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Phlebotomy
| Term | Definition |
|---|---|
| Responsible for the collecting of any bodily fluids e.g blood draw, urine, stool, pregnancy test etc. | |
| Roles of a Phlebotomist: | 1. Collect capillaries and venous specimen for testing. 2. Maintain safe working conditions. 3. Perform laboratory computer operations. 4. Carry out task assigned by supervisors. |
| Standards of right and wrong to avoid harming patients. | |
| Dependability, honesty, compassion etc. | |
| Urgent care centers, wellness clinics, nursing home and Dr office laboratory. | |
| Carries deoxygenated blood to from the right ventricle to the lungs (oxygenation takes place) returns oxygenated blood to the left atrium. | |
| Carries oxygenated blood from the left ventricle throughout the body. | |
| An atrioventricular valve, situated between the right atrium and right ventricle. | |
| A semi lunar valve situated between the right ventricle and the pulmonary artery. | |
| An atrioventricular valve, situated between the left atrium and the left ventricle. | |
| A semi lunar valve between the left ventricle and the aorta. | |
| Aorta, arteries, arterioles, capillaries, venules, vein, superior and inferior vena cavae. | |
| 1. Tunica adventitia- Outer connective tissue layer 2. Tunica media- middle smooth muscle layer 3. Tunica intima- inner endothelial layer | |
| Carry oxygenated blood from the heart to parts of the body. | |
| Carry deoxygenated blood back to the heart. | |
| A layer of endothelial cells, connects the arterioles and venules. The thin wall allows rapid exchange of oxygen, nutrients, carbon dioxide and waste between the blood and tissues cells. | |
| Liquid portion of the blood e.g water (92%), proteins, gases, hormones etc. | |
| Blood cells | The form elements of the blood e.g erythrocytes, leukocytes and thrombocytes (platelets). |
| Contains hemoglobin, the oxygen carrying protein. It enters the body as reticilocyte and in 1 to 2 days matured into an erythrocyte. It’s life span is 120 days. | |
| Provide protection against body infections. | |
| Increase in WBC (infection and leukemia). | |
| A decrease in WBC (viral infection or chemotherapy) | |
| Phlebotomist | |
| Code of ethics | |
| Characteristics of a phlebotomist are: | |
| Facilities where phlebotomist work are: | |
| Pulmonary circulation | |
| Systemic circulation | |
| Tricuspid valve | |
| Pulmonic valve | |
| Mitral valve | |
| Aortic valve | |
| Blood vessels | |
| Blood vessels have three (3) layers | |
| Aorta, arteries and arterioles | |
| Venules, veins, superior and inferior vena cavae | |
| Capillaries | |
| Plasma | |
| Erythrocytes | |
| Leukocytes | |
| Leukocytosis | |
| Leukopenia | |
| Endocardium | The endothelial inner layer of the heart. |
| Myocardium | The muscular middle layer, the contractile element of the heart. |
| Epicardium | The fibrous outer layer of the heart. The coronary arteries which supply blood to heart are, found in this layer. |
| Neutrophils | They fight bacterial infections. The most numerous 40% to 60% WBC. |
| Lymphocytes | They fight viral infections. The second most numerous 20% to 40% WBC. |
| Monocytes | They fight intracellular infections and tuberculosis. Also the largest WBC 3% to 8%. |
| Eosinophils | They fight skin infections and parasitic infections. 1% to 3% WBC. |
| Basophils | They carry histamine, released to fight allergic reactions. 0% to 1% WBC. |
| Hemostasis | The process by which blood vessels are repaired after injury. |
| Vascular phase | Injury to the blood vessel causes it to constrict, slowing blood flow. |
| Platelet phase | Injury to the endothelial lining causes platelets to adhere to it. |
| Aggregation | Additional platelets stick to the site forming a temporary plug. |
| Primary hemostasis | Evaluated by bleeding time test. |
| Coagulation phase | Converts temporary platelet plug to a stable fibrin clot. The intrinsic and extrinsic system comes together in a common pathway. |
| Fibrinolysis | The breakdown and removal of a clot. |
| Median cubital vein | Vein of choice because it is large and does not move when a needle is inserted. |
| Cephalic vein | Second vein of choice, more difficult to locate and moves. This vein can be palpated in obese patients. |
| Basilic vein | The third vein of choice, it’s least firmly anchor and located near the brachial artery. If needle is inserted to deep this artery may puncture. |
| Sclerosed veins | Hard cordlike vein, cause by disease, -itis, chemotherapy & repeated venipuncture. |
| Thrombotic & Tortuous veins | Winding or crooked veins, susceptible to infection that can cause Impaired blood flow which can lead to error test results. |
| Four (4) chambers of the heart | Left atrium Left ventricle Right atrium Right ventricle |
| Blood flows through the body: | 900-1000 times per day. |
| Blood flows from head to toes: | In one (1) minute. |
| STAT | Have to be processed first (1st). |
| Hematoma | Blood settles in the tissue surrounding the puncture site. Causes: needle going through the vein Failure to apply pressure after the needle has been removed. |
| Hemoconcentration | An increased in the form elements of blood to plasma. Causes: Tourniquet left on too long (more than 2 minutes). |
| Phlebitis | Inflammation of the vein Causes: Repeated venipuncture on that vein. |
| Petechiae | Tiny non-rise red spots on the skin Causes: Ruptured capillaries due to tourniquet left on too long or too tight. |
| Thrombus | Blood clot Causes: Not enough pressure applied after needle removal. |
| Thrombophlebitis | Inflammation of the vein with formation of a clot. |
| Septicemia | A systemic infection associated with the presence of pathogenic organisms Causes: Not going in the vein at a 15-30 degrees angle When gloves are popped. |
| Trauma | Injury to the underlying tissues Causes: Probing of needle. |
| Factors prior to venipuncture | Fasting- glucose, cholesterol, triglycerides (12 hr) Edema- accumulation of fluids in tissues Fistula- permanent surgical connection between artery and vein. Dialysis procedure and my cause infection if used for venipuncture. |
| Hemolysis | Destruction of a cell e.g. small needle |
| Special Venipuncture | Fasting specimen Timed specimen Two-hour Postprandial Test Oral Glucose Tolerance Test (OGTT) Therapeutic Drug Monitoring Blood cultures (BC) PKU |
| Special Specimen Handling | Cold Agglutinins Chilled Specimens Light Sensitive Specimens Dermal Punctures (Microcapillary collection) |
| Fasting Specimen | Collection of blood while the patient is in a basal state, i.e the patient has fasted and refrain from strenuous exercise for 12 hrs. |
| Timed Specimen | To monitor level of specific substance or condition in the patient. Measure blood level of substance (cortisol, hormone) Measure blood levels of medication (digoxin) Monitor changes in patient’s condition( decrease in hemoglobins level) |
| 2 Hour Postprandial Test | Evaluated diabetes mellitus. Fasting glucose levels compared with the level 2 hrs after a meal or ingesting a measured amount of glucose. |
| OGTT Scheduled to begin 0700-0900. | Diagnose diabetes & evaluate with frequent low blood sugar. 3hr OGTT- test hyperglycemia & diagnose diabetes mellitus 5hr OGTT- evaluate hypoglycemia for disorders of carbohydrate metabolism |
| Therapeutic Drug Monitoring | Monitor level of medication and maintain plasma level. Trough level(low) is collected 30 mins before dose. Peak level (highest) vary depending on patient medication, metabolism and routine administration of (IV,IM, or Oral) |
| Blood Cultures | Detects the presence of microorganisms in the blood. Fever of unknown origin(FUO) indicates pathogenic microorganisms in the blood (septicemia). BC-are ordered STAT or as timed specimen and collections are strict aseptic technique. |
| PKU | Ordered for infants 0-1yr) to detect phenylketonuria a genetic disease that causes mental retardation & brain damage. Blood is on heel or urine |
| Cold Agglutinins | Antibodies produced in response to mycoplasma pneumoniae infection (atypical pneumonia). Antibodies attach to RBC below body temperature. SPECIMEN MUST BE KEPT WARM. Collected in a red top tube, pre-warm at 30 degrees for 30 mins. |
| Chilled Specimen | Chilled immediately after collecting in ice or ice & water mixture. Transported immediately for processing e.g arterial blood, gases, ammonia, lactic acid, gastrin, parathyroid hormone. |
| Light Sensitive Specimen | Protected from light by wrapping tubes in aluminum foil immediately are drawn. E.g bilirubin, beta-carotene, vitamin A &B6 & porphyrins. |
| Dermal Puncture | Performed on both pediatrics and adult patients. Pediatric- lead test Adult- hyperglycemia |
| Infants dermal puncture | Done on the heel. Puncture must not exceed 2.0mm. Don’t do puncture on previous puncture site. Use medial and lateral areas of the plantar of the heel. |
| Adults dermal puncture | Third or fourth finger of the non-dominant hand. |
| Dermal Puncture Procedures | Identify patient Assemble equipment Warm site (PH or blood gases) Clean site Prepare the puncture device Perform the puncture |
| CLINICAL LABORATORY SECTION | Hematology Chemistry Blood Bank Serology (Immunology) Microbiology Urinalysis |
| Hematology Section | Formed elements of the blood is studied. Infections and disorders are detected. LAVENDER-TOP TUBE. |
| Chemistry Section | ELECTROPHORESIS - analyzes chemical components of the blood,with different electrical charge. TOXICOLOGY- analyzes plasma level of drugs & poison (overdose) IMMUNOCHEMISTRY- uses radio & enzymes immunoassay to detect measure substance (hormones, drugs) |
| Blood Bank Section | Blood is collect , stored and prepared for transfusion. |
| Serology (Immunology) Section | Test evaluate immune response, serum to analyze amount of antibodies to bacteria, viruses, fungi , parasites & antibodies against autoimmunity. |
| Microbiology Section | Detect pathogenic microorganisms and determine most effective antibiotic therapy. |
| Urinalysis Section | Urine test done to detect disorders, and infections of the kidney, UTI and metabolic disorders. |
| 3 Urinalysis Section | Physical- color, clarity & specific gravity Chemical- pH, glucose, ketones, protein, blood, bilirubin, nitrites & leukocytes. Microscopic- cast, bacteria, yeast and parasites. |
| Color | Clear- too much water Light yellow- enough water Yellow- boarder line dehydrated Dark yellow- dehydrated Light amber Amber- berries, beet, medication, organ function |
| Clarity | Clear- no visual presence of infection Slightly cloudy- visual presence of infection Cloudy- kidney stone Very cloudy- cancer, tumor etc. |
| Odor | Aromatic- smells like urine Ammonia- sitting for awhile Foul- infection UTI, kidney stone Fruity- diabetes (glucose & ketones) Musky-food & medications Nutty- coli &/or bacteria |
| Supernatant | The process by which the urine settles, crystallized. |
| Galactosemia | A genetic trait carry by both parents. It prevent the body from breaking down simple sugar (carbohydrates) and unable to process dairy products. |
| PH | Acidic or alkaline in the urine. |
| Specific gravity | Checks the amount of substance in the urine. High- more solid Low- more fluid |
| Protein | Fever, strenuous exercise, pregnancy, kidney disease cause protein in the urine. |
| Glucose | Very high blood sugar levels can cause sugar to spill over in the urine, also kidney disease, liver damage, ardeno glands.a |
| Nitrate | Shows UTI is present. |
| WBC Esterase | WBC in the urine shows an UTI is present. |
| Ketones | Diabetic ketoacidosis, carbohydrates (low), starvation or severe vomiting cause ketone in the urine. |
| Microscopic analysis | Urine is spun on a centrifuge, sediment settle at the bottom and then placed on a slide to be looked at under a microscope. |
| Cast | The type of cast in the urine shows the type of kidney disease present, RBC or WBC, waxy or fatty substance, protein. |
| Crystals | Kidney stone or metabolism problem. |
| Bacteria, yeast cells, or parasites | An infection is present. |
| Squamous cells | Sample is not pure. |
| Duffing | Gloves removal |
| Dorning | Apply gloves |
| CDC | Revises the Universal precautions |
| Biologic hazard | Bacterial, viral, fungal, or parasites infection. |
| Sharps hazards | Needle, lancet, broken glasses, can puncture & cut and cause blood borne pathogen exposure |
| Chemical hazard | Preservatives and chemical use in the laboratory, can cause exposure to carcinogenic or caustic substances. |
| Fire or explosive | Bunsen burners, oxygen & chemical can cause burns. |
| Physical hazard | Wet floors, heavy lifting. |
| Allergic reactions | Latex sensitivity |
| Biosafety level 1 | No harm, not fatal or severe. |
| Biosafety level 2 | Harmful but not fatal. Airborne, viruses, HIV. |
| Biosafety level 3 | Lethal, cause severe diseases. Must have a policy manual for any biohazard product ( inhaled product) |
| Biosafety level 4 | Easily contracted may be fatal, no cure, no vaccine. |
| Chain of infection/ Infection control | Agent (host) Mode of transmission Susceptible host |
| Agent | Person or thing that has virus or infection. |
| Susceptible host | Person who receives virus. |
| Mode of transmission | The way the virus travels: Contact- direct/ indirect Droplet- sneezing, coughing, spitting Airborne- breathing Common vehicle- door knobs, table, cup etc. Vectorborne- any species with venom, super, snake, bees, mosquitoes. |
Created by:
Cris37
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