Safety & Compliance
This federal agency enforces the Bloodborne Pathogens Standard to protect healthcare workers from accidental exposure.
What is OSHA (Occupational Safety and Health Administration)?
To ensure proper patient identification, an inpatient must state these two distinct pieces of information.
What are full name and date of birth?
When performing a capillary (micro-collection) puncture, this color-top microtainer must be collected first to prevent platelet clumping.
What is lavender (EDTA)?
The sudden appearance of tiny, non-raised red or purple spots on a patient's skin immediately after a tourniquet is applied is called this, and it indicates a localized capillary bleeding defect.
What is petechiae?
When performing a capillary (finger) stick on an adult, this is why the technician must always wipe away the very first drop of blood.
What is to eliminate tissue fluid contamination? (Interstitial fluid )
This is the first thing a phlebotomist should do immediately following an accidental needlestick injury.
What is wash the site with soap and water? (Followed by reporting it to a supervisor).
These microscopic, single-cell-thick blood vessels are where the exchange of oxygen, nutrients, and waste products occurs between blood and tissue.
What are capillaries?
Drawing a lavender tube before a gold or tiger-top SST tube can cause a falsely critical low reading of this essential electrolyte because the EDTA additive binds to it.
What is calcium? (Note: It can also cause a falsely high Potassium reading, as it is Potassium EDTA).
If a phlebotomist punctures a vessel and notices the blood rapidly pulsing into the tube with a bright, vivid crimson color, they have accidentally entered this structure and must hold pressure for a minimum of 5 minutes.
What is an artery?
Agglutinins, which cause red blood cells to clump together at lower temperatures, require specimens like Cold Agglutinins or Cryoglobulins to be collected and held at this exact temperature until processing.
What is 37°C? (Accept: "body temperature").
This type of isolation precaution requires the technician to wear an N95 respirator before entering the patient's room.
What are Airborne Precautions?
If a patient extends their arm out to the phlebotomist after being told blood needs to be drawn, they are giving this type of legal consent.
What is implied consent?
A gray-top tube, which contains sodium fluoride and potassium oxalate, is uniquely designed to preserve this specific analyte for up to 3 days.
What is glucose?
Veins that feel hard, cord-like, and lack elasticity upon palpation, typically due to repeated punctures or chemotherapy, are described by this medical term and should be strictly avoided.
What are sclerosed veins? (Accept: "occluded veins").
For a legally binding forensic blood alcohol or drug test, this specialized documentation protocol must track every single handoff of the specimen.
What is the chain of custody?
Under HIPAA guidelines, this type of data, abbreviated as PHI, must be rigorously protected from unauthorized eyes.
What is Protected Health Information?
This baseline biological condition is achieved when a patient has fasted for 12 hours and has been at rest, typically early in the morning.
What is the basal state?
If a physician orders a CBC, a PT/INR, and a Comprehensive Metabolic Panel to be drawn via a butterfly needle, the phlebotomist must bring the total number of tubes into the room to maintain the correct order of draw.
What is four?
(Explanation: You need a discard tube to clear the air from the butterfly tubing, then the Light Blue tube for the PT/INR, then the SST/Gold tube for the CMP, and finally the Lavender tube for the CBC).
If a patient vigorously opens and pumps their fist multiple times just before the needle is inserted, it alters the balance of intracellular fluid and causes a false spike in this specific electrolyte reading.
What is potassium?
When performing Therapeutic Drug Monitoring (TDM) for a medication such as Vancomycin, this specific specimen type must be drawn exactly 30 minutes before the patient's next scheduled dose.
What is a trough level?
This clinical standard-setting organization dictates the strict guidelines for the global order of draw and lab procedures
What is CLSI (Clinical and Laboratory Standards Institute)?
Drawing blood from an arm on the same side as this surgical procedure is strictly forbidden due to the risk of lymphedema.
What is a mastectomy?
When drawing blood cultures with a butterfly needle, this specific bottle must always be filled first to ensure that any residual oxygen in the needle's tubing doesn't kill the microbes.
What is the aerobic bottle?
(Explanation: The air in the butterfly tubing will enter the first bottle. Aerobic bacteria need oxygen to survive, whereas anaerobic bacteria will be killed by it. Therefore, aerobic always goes first.
If a patient has been vigorously exercising immediately prior to arriving for a routine draw, the phlebotomist should have them rest for 15 to 30 minutes to avoid a false elevation in this cellular waste product and its associated white blood cell count.
What is lactate (or lactic acid)?
Explanation: Heavy exercise spikes lactate levels and causes transient leukocytosis, a temporary surge in white blood cells, disrupting the patient's basal state.
During a 3-hour Glucose Tolerance Test (GTT), the patient must drink a specific glucose beverage. However, the phlebotomist must complete this critical step before letting the patient drink a single drop.
What is collecting and testing a baseline (or fasting) blood sample?
(Explanation: If the patient's fasting glucose level is dangerously high before the test even starts, giving them the highly concentrated sugar beverage could cause severe hyperglycemia, and the test must be aborted immediately).