a fast turn aroung time (TAT) for chemisty tests is needed. Heparinized plasma
Heparinized plasma, Faster TAT is possible because time is eliminated that would normally be required for the specimen to do what? to clot before serum could be obtained.
Heparinized plasma is preferred over serum for potassium tests because when blood clots, potassium is released from cells into the serum and can _?_ elevate results. falsely elevate results.
Heparinized specimens must be mixed immediately upon collection to prevent _?_ formation and _?_ generation. prevent clot formation, and fibrin generation
How many inversions are typically required for proper mixing of Heparinized specimens? 8 inversions
Why is gentle mixing essential to Heparinized specimens? is essential to prevent hemolysis, Hemolysed specimens are unsuitable for many chemistry tests.
Heparin is contained in tubes and microcollection contianers with _?_ stoppers and in _?_-_?_ tubes with _?_ on the label green-stoppers, royal-blue top tubes, with green on the label
Name the 3 heparin formulations. *ammonium *lithium and * sodium heparin
Which heparin formualation causes the least interference in chemistry testing and is the most widely used anticoagulant for plasma and whole blood chemistry tests? Lithium Heparin
It is essential to choose the right heparin formualtion for the type of test. In what testing instance would you not use Lithium Heparin? must not be used to collect lithium levels.
It is essential to choose the right heparin formualtion for the type of test. In what testing instance would you not use Sodium Heparin? Must not be used to collect sodium specimens or electrolyte panels because sodium is part of the panel.
_?_ prevent coagulation by precipitating calcium. Oxalates
What Oxalate is the most widely used? Potassium oxalate
Potassium oxalate is commonly added to tubes containing _?_ preservatives to provide plasma for glucose testing. glucose preservatives
Potassium oxalate is most commonly found in _?_ tubes and microcollection contianers with _?_ stoppers. evacuated tubes, with gray stoppers
True or False:Oxalate specimens must be mixed immediately upon collection to prevent clot formation and fibrin generation. True.
How many inversions of Oxalate specimens are required for proper mixing? 8 inversions.
Why is it essential to fill oxalate tubes to the stated capacity? Because excess oxalate causes hemolysis (destruction of red blood cell) and relaease of hemoglobin into the plasma.
Special use Anticoagulants = are combined with other additives and have additional properties for special use situations. Name 3 of these special use anticoagulants *Acid Citrate Dextrose (ACD) *Citrate-phosphate-dextrose (CPD) *Sodium polyanethol sulfonate (SPS)
Acid Citrate Dextrose (ACD) solution is available in two formulations (solution _?_ and solution _?_) for immunohematology tests such as DNA testing & human leukocyte antigen(HLA) phenotyping in paternity evaluation,or determine transplant compatibility. solution A and Solution B
Acid Citrate: prevents coagulation by binding _?_, with little effect on cells and platelets. binding calcium
Dextrose: acts as a red blood _?_ and preservative by maintaining red blood visability. red blood nutrient
ACD tubes have _?_ tops and require _?_ inversions immediately after collection to prevent clotting? yellow tops, 8 inversions
Citrate-phosphate-Destrose (CPD) is used in collecting units of blood for _?_. Citrate prevents _?_ by chelating calcium, phosphate stabilizes _?_ and dextrose provides cells with energy and helps keep them _?_. blood for transfusion, citrate prevents clotting, stabilizes pH, dextrose helps keep them alive.
Sodium Polyanethol Sulfonate (SPS) prevents coagulation by binding calcium,It is used for blood _?_ collection because in addition to being an anticoagulant, it reduces the action of a protein called _?_ blood culture, protein called complement
a protein called complement has what functions? protein: complement= destroys bacteria, slows down phagocytosis(ingestion of bacteria by leukocytes)and reduces the activity of certain antibodies.
SPS tubes have _?_ stoppers and require how many inversions to prevent clotting? yellow-stoppers and 8 inversions
What agent is a substance that prevents glycolysis, the breakdown or metabolism of glucose(blood sugar) by blood cells? Antiglycolytic Agent
Why is it important to prevent glycolysis? The clucose concentration is a blood specimen decreases at a rate of 10mg/dL per hour
True or False: Glycolysis occurs faster in newborns, because their metabolism is increased and in patients with leukemia because of high metabolic activity of WBCs. True.
Name the most common antiglycolytic agent ? sodium fluoride
What preserves glucose for up to 3 days , and also inhibits the growth of bacteria? Sodium fluoride
Sodium fluoride is commonly used in combination with the anticoagulant _?_ oxalate to provide plasma specimens for rapid-response situations. anticoagulant potassium oxalate
Sodium fluoride tubes have _?_-stoppers and require 8 inversions for proper mixing. Sodium fluoride tubes have gray-stoppers
Why are sodium fluoride tubes used to collect ethanol specimens? To prevent either a decrease in alcohol concentration due to glycolysis, or an increase due fermentation by bacteria.
Define what a clot activator is? is a substance that enhances coagulation.
Clot activator include substances that provide more surface for _?_ activation, such as glassA(silica)particles and inert clays like Celite and clotting factors such as thrombin. surface for platelet activation
_?_ particles are the clot activators in serum separator tubes (SSTs) and plastic _?_ top tubes. So;oca particles, plastic red-top tubes.
Silica particles cause the blood to clot within _?_ to _?_ minutes. Blood collected in thrombin tubes generally clots within _?_ minutes. Silica particles cause the blood to clot within 15 to 30 minutes. Blood collected in thrombin tubes generally clots within 5 minutes
_?_ tubes are used with some point of care coagulation systems. Celite tubes
How many inversions are needed with tubes that contain clot activators for complete and rapid clotting to occur. 5 gentle inversions
True or False: Blood in SST tube will eventually clot with out mixing , however when it is not mixed, glass particles may become suspended in the serum and interfere in the testing process. True.
pg247 What is the name of the gel separator that is an inert (nonreacting) synthetic substance initially contained in or near the bottom of certain blood collection tubes? Thixotropic gel separator
Thixotropic gel density is between that of the cells and the serum or _?_. plasma
When a specimen in a gel tube is centrifuged, the gel undergoes a change in _?_ (thickness) and moves to a position between the cells and the _?_ or plasma, forming a physical barrier between them. Viscosity(thickness), serum
The physical separation prevents the cells from continuing to metabolize substances, such as _?_, in the serum or plasma. Glucose
Becton Dickinson(BD) serum gel tubes have _?_ plastic or mottled _?_/_?_ rubber stoppers and are called plasma separator tubes. (SST's) have gold plastic or mottled red/gray rubber stoppers
Greiner serum gel tubes have _?_ plastic stoppers with _?_ tops. red plastic stoppers with yellow tops
BD heparinized gel tubes have light _?_ plastic or mottled _?_/_?_ rubber stoppers and are called plasma separator tubes, or PST's. light green plastic or mottled gray/green rubber stoppers
Grenier heparinized gel tubes have _?_ plastic stoppers with _?_ tops. green plastic stoppers with yellow tops
EDTA gel tubes have special _?_-colored stoppers and are called plasma preparation tubes(PPT'S) pearl colored stoppers
Although stopper colors normally indicate a type of additive in a tube, royal-blue-stoppers indicate _?_-_?_-free tubes. trace-element -free-tubes
Trace-element-free tubes are made of materials that are as free of trace element contamination as possible and are used for _?_ _?_ tests, toxicology studies, and nutrient determinations. trace element tests
These trace element tests measure substances present in such small quantities that trace element contamination commonly found in the glass or _?_ material of other tubes may leach into the specimen and falsely elevate test results. stopper material
Royal-Blue top tubes contain _?_,_?_ or no additive to meet various test requirements. Tube labels are typically color-coded to indicate the type of additive, if any in the tube. EDTA,Heparin or no additive
The order in which tubes are collected during a multiple tube draw or are filled from a syringe is important. This special sequences of tube collection is called ? Order of Draw
Filling tubes in the wrong order can lead to interference in testing from _?_ of the specimen by additive carryover, tissue thromboplastin or microorganisms. contamination
_?_ _?_ _?_ is a special sequence of tube collection that is intended to minimize these problems of contamination. Order of Draw
Order of Draw may vary slightly among institutions. Consult institution _?_ before using a specific order of draw. Protocol
What is the name for the transfer of additive from one tube to the next? Carryover/Cross Contamination
How can Carry over/cross contamination occur When blood in an additive tube touches the needle during ETS blood collection or when blood is transferred from a syringe into ETS tubes. Blood remaining on or within the needle can be transferred to the next tube drawn or filled, contamination that tube with additive from the previous tube and possibly affecting test results on the specimen.
pg248 Table 7-4 Common Tests affected by Additive Contamination. pg248 tab 7-4
Contaminating Additive name the tests potentially affected by: CITRATE *Alkaline Phosphatase *Calcium *Phosphorus
Contaminating Additive name the tests potentially affected by: EDTA *Alkaline Phosphatase*Calcium*Creatine Kinae *Partial thromboplastin *Potassium *Protime *serum iron *Sodium
Contaminating Additive name the tests potentially affected by: HEPARIN (all formulations) *Activated clotting time *acid phosphatase *calcium(some test methods)*Partial thromboplastin *protime *sodium (sodium formulations)*Lithium (lithium formulations)
Contaminating Additive name the tests potentially affected by: OXALATES *Acid phosphatase *alkaline phosphatase* *mylase *Calcium *Lactate dehydrogenase *partial thromboplastin *Potassium *protime *red cell morphology
Contaminating Additive name the tests potentially affected by: SILICA (clot activator) *Partial thromboplastin time*protime
Contaminating Additive name the tests potentially affected by: SODIUM FLUORIDE *Sodium, *urea nitrogen
What tubes have been the source of more carryover problems than any other additive. EDTA Tubes
_?_ causes the least interference in tests other than coagulation tests because it also occurs in the blood naturally. Heparin
Remembering which tests the various additives affect can be difficult. Order of draw eliminates confusion by presenting a sequence of collection that results in the least amount of interference should carryover occur.Chance of carryover can be minimized. Chance of carryover can be minimized by making sure that specimen tubes fill from the bottom up during collection and that the contents of tube do not come in contact with the needle during the draw or when transferring blood into the tubes from syringe
Tissue _?_ is a substance present in tissue fluid that activates the extrinsic coagulation pathway and can interfere with coagulation tests.It is picked up by needle during _?_ and flushed into the first tube filled during ETS collection, Tissue Thromboplastin, by needle during venipuncture,
Tissue Thromboplastin, or mixed with blood collected in the _?_ syringe
Created by: Account65