Phlebotomy

Front 1

List and describe the general guidlinges that should be followed when preforming a venipuncture.

Back 1

any advance preparatin, reviewing specimen collection and handling reuirements, identification of the patiens, reassuring the patient, assembling wquipment and supplies, positioning the patient, applying tourniquet, selecting a site for venipuncture, obtaining the type of blood specimen required, and following OHSA bloodborne pathogens standard.

Front 2

Explain how each of the following blood specimens is obtained; clotted blood, serum, whole blood and plasma

Back 2

*clotted blood: from tube that does not contain an anticoagulant.
*serum: from clotted blood by allowing the specimen to stand and then centrifuging it
*whole blood: tube that contains an anticoagulant. important to mix the anticoagulant with the blood by gently inverting the tube back and forth 8 to 10 times after collection,
*Plasma: from whole blood that had been centrifuged.

Front 3

List the layers the blood separates into when an anticoagulant is added to the specimen

Back 3

top layer -plasma; middle layer - Buffy coat (contains white blood cells and platelets); bottom layer - red blood cells

Front 4

list the layers the blood separates into when an anticoagulant is not added to the specimen

Back 4

top layer - serum;
bottom layer - clotted blood cells

Front 5

list the OHSA safety precautions that must be followed during venipuncture and when separating serum or plasma from whole blood.

Back 5

wear gloves;
avoid hand to mouth contact while working with blood specimens;
wear face mask or shield in combination with and eye protection device whenever splashes, spray, splatter, or droplets of blood may be generated;
preform all procedures involving blood in a manner so as to minimize splashing, spraying, splatter, and generating droplets of blood;
bandage cuts and other lesions on the hands before gloving;
sanitize hands as soon as possible after removing gloves;
if skin surfaces come in contact with blood, wash as soon as possible with soap and water;
if mucous membranes (eyes, nose, mouth...) come in contact with blood flush them with water as soon as possible;
do not bend, break, or shear contaminated venipuncture needles;
do not recap a contaminated venipuncture needle;
locate the sharps container as close as possible to the area of use;
immediately after use, place the contaminated venipuncture needle and plastic holder in the bio-hazard sharps container;
place blood specimens in containers that prevent leakage during collection, handling,processing, storage, transport, and shipping;
handle all laboratory equipment and supplies properly and with care as indicated by the manufacturer;
do not store food in refrigerators where testing supplies or specimen are stored;
if you are exposed to blood report the incident immediately to your physician- employer.

Front 6

state the additive content of each of the following of each of the following vacuum tubes, and list the types of blood specimens that can be obtained from each: red, lavender, gray, light blue, green , royal blue

Back 6

RED: no additive, used to obtain clotted blood or serum.
LAVENDER: contains anticoagulant ethylenediaminetetraacetic acid (EDTA) used to obtain whole blood or plasma, most common use is to collect a blood specimen for a complete blood count (CBC)
GRAY: contains sodium fluoride ( a preservative) and potassium oxalate (an anticoagulant) used to obtain whole blood or plasme; most common use is to collect blood specimens to preform blood alcohol and drug test or and oral glucose tolerance test (OGTT)
LIGHT BLUE: contain anticoagulant sodium citrate and used to obtain whole blood or plasma; most common use is for coagulation test such as prothrombin time.
GREEN: contains anticoagulant heparin and commonly used to collect blood specimens to preform blood gas determinations and pH assays.
ROYAL BLUE: contain either EDTA or no additive at all, made of a specially refined glass and rubber stopper and are used to detect traces of elements ; such as lead, zinc, arsenic, and copper.

Front 7

identify and explain the order of draw for the vacuum tube and butterfly methods of venipuncture

Back 7

Order of draw is identical for both Vacuum tube and Butterfly methods of venipuncture;
Blood cultures :rationale: to prevent contamination of the specimen by other tubes, which may lead to inaccurate test results.
Blue: rationale: to prevent additives from other tubes from getting ito the tube.
Red: rationale: to prevent contamination of serum tubes by tubes with an anticoagulant.
Green / Lavender/ Gray: rationale: to prevent cross contamination between different types of anticoagulants, which may lead to inaccurate test results.

Front 8

identify possible problems during a venipuncture

Back 8

failure to obtain blood, inappropriate puncture site, scarred and sclerosed veins, rolling veins, collapsing veins, hematoma, hemolysis, fainting, tube selection, preparation of the specimen, removal of the serum, serum separator tubes.

Front 9

list four ways to prevent a blood specimen from becoming hemolyzed

Back 9

store at room temperature, allow alcohol to air dry completely before preforming venipuncture, use an appropriate gauge needle to collect specimen, practice good technique in collecting the specimen, always handle the blood tube carefully.

Front 10

explain how the serum separator tube functions in the collection of a serum specimen

Back 10

serum separator tubes contains a thixotropic gel, during centrifugation the gel temporarily becomes fluid and moves to the dividing point between the serum and clotted cells where it re-forms into a solid gel serving as a physical and chemical barrier between the serum and the clot.

Front 11

explain when a skin puncture would be preferred over a venipuncture

Back 11

skin puncture would be preferred when a test requires only a small amount of blood specimen, preferred method when obtaining blood from infants and young children.

Front 12

describe each of the following skin puncture devices: disposable semiautomatic lancet and reusable semiautomatic lancet

Back 12

Disposable semiautomatic lancet: consist of a spring loaded plastic holder with a metal blade inside the holder, are available in different lengths of blades to control the depth of the puncture. the plastic holder conceals the blade so the patient cannot see it during the puncture.

Reusable semiautomatic lancet: The safest reusable device is one in which the part that becomes contaminated is retractable and can be disposed of easily.