Safety And Compliance
What should you do with a used needle right after a draw?
Put it directly into the sharps container.
A phlebotomy technician is preparing to draw blood from an inpatient. Which of the following is the most reliable way to confirm the patients identity?
Ask the patient to state their full name and date of birth.
When choosing a vein in the antecubital fossa (the crook of the elbow), which vein is the first choice because it is usually the largest, best anchored, and least painful?
Median Cubital Vein
After collecting a blood sample in a tube containing an additive (like an anticoagulant), what should the technician do immediately?
Gently invert the tube 5 to 10 times
If a patient tells you they have a history of fainting during blood draws, what is the safest way to position them?
Lying down (supine) on an exam table
What is the single most effective way to prevent the spread of infection?
Proper Hand Hygiene.
To ensure a safe blood draw and prevent the patient from falling if they faint, how should their arm be positioned?
Placed down on a steady surface and extended straight out from the shoulder to wrist.
When inserting the needle into the vein, the bevel (the slanted opening at the tip of the needle) should always be facing in which direction?
Facing up.
When placing tubes into a centrifuge to separate serum or plasma, what is the most important rule to follow?
Place tubes of equal size and volume directly across from each other
Before applying a bandage or using an antiseptic, what is the most important question to ask the patient regarding safety?
"Do you have any allergies to latex or adhesives?"
What is the maximum amount a tourniquet should be left on the patients arm to avoid hemoconcentration?
1 Minute.
A patient is scheduled for a Lipid Panel and asks if they can have their morning coffee with cream and sugar before the draw. What is the correct response?
No, they must not eat and must only drink water.
A phlebotomy technician is performing a venipuncture. As soon as the vacuum tube is engaged, blood begins to flow into the tube but then suddenly stops. The technician notices a small, bluish swelling beginning to form around the insertion site. Which of the following is the most likely cause, and what is the required immediate action?
The needle has transfixed (gone through) the vein; discontinue the draw immediately.
A phlebotomy technician has just collected a chemistry profile in a Serum Separator Tube (SST) with a gold top. Which of the following is the correct protocol for processing this specimen?
Allow the tube to sit upright for 30–60 minutes before centrifuging.
A technician is performing a venipuncture in the antecubital area. Upon needle insertion, the patient screams and describes a "shooting, electric-like pain" radiating down their arm into their hand. Which of the following is the most appropriate safety response?
Immediately terminate the draw and remove the needle.
A phlebotomy technician is transferring serum into an isolator tube when a splash of blood occurs, striking their eyes. Which of the following actions should the technician take first?
Rinse eyes with water or sterile saline.
A phlebotomy technician is preparing to collect a blood sample for a triglyceride test. Which of the following patient preparation steps is most critical for ensuring accurate results for this specific analyte?
Confirm the patient has fasted for at least 12 hours.
A phlebotomy technician is preparing to draw a blood specimen for a peak level of a therapeutic drug. Which of the following is the most critical action to take during patient preparation?
Check with the nurse to confirm the exact time the medication was administered.
A technician is processing multiple specimens. Which of the following specimens requires the most stringent temperature-controlled processing, specifically requiring pre-chilled tubes and transportation in an ice slurry?
Ammonia.
In a neonatal intensive care unit (NICU), a phlebotomy technician is required to track the total volume of blood collected from a premature infant over a 24-hour period. What is the primary patient safety reason for this strict documentation?
To prevent iatrogenic anemia caused by excessive blood loss.
A technician notices that the laboratory's centrifuge is making a loud, rhythmic "thumping" noise while in operation. Which of the following is the most likely cause and the first troubleshooting step that should be taken?
The tubes are not balanced, stop the centrifuge and redistribute tubes.
A phlebotomist is preparing to perform a venipuncture on a patient who has an IV line in the right antecubital area and a mastectomy on the left side. Which of the following is the most appropriate action for the technician to take?
Perform the draw from the right arm, below the IV site.
A technician is performing a morning draw for a patient's Cortisol level. The patient mentions they were up all night working a late shift and just finished a vigorous workout. Why might the technician need to document this or consult a supervisor before proceeding?
Strenuous exercise and lack of sleep can falsely elevate Cortisol levels.
A technician is preparing to aliquot a plasma specimen after centrifugation. They notice a thin layer of "buffiness" between the plasma and the packed red cells. What is this layer, and what is the risk if it is accidentally included in the aliquot for a Coagulation Study?
It is the "buffy coat" containing WBCs and platelets; it can alter clotting time results.
While performing a venipuncture, a technician notices the patient has become very pale, has started sweating (diaphoresis), and is giving incoherent answers to questions. What is the first safety priority for the technician?
Release the tourniquet and remove the needle immediately.