ROUTINE VENIPUNCTURE AND SPECIMEN HANDLING
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
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| On a requisition form what patient information MUST you verify and record before proceeding? | Patient's Full name
ID number
Date of birth and sex
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| Besides Patient Identification What additional information does a requisition form include? | Requesting Physician's full name
Source of specimen
Date and time of collection
Initials of phlebotomist
Indicated test requests.
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| What information needs to be labeled on the sample? | Patients Last name, First and middle
Patients ID number
Date/time of collection
The initials of the phlebotomist who did the collection.
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| The label on the sample must match? | The requisition form
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| Since blood tubes can have different additives or coatings, what must you NEVER do? | Blood should NEVER be poured from one tube to another
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| What supplies is needed to draw blood? | Evacuated Collection Tubes
Appropriate needle
Holder/Adapter
Tourniquet
Alcohol Wipes
Gauze
Bandage
Needle Disposal unit
Gloves
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| What are Evacuated Collection Tubes? | Tubes that are designed to fill with a predetermined volume of blood by vacuum.
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| What do the various colors of rubber stoppers indicate on collection tubes? | The rubber stoppers are color coded according to the additive that the tube contains.
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| Why must blood collection tubes be drawn in a specific order? | To avoid cross-contamination of additives between tubes.
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| In order, what are the first 3 blood collection tubes you would use? | First- (Yellow or Yellow- Black top) For blood cultures.
Second- (Light Blue Top) Coagulation
Third- (Red Top) Non-additive
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| On your last draw, what order of additive tubes would you draw? | 1. SST (red-gray or gold top)
2. Sodium heparin (dark green top)
3. PST (light green top)
4. EDTA (lavender top)
5. ACDA or ACDB (pale yellow top)
6.) Oxalate/fluoride (light gray top)
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| What may be obtained if the blood is not thoroughly mixed with the additive? | Erroneous test results
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| In regards to proper patient identification in what case(s) would you not proceed with drawing the patients blood? | If patient information does not match id armband.
If patient is missing id armband.
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| What areas are to be avoided when choosing a site? | Extensive scars
The upper extremity on the side of a previous mastectomy
Hematoma
Above the IV site
Intravenous lines
Cannula/fistula sites
Edematous extremities
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| Where does the tourniquet need to be placed and how long can you leave it on? | 3-4 inches above the selected puncture site
No longer than 2 minutes. 1 minute is ideal.
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| If blood stops flowing into the tube during collection what can you do? | Resecure the tourniquet to increase venous filling.
If this is not successful, remove the needle, take care of the puncture site, and redraw.
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| When the last tube to be drawn is filling what should you go ahead and do? | Remove the tourniquet.
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| Describe what you should do after you remove the tourniquet and blood collection tube. | Remove needle in the patient's arm using a swift backwards motion.
Then apply gauze once needle is out of arm
Dispose of all contaminated materials in the appropriate containers.
Then immediately mix and label all appropriate tubes
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| Where are the best locations for fingersticks? | The 3rd (middle) and 4th (ring) fingers of the non-dominant hand.
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| What finger locations must you avoid sticking? | The tip of the finger or the center of the finger.
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| What must you do after initially sticking a finger before you can start blood collection? | Wipe away the first drop of blood, which tends to contain excess tissue fluid.
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| What can you do to prevent hemolysis in a blood sample? | Mix tubes with anticoagulant additives
Avoid drawing blood from a hematoa
Making sure venipuncture site is dry
Avoiding a traumatic venipuncture
Avoid prolonged tourniquet application
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| What is hemoconcentration? | An increased concentration of larger molecules and formed elements in the blood
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| What can happen if the tourniquet is left on for too long? | Hemoconcentration
Increase of protein from tourniquet site down
Can affect packed cell volume
Can cause hemolysis.
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| What are some universal precautions you can take to protect yourself? | Wear gloves and a lab coat or gown when handling blood/body fluids.
Change gloves after each patient or when contaminated.
Wash hands frequently.
Dispose of items in appropriate containers.
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