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CCMA M8: Phlebotomy
CCMA Module 8: Phlebotomy general terms
Laboratory requisition form includes: | Ordering provider's name & contacts Test & Test code Diagnosis code (ICD-10) Special specimen requirements i.e. fasting Patient demographics Insurance/billing info |
Phlebotomy Supplies | Alcohol wipes, gauze, adhesive bandages (wrap), biohazard sharps container, PPE (including disposable gloves), tourniquet, collection tubes, needle system |
Lumen | Hollow space inside the needle AKA gauge. |
Bevel | Shaft at the end of the needle that creates the point. |
Which hand should the needle be held in for venipuncture? | Dominant hand |
Where should the supply tray be during venipuncture? | Opposite of the dominant hand (on the nondominant side) |
What is blood composed of? | Plasma, RBCs, WBCs, platelets |
Plasma makes up ____% of blood | 55% |
RBCs (Erythrocytes) make up ____% of blood | 45% |
WBCs and platelets make up ____% of blood | <1% |
Serum | Liquid portion of the blood obtained after a serum sample tube has clotted and centrifuged. Does NOT contain clotting factors. |
Plasma | Liquid portion of blood obtained after centrifuging. Contains clotting factors. |
Clotted blood | Blood is drawn in a tube that does not contain an anticoagulant. |
Whole blood | Obtained when a tube is used with an anticoagulant. |
Blood tubes should be_______ | Filled completely, some tubes will have a minimum fill indicator line (i.e. light blue). |
What vein is preferred for venipuncture? | Median cubital vein (within the antecubital space) |
What are alternative veins for venipuncture? | Cephalic vein (radius side), basilic vein (ulna side) These veins are found on either side of the median cubital vein. |
What are alternative places for venipuncture? | Back of the hand, wrist, and foot (venipuncture of the foot should only be done under provider supervision |
Tourniquets should be applied | 3-4 inches above the draw site |
A tourniquet should not be left on for___________ | longer than 1 minute (may cause hemoconcentration if left in place longer than 1 minute) |
Site restrictions | Certain medical conditions require specific blood draw procedures, i.e. fistulas, ports, or mastectomy. |
After cleansing with an antiseptic wipe, the venipuncture site must______________ | be left to air dry. Tourniquet must be reapplied after site is dry. |
Anchoring veins | Grasp the skin 2-3 inches below puncture site |
Needle angle | The needle must be inserted at a 15-30 degree angle with the bevel facing upward. |
Capillary punctures | Performed only when a small amount of blood is needed for testing, or for immediate results. |
Capillary puncture supplies | Gloves, automatic retractable lancet, disinfectant pads (70% isopropyl alcohol), clean gauze pads. bandage, appropriate blood collection device, capillary tube sealer, biohazard sharps container |
Capillary puncture blood collection devices | Micropipette, small glass tube (capillary tube), micro-collection devices, glucometer and testing strip, screen card or paper, plastic cartridge, or cassette |
Capillary puncture site: Adults | Preferred puncture site is the middle or ring finger of the nondominant hand. |
Capillary puncture site: Infants | Performed on the outer edge of the underside of the heel. |
First drop of blood is wiped away during a capillary puncture unless ________________ | performing a prothrombin time (PT) test |
Bandaging procedures | Bandaging must be left in place for a minimum of 15 minutes. |