Pt prep & Details
not to eat or drink anything but water for a certain period of time prior to having their blood drawn
fasting- 12 hrs
This system consists of a double-pointed needle, a plastic needle holder/adapter, and collection tubes. The collection tube system creates a slight vacuum that helps transport the blood from the vein into the collection tube when penetrated.
Evacuated System - most commonly used
Light blue tube
Sodium citrate; removes calcium to prevent blood from clotting
Coagulation Tests
3-4 inversions
Why is it important to draw the tubes in the correct order?
avoid cross-contamination of the additives
How does the CCMA obtain “clotted blood”?
blood is drawn in a tube that does NOT contain an anticoagulant
You may have to stop taking this prior to a lab draw as it may alter results
medication
System the consists of flexible wings attached to a needle with 5-12 inches of flexible tubing. Best used on pts who have small or fragile veins.
Butterfly System (Winged Infusion Set)
Gray tube
Gray
Potassium oxalate and sodium fluoride; removes calcium to prevent blood from clotting; fluoride inhibits glycolysis
Chemistry testing, especially glucose and alcohol levels
8-10 inversions
Why does the light blue top have a “minimum fill” line on it?
It indicates the minimum amount of blood required for accurate test results
How does the CCMA obtain “whole blood”?
Blood obtained when drawn in a tube that contains an anticoagulant.
How would you position the patient in preparation of a phlebotomy procedure?
Position the patient with their arm extended out. If a phlebotomy chair with an extended arm rest is not available, have the patient make a fist with the opposite hand and place it behind the elbow of the arm being used for the procedure.
blood draw that only a small amount of blood can be obtained with this method. One advantage is the amount of suction can be controlled by the plunger of the syringe instead of the vacuum method. Generally, a 16-gauge injection needle and syringe are used with this method.
Needle Syringe System
Green tubes
Green/Gray Marbled
Green
Heparin: inhibits thrombin formation to prevent clotting
Chemistry Test
8 inversions
Green/Gray Marbled
Lithium heparin and gel; for plasma separation
Plasma determinations in chemistry studies
8 inversions
What is best practice when determining how much blood to draw?
allow blood to fill the tube until blood flow stops
What are the three layers of blood after the sample has been centrifuged?
Plasma (top layer)
Buffy coat (middle layer)
RBC (bottom layer)
A catalog of information regarding laboratory tests with up-to-date test menus; testing information; specimen collection requirements; and storage, preservation, and transportation guidelines.
laboratory directory
Name the four components of blood
Plasma
RBC
WBC
Platelets
Red Tube
Re/Gray Marbled tube
Red
None
Serum test; chemistry studies; blood bank; immunology
5
Red/Gray Marbled
No anticoagulant but contains silica particles to enhance clot formation; use for serum separation
Serum test; chemistry studies; immunology
5 inversions
What could happen if the tubes are shaken or forcefully inverted?
hemolysis - destruction of red blood cells
The liquid portion of the blood obtained after a serum sample tube has clotted and centrifuged.
What is “serum”?
Before performing a phlebotomy procedure you MUST have this
providers order for lab testing
The liquid portion of the blood; mainly made of water; contains proteins, electrolytes, gasses, some nutrients, and waste products; is required to recover from injury, distribute nutrients, and remove waste from the body.
What is plasma?
Yellow top tube or blood culture bottles
-additive? use? inversions
Additive: Sodium polyanethol sulfonate; prevents blood from clotting and stabilizes bacterial growth
Blood or body fluid cultures
No inversions
What extra step is required for vacuum tubes that contain an additive?
gentle inversion for mixing of the blood and the additive after they are filled
What needs to be on a requisition form? (6)
Ordering provider’s name and contact information
Test and test code (unique to each lab, usually on the requisition or in the laboratory reference manual)
Diagnosis code that correlates with the tests being ordered (ICD-10)
Special specimen requirements, such as fasting
Patient demographics
Insurance or other billing information