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BLOOD COLLECTION
ROUTINE VENIPUNCTURE AND SPECIMEN HANDLING
Question | Answer |
---|---|
On a requisition form what patient information MUST you verify and record before proceeding? | Patient's Full name ID number Date of birth and sex |
Besides Patient Identification What additional information does a requisition form include? | Requesting Physician's full name Source of specimen Date and time of collection Initials of phlebotomist Indicated test requests. |
What information needs to be labeled on the sample? | Patients Last name, First and middle Patients ID number Date/time of collection The initials of the phlebotomist who did the collection. |
The label on the sample must match? | The requisition form |
Since blood tubes can have different additives or coatings, what must you NEVER do? | Blood should NEVER be poured from one tube to another |
What supplies is needed to draw blood? | Evacuated Collection Tubes Appropriate needle Holder/Adapter Tourniquet Alcohol Wipes Gauze Bandage Needle Disposal unit Gloves |
What are Evacuated Collection Tubes? | Tubes that are designed to fill with a predetermined volume of blood by vacuum. |
What do the various colors of rubber stoppers indicate on collection tubes? | The rubber stoppers are color coded according to the additive that the tube contains. |
Why must blood collection tubes be drawn in a specific order? | To avoid cross-contamination of additives between tubes. |
In order, what are the first 3 blood collection tubes you would use? | First- (Yellow or Yellow- Black top) For blood cultures. Second- (Light Blue Top) Coagulation Third- (Red Top) Non-additive |
On your last draw, what order of additive tubes would you draw? | 1. SST (red-gray or gold top) 2. Sodium heparin (dark green top) 3. PST (light green top) 4. EDTA (lavender top) 5. ACDA or ACDB (pale yellow top) 6.) Oxalate/fluoride (light gray top) |
What may be obtained if the blood is not thoroughly mixed with the additive? | Erroneous test results |
In regards to proper patient identification in what case(s) would you not proceed with drawing the patients blood? | If patient information does not match id armband. If patient is missing id armband. |
What areas are to be avoided when choosing a site? | Extensive scars The upper extremity on the side of a previous mastectomy Hematoma Above the IV site Intravenous lines Cannula/fistula sites Edematous extremities |
Where does the tourniquet need to be placed and how long can you leave it on? | 3-4 inches above the selected puncture site No longer than 2 minutes. 1 minute is ideal. |
If blood stops flowing into the tube during collection what can you do? | Resecure the tourniquet to increase venous filling. If this is not successful, remove the needle, take care of the puncture site, and redraw. |
When the last tube to be drawn is filling what should you go ahead and do? | Remove the tourniquet. |
Describe what you should do after you remove the tourniquet and blood collection tube. | Remove needle in the patient's arm using a swift backwards motion. Then apply gauze once needle is out of arm Dispose of all contaminated materials in the appropriate containers. Then immediately mix and label all appropriate tubes |
Where are the best locations for fingersticks? | The 3rd (middle) and 4th (ring) fingers of the non-dominant hand. |
What finger locations must you avoid sticking? | The tip of the finger or the center of the finger. |
What must you do after initially sticking a finger before you can start blood collection? | Wipe away the first drop of blood, which tends to contain excess tissue fluid. |
What can you do to prevent hemolysis in a blood sample? | Mix tubes with anticoagulant additives Avoid drawing blood from a hematoa Making sure venipuncture site is dry Avoiding a traumatic venipuncture Avoid prolonged tourniquet application |
What is hemoconcentration? | An increased concentration of larger molecules and formed elements in the blood |
What can happen if the tourniquet is left on for too long? | Hemoconcentration Increase of protein from tourniquet site down Can affect packed cell volume Can cause hemolysis. |
What are some universal precautions you can take to protect yourself? | Wear gloves and a lab coat or gown when handling blood/body fluids. Change gloves after each patient or when contaminated. Wash hands frequently. Dispose of items in appropriate containers. |