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phlebotomy
| Question | Answer |
|---|---|
| Median cubital vein | First choice for routine venipuncture |
| Cephalic vein | Second choice for venipuncture |
| Basilic vein | Last choice because it is close to nerves and arteries |
| Antecubital fossa | Inside of the elbow |
| Bevel | Faces upward during venipuncture |
| intravenous Needle insertion angle | 15-30 degrees |
| Tourniquet | Do not leave on longer than 1 minute |
| Order of draw | Blood cultures, Light Blue, Red, Gold/Tiger, Green, Lavender/Pink, Gray |
| Blood culture bottle | Sterile specimen for microorganisms |
| Light blue tube | Contains sodium citrate; coagulation tests (PT, INR, aPTT) |
| Red tube | No additive or clot activator; serum tests |
| Gold/Tiger top tube | SST with clot activator and gel separator; chemistry tests, thixotropic gel |
| Green tube | sodium Heparin; plasma chemistry tests (lIthium herpain) |
| Lavender tube | EDTA; CBC and hematology |
| Pink tube | EDTA; blood bank testing |
| Gray tube | Sodium fluoride/potassium oxalate; glucose and lactic acid |
| Yellow tube (SPS) | Blood cultures & sepsis diagnosis |
| Yellow tube (ACD) Acid Citrate Dextrose | Genetic and DNA testing |
| Royal blue tube | Trace elements and toxicology |
| Microcapillary order of draw | Blood gases, EDTA, Other additive tubes, Serum |
| EDTA tube | Invert 8-10 times |
| Light blue tube | Invert 3-4 times |
| Serum separator tube | Invert 5 times |
| Heparin tube | Invert 8-10 times |
| Gray tube | Invert 8-10 times |
| Never shake tubes | Can cause hemolysis |
| Hemolysis | Destruction of red blood cells |
| Hematoma | Blood collecting under the skin |
| If hematoma develops | Stop draw immediately and apply pressure |
| Syncope | Fainting |
| If patient faints | Remove needle first, lower head, seek assistance |
| Petechiae | Tiny red spots caused by capillary bleeding |
| Hemoconcentration | Occurs when tourniquet is left on too long |
| Most common cause of hemoconcentration | Tourniquet over 1 minute |
| First step before blood draw | Identify patient using two identifiers |
| Two patient identifiers | Full name and date of birth |
| Hand hygiene | Before and after every patient |
| Gloves | Required for every venipuncture, every |
| after Cleaning site with alcohol | Allow to air dry completely |
| Do not palpate after cleaning | Unless wearing sterile gloves |
| Blood culture site preparation | Vigorously scrub the site with a 70% isopropyl alcohol swab for 30 seconds. Allow it to air dry completely. |
| Sharps disposal | Immediately after use; never recap needles |
| Needle safety device | Activate immediately after removing needle |
| Specimen labeling | At the bedside in front of the patient |
| Specimen rejection causes | Wrong label, hemolysis, insufficient quantity, wrong tube |
| CBC | Lavender tube |
| PT/INR; measures how long it takes your blood to clot. | aLight blue tube |
| BMP/CMP | Gold or green tube |
| Glucose | Gray tube |
| Blood cultures | Yellow SPS or culture bottles collected first |
| Fasting specimen | Usually 8-12 hours with only water allowed |
| Capillary puncture adult site | Middle or ring finger |
| Capillary puncture infant site | Medial or lateral plantar heel |
| Do not use thumb | Has a pulse |
| Do not use index finger | More sensitive |
| 'boys like real girls good lets Go' | order of draw memonic |
| Maximum heel puncture depth | 2.0 mm |
| Wipe away first drop of capillary blood | Removes tissue fluid contamination |
| Arterial blood gases (ABGs) | Collected from an artery, not a vein |
| Chain of custody | Maintains legal documentation for forensic specimens |
| Therapeutic drug levels | Collected at specific times |
| Peak drug level | Collected after medication reaches highest concentration |
| Trough drug level | Collected immediately before next dose |
| Needle gauge for routine venipuncture | 21-22 gauge |
| Butterfly needle | Used for small or fragile veins |
| Evacuated tube system | Most common blood collection method |
| Syringe method | Used for fragile veins when vacuum may collapse vein |
| Subcutaneous (Subcut) (SQ) | 45 degree angle (or 90 if patient has more fat or using a very short needle) |
| intramuscular (IM) | 90 degree angle |
| intradermal needle (ID) | 10-15 degree angle |
Created by:
Valentine.Taylor