| Question |
Answer |
| Preferred Puncture Sites |
Fleshy surface of the distal degment of the third (middle) or fourth (ring) finger |
| Not recommended Puncture Sites |
Sides or extreme tip of the finger |
| Preferred Puncture Site |
Lateral or medial plantar surface of the heel (pediatric phlebotomies) |
| Blood volume of a human |
4-5 L |
| Not recommended Puncture Site |
Earlobe |
| Not Recommended Puncture Site |
Central arch area of an infants heel and posterior curve of the heel |
| Not recommended Puncture Site |
Fingers of a newborn or infant |
| Not recommended Puncture Site |
The fifth (pinky) finger |
| Not recommended Puncture Site |
The thumb, because it has a pulse |
| Not Recommended Puncture Site |
The index (pointer) finger |
| Not Recommended Puncture Sites |
Fingers on the side of a mastectomy |
| Not Recommended Puncture Sites |
Swollen or previously punctured sites |
| Complications from heelsticks |
Cellulitis |
| Complications from heelsticks |
Osteomyelitis of the calcaneus |
| Complications from heelsticks |
Abscess formation |
| Complications from heelsticks |
Tissue loss |
| Complications from heelsticks |
Scarring of the heel |
| Complications from heelsticks |
Calcified nodules (most common in neonates) |
| Professional Organizations for Phlebotomists |
NPA - National Phlebotomy Association |
| Organizations for Phlebotomists |
ASCP - The American Society for Clinical Pathology |
| Organizations for Phlebotomy |
ASCLS - The American Society for Clinical Laboratory Science |
| Organizations for Phlebotomy |
AMT - American Medical Technologists |
| Organizations for Phlebotomy |
ASPT - American Society of Phlebotomy Technicians |
| Organizations for Phlebotomy |
NAACLS - National Accredediting Agency for Clinical Laboratory Sciences |
| Organizations for Phlebotomy |
NHA - National Healthcareer Association |
| Order of the Draw |
Yellow, Light Blue, Red or Gold, Green, Lavender or Pink, Gray |
| Order of the Draw |
EDTA specimens, other tubes with additives, non-additive tubes |
| EMLA |
A topical anesthetic, needs to sit approx. 1 hr before working |
| Certification Agencies for Phlebotomists |
NPA - National Phlebotomy Association |
| Certification Agencies for Phlebotomists |
ASCP - The American Society for Clinical Pathology |
| Certification Agencies for Phlebotomists |
AMT - American Medical Technologists |
| Certification Agencies for Phlebotomists |
ASPT - American Society of Phlebotomy Technicians |
| Certification Agencies for Phlebotomists |
NHA - National Healthcareer Association |
| Specimen of choice of Chemistry Department |
Green or Gold |
| Indications for Capillary Blood Collection |
Burn Victims |
| Indications for Capillary Blood Collection |
Obesity |
| Indications for Capillary Blood Collection |
Thrombic tendencies - people who tend to have blood clots |
| Indications for Capillary Blood Collection |
Fagile, shallow veins |
| Indications for Capillary Blood Collection |
Saving veins for chemotherapy or other treatment |
| Indication for Capillary Blood Collection |
Point of care testing - only requires a ver small amount of blood, such as hematocrits, hemoglobin, or blood glucoses |
| Capillary Collection |
Step 1 - Chose a finger that is not cold, cyanotic or swollen-preferably the 3rd or 4th finger on the non-dominate hand or the heel on infants less than 1yr of age |
| Capillary Collection |
Cleanse site with 70% alcohol |
| Capillary Collection |
Step 3 - Allow to air dry |
| Capillary Collection |
Step 4 - Secure finger or heel firmly |
| Capillary Collection |
Step 5 - Use a retractable safety device for capillary puncture |
| Capillary Collection |
Step 6 - Position devive perpendicular to the fingerprints and activate device by pressing on the release mechanism |
| Newborn Screening Tests |
PKU - Phenylketonuria |
| Newborn Screening Tests |
Toxoplasmosis |
| Newborn Screening Tests |
Sickle cell disease |
| Newborn Screening Tests |
HIV |
| Newborn Screening Tests |
Galactosemia |
| Newborn Screening Tests |
Maple syrup disease |
| Venipuncture in pediatrics |
Use the standard antecubital space if possible |
| Venipuncture in pediatrics |
Use a 23 guage needle |
| Venipuncture in pediatrics |
Stabilize the childs arm |
| Venipuncture in pediatrics |
Make sure the alcohol is dry |
| Venipuncture in pediatrics |
Select the median cubital vein |
| Venipuncture in pediatrics |
Stretch the skin tight |
| Interventions to Alleviate Pain |
EMLA |
| Interventions to Alleviate Pain |
Oral sucrose - 24% solution |
| Albumin |
Serum protein formed from amino acids, values can provide information on hydration, nutrition and liver function |
| Globulin |
Serum protein formed from amino acids, valus can provide information on hydration, nutrition and liver function |
| Alkaline Phosphates |
An enzyme that plays a role in the crystalization of calcium salts |
| Bilirubin |
A waste product removed by the liver and excreted in the bile |
| BUN |
Blood Urea Nitrogen, excess amino acids are converted to urea, high BUN levels indicate poor kidney function |
| Creatinine |
A metabolic prodict of creatine, a substance stored in the muscle and used for energy, creatinine is excreted by the kidneys |
| Creatine kinase (CK) |
An enzyme in the blood that may indicate that an infarction has occured |
| Electrolytes |
Includes K+, Na+, CO2, and Cl- |
| Electrolytes |
Vital to acid/base balance, pH, heart and muscle function |
| Gout |
A metabolic disorder caused by the formation of crystals of uric acid within the synovial fluid of joints |
| Lactate dehydrogenase (LDH) |
An enzyme in the blood that may indicate that an infarction has occured |
| Liver enzymes |
ALP, ALT, AST, GGT, and LDH |
| Triglygerides |
The main form of lipid storage in adults, the serum or plasma may be milky in appearance when hyperlipidema is present |
| Glucose |
The main analyte measured when evaluating carbohydrate metabolism |
| Glucose |
Normal values 70-110mg/dl |
| Fasting blood glucose |
A blood specimen is collected when a patient has been fasting for a specified period of time, usually 8-12 hrs |
| Fasting blood glucose |
A value above 126 mg/dl is indicative of hyperglycemia in the fasting patient |
| 2 hour post-parandial |
A blood specimen is collected when a patient is fasting, and the patient is then instructed to eat a meal rich in carbohydrates or to drink a standardized bottle of glucola (50-100g of glucose) |
| 2 hour post-parandial |
Blood is drawn 2 hours post meal |
| 2 hour post-parandial |
Blood glucose level should return to normal or below 110mg/dl after 2 hours |
| Lipids |
Organic compounds containing carbons, hydrogens, and oxygens, includes fats, oils and waxes, synthesized from dietary fats in the body |
| Uric acid |
A metabolic waste product formed by the breakdown of nucleic acids and excreted by the kidney, cause of gout when it precicipitates into crystals |
| GTT |
Glucose Tolerance Test |
| GTT |
Test for diabetes & hypoglycemia |
| GTT |
Critical values - blood glucose below 40 mg/do or above 400 mg/dl |