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BLOOD COLLECTION

ROUTINE VENIPUNCTURE AND SPECIMEN HANDLING

QuestionAnswer
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.
Created by: kelliekountis