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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.
Created by: 512126904