Phlebotomy Potpourri
Technique
It's All About the Tubes.....
Supporting Roles
Location, Location,
Location
100
What is the cooking measure that is 5 ml of blood?
One teaspoon
100
Why must the alcohol be dried?
Prevent patient discomfort, contamination of the specimen and/or hemolysis of the specimen
100
Specimen in the gray stoppered tubes are collected for what tests?
Lactic acid and sometimes, glucose in series.
100
When identifying a patient, what information do you need?
Outpatient: 2 of the four Name (spelling, last, first); Date of birth, Address, SSN or last 4 digits Inpatient: Name, Medical record number from attached hospital ID band. If conscious, involve them with supplying 2 of the above information
100
In the antecubital area which vein would you choose first, second, and third?
Median, cephalic and last basilic
200
On an average, how much serum can you get from a 7 ml SST tube?
1.5 - 2.0 ml
200
Why do we say “stretch” the skin?
To anchor the vein and to thin out the skin for a quicker entry
200
Specimens in lavender stoppered tubes are collected for which department(s)? Name a test for each department.
Hematology - CBC, H&H, SR Blood Bank - Type and Rh, Crossmatch, Type and Screen Special Chem - Hgb A1c, BNP, Ammonia
200
While setting up for your blood collection, what supplies do you need to prepare?
Gloves, Gauze, Alcohol, Tourniquet, Tape
200
What information does your finger gather for you when searching for a vein?
Size, Depth & Direction
300
What tests are included in a Basic Metabolic Profile?
Glucose, BUN, Creatinine, Sodium, Potassium, Chloride, CO2, Calcium
300
Why must the bevel of the needle be facing up?
It is the sharpest point going through the skin and vein walls and blood flow into the tube is better
300
Specimens in the citrate tubes are collected for which department(s)? Name a test for each department.
Coagulation - PT, PTT, fibrinogen, PFA Flow Cytometry - CD4/CD8, HLA Typing, PNH, T helper-inducer cell
300
When you have no Antrim labels, what hand written information should be on all tubes?
PSC - Full name of the patient (matching the requisition), Date of birth, & phlebotomist's initials/number Inpatient - Full name of the patient (matching the requisition), Medical Record Number, phlebotomist's initials/number, Date of collection & Time of collection
300
When searching for a vein, what are 3 tips for difficult to find veins?
Re-tie the tourniquet tighter Warming the area Rotating the wrist Relax a hyper-extended arm Lower the arm Closing a fist Shadow from the wet alcohol Find a landmark and use your peripheral vision - fixing your eyes on the site. Avoid looking away.
400
Why should we remove the tube from the back of the holder before withdrawing the needle from the arm?
Prevent backflow (injecting the contents of the tube back into the patient who may go into anaphylactic shock)
400
What is the angle for insertion and why?
15 to 20 degrees and no more than 30 to prevent going through the vein and damaging a nerve or underlying structure
400
Specimens in heparin tubes are collected for which department(s)? Name a test for each department.
Automated chemistry in institutions - Glucose, BMP, lytes Special chemistry - ionized calcium, alcohol Cytogenetics - B cell, chromosome analysis, Bonus: Flow cytometry - leukemia/lymphoma panel
400
When do you label the blood specimens?
After blood is in the tube and before letting the patient go or leaving the bedside.
400
While selecting a venipuncture site on the antecubital area of the arm, list 3 reasons that you will not be able to perform the venipuncture there.
Side of a mastectomy Bruised Edematous Scarred from surgery or burns Casts or Dressings Side of an IV Overused veins
500
What are the effects of having a tourniquet on too long? These effects can also occur in what other situation?
Hemoconcentration and an elevated potassium. Having the patient pump (open and closing of the fist) during the venipuncture procedure.
500
What steps do you take before you withdraw the needle from the patient’s arm?
Check that the tourniquet is removed, take the tube off the back of the needle, have your gauze ready, withdraw the needle completely, apply pressure on the gauze while activating the safety device over the needle.
500
What departments generally accept only one type of tube? Indicate the department and the tube associated with it.
Hematology - lavendar Coagulation - blue Blood Bank - large lavendar Automated chemistry (Core) - SST
500
What post patient care instructions do you give the patient?
Please hold pressure for another 5 minutes to minimize bruising. Keep the bandage on for at least 15 minutes but no longer than an hour.
500
Why are veins on the foot our last choice for a venipuncture?
In patients with poor blood circulation, they are more prone for thrombosis to occur that could block flow of blood to extremities, heart, brain, kidneys causing more harm.
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