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AMC CLS Test Study

Study Guide based on tips from class

QuestionAnswer
If exposed to blood or body fluid, what is the first thing to do? Wash the affected area first! After this you need to report it to the supervisor and get to Employee health.
What is the difference between plasma and serum? Serum is the liquid portion of blood after the blood is clotted. Plasma is the liquid portion left over when the blood was not allowed to clot
What needs to be done to identify patients when drawing blood? Use two unique identifiers and not the name and birthdate, use the name and the medical record number.
What is the length of time allowed for a tourniquet to be left on? Only one minute at most. Any longer and it causes hemoconcentration, or a concentration of more cells than normal in the draw.
What is the best vein to select? The Median cubital located around the middle of the antecubital region.
What is the worst vein to select (or the last option)? The Basilic vein which is located on the pinky side of the arm.
Which vein is OK to use, but not the first choice? The cephalic vein which is on the thumb side of the arm. The median cubital is a better vein, but cephalic is better than the basilic.
What is the order of draw? Cultures, light blue, red/dark blue, gold/SST, Green, Lavender/Pink, Gray, and then any other tubes.
What does the EDTA anticoagulant do? binds up all the calcium which cannot then participate in coagulation so no clot forms
how do you mix tubes after blood draws and when? invert every tube several times to mix them immediately after draw.
Why do we mix tubes after blood draws? So we don't forget to mix the anticoagulant tubes. In these tubes the anticoagulant needs to be mixed in with the sample real well.
How do you insert the needle for venipuncture? Bevel up and at a 15-30 degree angle
How many times can you stick a patient? Only stick the same patient twice After the second miss, ask if it is OK to get someone else to try.
what is the propper needle gauge for venipuncture? 22 gauge is the best for the straight stick. 15-16 is best for drawing blood for donation, and 23-22 is a butterfly needle
What is the meaning of the biohazard symbol? This means that the materials contained within may be biologically hazardous to humans, animals, or the environment and is most likely a pathogenic substance.
Who is consulted if there is an incident? During hourse, employee health is contacted in the case of an incident. After hours, the nursing supervisor is consulted.
how is polarizing microscopy set up? a technique of microscopy where a polarizer filter is placed between the light source and sample and then an analyzer filter is placed between the at a right angle to the polarizer. A compensator is placed between the two filters so it bisects them
What is polarizing microscopy used for? it is used for urine sediment study and histological use as well as to differentiate between monosodium urate (MSU) and calcium pyrophosphate dihydrate crystals in synovial fluid. It makes optical properties of objects in the scope easier to determine.
Code Blue Physician is needed
Code Red Fire or activated fire alarm
Code black bomb threat
Code Silver Active shooter
Code Orange Hazmat spill, release or exposure
Code Green Crisis intervention
Code Pink Infant abduction (birth-1 month)
Code Adam Missing child (1 month - 18 years)
Code Yellow Missing adult (over 18 years)
Code Purple disaster with mass casualty incident, either internal or external
Code Gray Tornado Warning or alert
Code Brown evacuation
Stroke alert patient with signs and symptoms of stroke
STEMI alert patient with signs and symptoms of STEMI
Which is a legal entity Joint Commission or OSHA? Joint Commision is not a legal organization, just an accreditation, so it is not required but strongly recommended for accreditation. OSHA on the other hand has a legal side and thus must be universally followed to avoid legal issues.
What does PASS stand for? Pull the pin Aim the hose Squeeze the handle Sweep the stream
What does RACE stand for? Rescue anyone in danger Alarm the facility by pulling the alarm or calling 2222 from a hospital line. Confine the fire Extinguish flames with a fire extinguisher aiming for the base
What is a class A fire extinguisher for? Class A fires which includes any ordinary combustible or fibrous material (like wood, paper, etc.)
What is a Class B fire extinguisher for? Class B fires are flammable or combustible liquids like gasoline, propane, kerosene, paint, or paint thinners
What are Class C fire extinguishers for? Class C fires include electrical equipment
What type of extinguishers do we have at Augusta? We have Class ABC fire extinguishers in the laboratory.
What goes in the red bags? anything covered in blood, tissues, or other possibly pathogenic materials. NOT FOR NORMAL TRASH LIKE CUPS, PAPERS, ETC. Do not put sharp items in the bag though.
What goes in the sharps container? anything that can cut someone, so glassware, needles, IVs, etc.
What goes in normal trash? anything not oozing with blood and tissues i.e. bandaids, cups, paper towels, and other items that would normally be thrown in trash at home as long as it is not Protected Health Information
What goes in recycling? PHI and paper products go in the locked recycle boxes as the items in these are put through the shredder.
If you have a 1/4 dilution, what does this mean? there is 1 part of diluent with three parts dilutent making a 4 part total
How often will ata fall within +/- 1 SD? 68.3% of the time
How often wil data fall within +/- 2 SD? 95.5% of the time
how often will data fall within +/- 3 SD? 99.7% of the time
What is the 1 2S rule? a warning rule, meaning one of the 2 control results falls outside +/- 2 SD. Pt results can still be run with this
What is the 2 2S rule? means two consecutive control values for the same level of QC fall outside +/- 2 SD. Also could be both in the same run falling outside 2 SD. Cannot report pt results and needs to be corrected.
R 4S rule in one run the control exceeds + and - 2 SD between the two controls. Test run must be rejected in these cases
4 1S rule 4 consecutive QC results for one level are outside 1 SD or both levels have consecutive results that are outside 1 SD
10x rule 10 consecutive QC results for one level of control are on the same side of the mean or both levels have 5 consecutive on the same side of the mean. Out of control reject the run
1 3S rule if either of the two controls falls outside the 3SD limit the run is out of control and should be rejected.
Standard deviations a statistical value determined by multiplying the sum by (xsub1-xbar)squared and then dividing this by n-1 and square rooting it.
Coefficient of variation the standard deviation as a percentage of the mean (SD/mean).
What are qualitative tests? describe qualities, not numbers
What are quantitative tests? describe numbers
What is being looked for in audits (both external and internal)? breakdowns in system or departure from procedures so that corrections can be made. In external audits, another company audits everything and suggests how to fix it. Internally, people from different areas of the facility audit areas they don't work.
What is external Quality Management? a system for objectively checking labs performance using external proficiency testing, rechecking retesting, and onsite evaluation.
How are PT (proficiency tests) handled? Proficiency tests are received from an outside entity and then tested by one member of the lab in the manner that it would normally be handled in the laboratory setting. No second opinions unless that is common procedure.
How is competency assessed or appraised? Directly through checklists and indirectly through monitoring of records as well as re-testing.
When should personnel issues be addressed? Issues should be addressed as they are noticed, not only at official performance evaluation.
What is the definition of an occurrence? Any event that has a negative impact or potential negative impact on an organization and includes personnel, product, equipment, or the environment
Why is Customer Service important? Customer service will effect whether the patients are given the treatment needed for desired outcomes.
What is lean? Optimizing the space, time, and activity to improve the physical paths of workflow. Makes work less tiring and straining than previous methods.
What are quality indicators? established measures used to determine how well an organization meets needs and operational and performance expectations
Define Policies written statement of overall intentions and directions defined by those in the organization and indorsed by managemnt. tell what to do in a broad general way.
Define Processes A set of interrelated or interacting activities that transform input into outputs
Define Procedures Standard operating procedures are the step-by-step instructions for performing an activity. Job aids are shortened versions of the SOP, but do not replace it.
Created by: wulfmannwarrior