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Phlebotomy
Phlebotomy Technician Class
| Nosocomial infections | An infection that is acquired during a hospital stay. The UTI is the most common infection. |
| OSHA | A government agency that protects employees and develop safety standards and establishes maximum levels of exposure to many biohazardous materials. This also mandates all workers to be educated in exposure incidents, blood borne pathogens, needle safety, |
| JCAHO | A voluntary nongovernmental agency that establishes standards for the operation of hospitals and other health-related facilities and services. |
| Infectious Agent | Any disease-causing microorganism(pathogen) ie: viruses, bacteria, fungi and parasites |
| Reservoir Host | An individual in which the infectious microorganism resides. ie: Animals, humans, water, air, plant, or soil |
| Portal of Exit | The route by which the pathogen leaves the body. ie: Blood, break in skin, respiratory secretions, urinary tract, sneezing, or reproductive secretions. |
| Route of Transmission | Method by which the pathogen transfers from the reservoir to the new host. ie: air, direct contact, indirect contact, insect bites, food or water |
| Portals of entry | The route at which the pathogen enters its new host. ie: Breaks in the protective skin barrier, eyes, lungs, respiratory tract, gastrointestinal, and reproductive. |
| Susceptible Host | A person capable of being infected by invading pathogens, depending on the degree of that persons resistance. |
| Sharps container | Spill proof, tamper proof, puncture resistant plastic containers that are used to dispose used phlebotomy equipment. |
| Used needles should be dropped in the sharp container how? | With the needle tip first. Never by the holder first. |
| What goes into sharps container? | Needles with holder attached Lancets (finger pokes) Evacuated tubes with blood in them Evacuated tubes that are used without blood in them Glass Slides Anything made of glass Anything sharp |
| Plastic tubes go into: Glass tubes go into: | Waste Basket Sharps container |
| Sterilization | The process of killing all microorganisms in a certain area |
| Contamination | Process by which an object or area has become unclean |
| Blood is sterile so is: | Blood marrow |
| Personal Protective Equipment (PPE) | Gloves, gowns, protective eyewear, face masks, closed toe shoes |
| Universal Precaution | Treat everyone as if they are infectious. This should apply every time you are with a patient. |
| Immune Globulin | Boosts the immune system against Hepatitis B after an exposure to blood by needle stick, or a food exposure such as Hepatitis A. |
| AIDS stands for: | Acquired immune deficiency syndrome |
| Hepatitis B is the most common | cause of infections in healthcare workers |
| AIDS can be transmitted through | other body fluids and sexual contact |
| Protective Isolation | Protects patients from outside illness |
| Red Signal | Flammability |
| Yellow Signal | Reactivity |
| Red Signal 4: | Materials that will rapidly or completely vaporize at atmospheric pressure and normal ambient temperature, or that are readily dispersed in air and that will burn readily |
| The vacuum tube system is the most efficient, safest and easiest method of venous blood sample, especially when | multiple tests are ordered |
| Most common vacuum tube needle size is: | 21 gauge |
| Larger vacuum tubes have: | More vacuumm, not appropriate tubes to use for small or fragile veins. |
| 2ml tubes are often used for | pediatric or small and fragile veins of adults |
| Smaller the gauge number: | Larger the needle ie:20 gauage is bigger than 23 gauge |
| Most common butterfly needle gauge is: | 23 gauge needle |
| Gauge | A standard for measuring the diameter of the lumen of a needle. ie: Most common used is 21 gauge |
| Capillary sample | Collecting blood after puncturing the skin or heel with a lancet or similar skin puncture device |
| Serum | Tubes without additives, the liquid part of the specimen that is recovered after the blood has been centerfuged |
| Serum colored tubes | Red, Tiger, Gold, Marble |
| Plasma (Additive tubes) | Yellow, Blue, Green, Purple, Gray |
| Anticoagulant | chemical that prevents clotting |
| Yellow Stopper Tubes | SPS, Microbiology Dept, Blood Cultures or sterile tube tests |
| Blue Stopper Tubes | Sodium Citrate, Coagulation Dept, PT or PTT or INR |
| Green Stopper Tubes | Sodium& Lithium Heparin, Chemistry Dept, STAT tests |
| Purple or Lavender Stopper Tubes | EDTA, Hematology Dept. whole blood tests or CBC (complete blood count) |
| Gray | Sodium Fluoride& Potassium Oxalate, Chemistry Dept. glucose, alcohol, and ethanol testing |
| Red | None, Chemistry Dept. Cholesterol test |
| Order of Draw | Yellow Blue Red Green Lavender Gray |
| Never leave tourniquet on for | more than one minute |
| Most common vein | Median cubital vein |
| Order of preference vein: | Median, Cephalic, and basilic |
| Label on tube: | Name, DOB, Time, Date, Initials |
| Numbing cream on a venipuncture is: | EMLA |
| Hemoconcentration | An increase in the concentration of formed blood elements caused by lack of fluid in the blood; often caused by a tourniquet too tightly applied to the arm or left on too long |
| Antecubital space | The area of the arm located in the vicinity of the bend of the elbow where the major veins for venipuncture are located. |
| Edema | Swelling due to fluid in the tissues; fluid retention |
| CLSI | Clinical and Laboratory Standards Institute, formerly known as NCCLS A national organization that develops standards for the accurate performance of laboratory procedures, phlebotomy program approval, and certification examination questions are based on t |
| Abbre. AIDS | Acquired Immune Deficiency Syndrome |
| BUN | Blood urea nitrogen |
| CBC | Complete blood count |
| DOB | Date of Birth |
| FBS | Fasting blood sugar |
| GTT | glucose tolerance test |
| Hgb | Hemoglobin |
| NPO | Nothing by mouth |
| PKU | Phenylketonuria |
| Post-op | after surgery |
| QNS | Quantity not sufficient |
| STAT | immediately |
| UA | urinalysis |
| UTI | urinary tract infection |
| WBC | white blood cell/count |
| Hyper- | above, increase |
| Hypo- | below, decrease |
| Itis | inflammation |
| Hemolysis | Rupture of a red blood cell |
| Hemostasis | Process by which the body stops blood from leaking out of a wound |
| Basal state | When the body is at rest for 8-12 hours after the last intake of food (fasting) |
| Petechiae | small red dots that appear on the skin because of capillary hemorrhage |
| Edema | Edema results when excessive fluid collects in the tissues of a patient, resulting in swelling of the tissues. |
| Arteriole | smallest artery |
| Venule | Smallest vein |
| Arterial blood gases | The blood tube must be put on ice |
| Capillaries | smallest major blood vessels in the body |
| Order of Blood flow: | Arteries to arterioles to capillaries to venules to veins |
| Systole | contracts |
| Diastole | Relax |
| Bleeding Time Test | Performed to test a platelet plug formation. This test makes sure coagulation of the blood will occur |
| Bilirubin test | Tests the liver: KEEP OUT OF LIGHT Chemistry Dept. |
| Blood Gases Test | Carbon dioxide test Chemistry Dept. |
| Autologos | Donates own blood to use later on himself if need be |
| POCT | Point of Care Testing. (glucose test, PT, INR, istat, hemoglobin test) |
| Skin puncture | Also called microcapillary blood collections, fingersticks, and capillary punctures or sticks, are performed when a patient has no adequate veins for venipuncture and if a small amount of blood is needed. |
| Order of Draw Capillary | 1. Purple: EDTA 2. All other additive: Yellow, blue,green, grey 3. Serum-Red |
| The first drop of blood obtained from a skin puncture should be | Wiped away because the first drop contains interstitial fluid |
| The puncture on a fingertip should be: | perpendicular to the grooves on the fingertip |
| The heel stick is recommended for | children less than 1 year-old. |
| Osteomyelitis | serious bone infection |
| Osteochondritis | bone and cartilage inflammation |
| Puncture must not go deeper than | 2.4mm |
| PKU Test | All newborn babies aged 24 hours up to 7 days need to have this test |
| Arterial blood gases need to be: | PUT ON ICE! |
| When blood is centrifuged it separates into separate parts: | Serum or Plasma |
| Stable for 24 hours refrigerated: | Plasma and Whole Blood |
| Stable for 5-7 days if refrigerated, depending on facility | Serum |
| Blue top tubes have a ratio of | 9:1 (9 parts blood and 1 part anticoagulant) |
| Butterfly gauge | 23 most common |
| To disinfect site use | 70% isopropyl alcohol |
| Specimens for local transport should be placed in: | securely closed, leak proof primary container. then must be put into a secondary leak proof, water tight container. |
| Boxes or Containers must be labeled as: | biohazard, the name of your clinic, and sent to CDC if broken. |
| CDC | Center of Disease Control |
| Pre-Analytical phase | Phlebotomy ID patient Do correct draw order Use the correct tubes |
| Pre-Analytical phase | *sample disposal *Area clean up *Notifies the doctor of abnormal results *Records all test results in log books |
| Centrifuge must remain closed to: | help eliminate aerosol in the air |
| Always keep the spreader slide at a | 15-30 degree angle |
| You "smear" the blood to look at the | WBC under the microscope after it has been stained. |
| Ammonia | Lavender topped tube, placed immediately on ice slurry. Centrifuge within 15 minutes without removing stopper, separate plasma and freeze in plastic vial |
| Bilirubin | Gel-barrier tube, spin and separate within 45 minutes. Wrap in foil to protect from light, refrigerate |
| Differential | Blood smear stained with Wrights stain |
| Drug Monitoring | Plain red, no gel barrier. Centrifuge and separate within 1 hour and transfer to plastic transfer tube |
| Erythrocyte | Lavender top. Invert gently 6-8 times immediately after drawing |
| Glucose Tolerance test (GTT) is the most frequently ordered | multiple-timed test on the blood. |
| GTT is useful in helping physicians diagnose: | diabetes mellitus (DM),and hypoglycemia |
| There are 3 different types that can be drawn. They are: | 1-hour GTT, 2 hour GTT and 3-hour GTT |
| 1 Hour GTT | This is done on pregnant women to see if they become gestational diabetic |
| 2- Hour GTT | The phlebotomist draws a fasting glucose on the patient; if this is normal the patient is then given the solution to drink. Used to screen DM |
| 3-Hour GTT | Same as the 2-Hour GTT but drawn 3 times instead of 2 |
| Fasting glucose test | When patient has fasted for 10-12 hours |
| 2-Hour Postprandial | Drawn 2 hours after a patient has eaten a meal |
| Blood cultures must be drawn in sets of: | Two. One from the left arm and one from the right arm. |
| When using a yellow tube for blood cultures you must collect: | 2 tubes per set making sure sterility is not broken when drawing the blood |
| For blood culture bottles always collect the: | Aerobic bottle first |
| The average amount of blood that needs to go in the bottle may vary. Generally it is: | 8-10ml |
| Trough Level: | A trough level is described as a drug level in the blood collected when the lowest serum concentration is expected, which is usually just before the next drug dose is given. |
| Peak Level | A peak level is defined as a drug level in the blood collected 15 to 30 minutes after the medication has been given to a patient and when the highest level of the drug is expected in the blood. |
| Chain of Custody | Sequential way of tracking blood |
| IV therapy Steps to remember: | Apply the tourniquet below the IV site. Discard the first sample of blood taken before collecting test blood. 5ml is the min for regular testing; 10ml is required before drawing coagulation tests Locate a different suitable vein not being used 4 IV |
| Central Venous line | catheter, is a long, thin flexible tube used to give medications, fluids, nutrients or blood products over a long period of time. |
| Shunt or Port | Surgically implanted beneath the skin |
| PICC Line | can be used to give you treatment such as chemotherapy, antibiotics and IV fluids and feeding |
| VAD (Vascular Access Devices) | Central Venous line, Shunt or Port, PICC line |
| Malpractice | professional misconduct or lack of professional skill that results in injury to the patient; negligence by a professional, such as a physician or nurse |
| Assault | Threat |
| Battery | Unlawful Touch |
| False imprisonment | restraining against their will |
| Abandonment | is the termination of supervision of a patient by a physician without adequate written notice or the patient consent. |
| Duty of Care | the understanding that the patient has the assurance of safe care |
| Libel | is defined as a written attack |
| Slander | is spoken attack |
| Reasonable care | is a legal term which protects the healthcare worker if the worker can prove that he or she acted reasonably as compared to fellow workers |
| Advance directives | Is a document prepared while an individual is alive, and gives specifications when a patient is no longer able to make decisions. |
| Clinical Laboratory Improvement Act 1988 | regulations placed on all laboratory procedures, regardless of where such procedures are performed. |
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