ASCP Review for Special Procedures
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| show | Require collection of one or more Lavender or Pink Stopper EDTA tubes. In some cases a non-additive glass Red Stopper tube is used.
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| Blood Bank Specimens - Identification and Labeling Errors: | show 🗑
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| Blood Bank Specimens - Identification and Labeling Requirements | show 🗑
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| show | 1. The clinicians ID (scanned from bar code ID)
2. Patients ID (Scanned from wrist band)
3. Blood Products unique Donor ID bar code
4. Blood Products bar code on Blood Unit
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| show | Patient Identification Check can require a second Nurse validation.
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| show | >Most Common Test Performed by Blood Bank
>Blood Type(A, AB, B, O)
>Screen Rh Factor (+ or, - )
Cross Match is performed by using the type and screen results to select donor unit of blood.
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| Type, Screen, and Cross-Match - Procedure: | show 🗑
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| show | A Transfusion of incompatible blood can be Fatal because Agglutination (Clumping) and Lysis (rupturing) of RBCs within Patients Circulatory System.
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| show | Requires Special Training and Exceptional Venipuncture Skills.
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| show | American Association of Blood Banks (AABB)- Quality Assurance & Standardization.
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| Blood Bank Specimens - Blood Bank Regulating Agency: | show 🗑
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| show | Ages 17-66 years of age and weigh at least 110 lbs. Minors must have written permission from parents. Over 66 may donate at the discretion of the Blood Bank Physician.
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| Blood Bank Specimens - Anticoagulant and Preservative: | show 🗑
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| show | Citrate: prevents clotting by Chelating Calcium
Phosphate: Stabilizes pH
Dextrose: provides energy/food for the cells to keep them alive.
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| Blood Bank - Lookback Program: | show 🗑
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| Blood Bank - Autologous Donation | show 🗑
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| Blood Cultures - Bacteremia or Septicemia | show 🗑
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| show | The presence and extent of infection as well of indicating the type of organism responsible and the antibiotic to which it is most susceptible.
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| Blood Cultures - Should be ordered: | show 🗑
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| show | Immediately before or after anticipated Fever spikes, which is when bacteria is most likely to be present.
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| show | Timely Collection is essential. Best time to detect Bacteremia 30 minutes to 2 1/2 hours prior to fever spike.
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| Blood Cultures - Specimen Requirements as cited by the ASM American Society of Microbiology: | show 🗑
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| show | Contain Sodium Citrate for Coagulation must be filled until vacuum is exhaustes to obtain a 9:1 ratio of blood to Anticoagulant.
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| Coagulation Specimens - If Hemoglobin is High or Low: | show 🗑
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| show | Not Stable should be in ice slurry during transport. If test can not be done in a timely manner then Centrifuge and Freeze Plasma.
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| Coagulation Specimens - Catheter Collection | show 🗑
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| 2-Hour Postprandial Glucose (2-hourPP) | show 🗑
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| show | 1. Patient on High Carb diet 2-3 days
2. Fast min of 10 hours
3. Fasting Glucose may be collected before start of test.
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| 2-Hour Postprandial Glucose (2-hourPP) - Start of Test: | show 🗑
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| show | is use to diagnose problems of carb metabolism. Evaluating the body's ability to metabolize glucose by monitoring tolerance to high levels of glucose without adverse effects.
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| show | 1. Diabetes Mellitus, Hyperglycemia the blood glucose level is increased.
2. Hypoglycemia blood glucose levels are decreased.
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| show | The Insulin response to a measured dose for glucose by recording glucose levels on specimens collected at specific time intervals.
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| Glucose Tolerance Test (GTT) - Length: | show 🗑
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| show | If first specimen venipuncture then all taken via venipuncture. If taken via skin puncture then all taken via skin puncture
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| Glucose Tolerance Test (GTT) - Preparation & Procedure (Time Intevals 30min, 1hr, 2hr...) | show 🗑
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| Lactose Tolerance Test (LTT) - & GTT | show 🗑
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| Lactose Tolerance Test (LTT)- Blood Samples | show 🗑
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| show | If the patient has mucosal lactase, the resulting glucose curve will be similar the GTT curve.
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| Lactose Tolerance Test (LTT) - No Lactase Enzyme: | show 🗑
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| show |
exclude the possibility of paternity rather than prove paternity.
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| show | 1. Blood Sample Testing: ABO and Rh Typing, if not excluded then a Red cell antigen test is performed.
2. Cheek Samples
3. DNA
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| Paternity / Parenting Testing - Before infant is born: | show 🗑
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| Therapeutic Drug Monitoring (TDM) | show 🗑
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| Therapeutic Drug Monitoring (TDM) - Drug Dosage Management: | show 🗑
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| show | For a drug to be beneficial the peak level must not exceed toxic level - Peak times 30 min after intravenous, 60min after intramuscular, 1-2 hours after oral
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| Therapeutic Drug Monitoring (TDM) - Trough Level (min level)Collection | show 🗑
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| show | Critical with drugs that have a short half life.
Timing less critical with drugs having a longer half life.
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| show | Withdrawal of large volumes of blood that as treatment in medical conditions like: Polycythemia & Hemochromatosis
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| show | Over production of RBCs - most common reason for performing therapeutic phlebotomy, blood letting.
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| Therapeutic Phlebotomy - Hemochromatosis | show 🗑
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| show | Clinical Toxilogy is concerned with the detection of toxins and treatment for the effects they produce
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| Toxicology Specimens - Forensic | show 🗑
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| Toxicology Specimens - Forensic Chain of Custody | show 🗑
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| show | Blood Alcohol (Ethanol) Specimens
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| show | Law enforcement agencies order BAC on drunk drivers, or suspected drinkers in car accidents.
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| Toxicology Specimens - Skin Preparation | show 🗑
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| show | A Glass Grey Stopper Sodium Fluoride Tube w/or without anticoagulant. Exhaust Vacuum and fill tube to top. Glass preferred due to porous nature of plastic tubes.
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| show | Testing is typically performed on Urine rather than blood because it is easy to obtain and a wide variety of drugs or their metabolites can be detected in urine for a longer period of time.
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| show | There are legal implication to drug screening and chain of custody protocol required regardless if the test is being performed for legal reason.
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| Toxicology Specimens - National Institute of Drug Abuse Patient Preparation Requirements | show 🗑
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| show | Aluminum, Arsenic, Copper, Lead, Iron, and Zinc
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| show | Typically Royal Blue Stopper and contain EDTA, Heparin or No Additive. Noted on the label and color coded: Lavender for EDTA and Green for Heparin.
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| show | It is best to draw it by it's self. using a needle/tube assembly.
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| show | 1%-4% of infant to young children total blood volume to be drawn. Those weighing 80lbs or more 20-30mL per culture with min. 10mL per draw.
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| show | 1 aerobic & 1 anaerobic. With syringe: Anaerobic bottle 1st then Aerobic 2nd. With Butterfly: Aerobic 1st to pull out air in tubing then Anaerobic 2nd.
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| show | Skin Antisepsis: the destruction of microorganisms on the skin critical at draw site before drawing for Blood Culture. Concentric Circles 3-4 inches in diam.
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| Blood Cultures - Skin Antisepsis. | show 🗑
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| Blood Cultures - According to the CLSI Clinical Laboratory Standards Institute: | show 🗑
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| show | >Remove lid to blood cultures - clean
>Mark Min & Max fill on bottles
>Apply tourniquet, perform venipuncture
>Inoculate the Culture medium
>Invert Bottle several times
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| Blood Cultures - Media Inoculation Methods: | show 🗑
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| show | OSHA requires the use of a safety Transfer Device
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| Blood Cultures - Intermediate Collection Inoculation Method | show 🗑
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| Antimicrobial Neutralization Products | show 🗑
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| show | Antimicrobial Removal Device: contains a resin that removes antimicrobial's from the blood.
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| Antimicrobial Neutralization Products - FAN | show 🗑
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| Lactose Tolerance Test (LTT) - False Positives | show 🗑
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| show | Blood Glucose levels speak with in 30 minutes to 1 hour following glucose ingestion. The peak in glucose levels triggers the release of insulin which brings glucose levels back down to fasting levels within 2 hours now glucose spills over into urine.
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| Toxicology Specimens - National Institute of Drug Abuse Specimen Collection Requirements | show 🗑
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