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blood
| Question | Answer |
|---|---|
| glass tube with red stopper | no additive; plain old vial use when serum is needed |
| plastic tube with red stopper | clot activator used to separate the hemoglobin? from the serum |
| grey stopper | oxalate and sodium fluoride anticoagulant decreases calcium glycolytic inhibitor (preserves glucose in sample) used for glucose testing if there will be a delay before testing |
| light blue stopper | sodium cytrate (anticoagulant) used for PT, aPTT, and fibrinogen assay |
| yellow stopper | citrate +ACD used for tissue typing, DNA and paternity testing, HLA phenotyping |
| yellow stopper | no citrate, sodium polyanethol sulfonate (SPS) for cultures |
| how to tell the yellow stoppers apart | read for additives! ACD or SPS |
| lavender stopper | contains EDTA anticoagulant (preserves whole blood) can be: glass tubes: tripotassium, liquid form plastic tubes: dipotassium, spraydried poweder - for hematology such as CBC, smears, microhematocrit |
| hematocrit test | measures the % RBCs in your blood |
| green stopper | heparin for chemistry tests! comes in 3 forms -lithium, sodium, and ammonia heparin |
| when is the cutoff for how long blood samples can be stored before testing | 48 hours |
| how full do tubes with additives need to be | completely full so that the ratio of additive to blood is good |
| white/pearl top stopper | EDTA + gel for EDTA plasma, centriguge; doesnt leave the tube (the gel seperates plasma from blood cells) - good for HIV patients used for molecular tests like PCR (polymerase chain reaction) and branched DNA amplification techniques |
| EDTA | an anticoagulant |
| royal blue stopper | used in trace element studies ex: testing for traces of zinc, lead, arsenic, copper etc 3 types 1) no anticoagulant 2) sodium heparin (green) 3) disodium EDTA (lavender) |
| when you fill a tube with an additive | gently invert 5-8 times to mix |
| when can you use a blood pressure cuff and how | 1/2 inflates between diastolic and systolic with obese, geriatric, and pediatric patients |
| disposable calibrated micropipette | the kind you use in bio used for blood transfer hold tube semihorizontally and let blood flow into it 1-200 microliters |
| microhematocrit capillary tubes | like the kind we use in chem lab intended for determining packed red blood cell volume in microsamples must be filled at least 2/3 full 50-75 microliters required |
| blood gas collection pipettes | for blood gas determinations 50-250 microliters amount needed depends on instrument used |
| noncapillary plastic microcollection devices | includes means for filling, measuring, color coding, stoppering, centrifugation, storage matches anticoagulant tubes |
| samples for bilirubin | collected in amber tubes to protect blood from light |
| for neonatal screening samples | prick/puncture heel of newborn, let blood drop onto a filter paper card, let blood dry and send to lab |
| what should the phlebotomists tray include | -alc swabs -gauze squares/cotton balls -evacuated tube holders -syringes -syringe transfer device -various size syringes & evacuated tube needles -butterfly collection sets -microcollection equip -tourniquets -gloves -sharps cont -marking pen |
| what should you do every time you set out equiment | check for expiration dates |
| order of draw | yellow (blood culture or yellow or bottles for blood culture) light blue red or speckled tubes (plastic or glass) green lavender grey |
| why must you always draw in the arm down position | to prevent backflow of additives back into body |
| when labeling a sample include | name identification number (or DOB) collection date time of sample collection your initials (or of person collecting sample) aliquots or dilutions must have type of sample too (plasma, serum...etc) |
| order of what site to check a draw from, first to last | 1) upper bend o arm (antecubital area) - median cubital vein (the one thats kinda across) - basilic (less preferred bc there are nerves, b careful & dont go 2 deep) 2) back of hand 3) wrist 4) foot & ankle -need permission from physician |
| when drawing from back of hand | to avoid rolling, hold vein below puncture site with thumb and use a small gague needle (23 or lower) or butterfly |
| sites to avoid | edematous arms arms in casts arms with IVs cannulas fistulas excessive scarring like burns and hematomas arm on the same side of a masectomy |
| HOW TO TELL A VEIN FROM AN ARTERY | when palpating, if it pulsates THATS AN ARTERY!! RUN!! |
| when to don gloves | after cleansing is fine |
| where to palpate | 1-2 inches above and below puncture site DONT TOUCH PUNCTURE SITE |
| what to do if you need more than one needle/syringe | use a butterfly |
| when to remove tourniquet | after 1 min, reapply if needed BEFORE removing needle |
| when using a butterfly collector | will need to make a discard tube because there will be air use a plain glass red tube butterfly system should be inserted at 5-10 degrees rather than the usual 15 to 30 |
| with kids | use 23 gague needle (25 maybe if needed) and a butterfly needle use 2-3 ml evacuated tubes or small syringe stick to superficial veins can consider when theyre older than 1 use dorsal hand vein if possble child must be securely held |
| when to use capillary puncture | with kids younger than 1; heel with adults with inaccessible veins: finger puncture also used in adults with severe burns or other circumstances that dont allow for venipuncture |
| capillary puncture how to | cut ACROSS fingerprint grain use center of finger puncture site must be warmed and site must not be edematous can use earlobe in severely burned patient but only if no other option only use alcohol to clean wipe first drop of blood |
| NPO | nothing per oral or whatevr means they cant be given anything to eat or drink; fasting sample ask them if theyve had anything to eat or drink if this is on their file after draw, check with nurse before you tell them they can eat |
| for tests for alcohol testing | use a non alcohol swab DONT USE IODINE it includes alcohol use soap, zephrin chloride, hydrogen peroxide, etc |
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