Who requires the wearing of gloves when performing phlebotomy?
OSHA
Who regulates glove quality
U.S. Food and Drug Administration
What prevents or inhibits the growth and development of microorganisms?
Antiseptics
What is the most common antiseptic?
70% isopropyl alcohol (isopropanol)
What is used to remove or kill microorganisms on surfaces and instruments?
Disinfectants
Disinfectants are regulated by whom?
EPA
List of 7 antiseptics used in blood collection
70% ethyl alcohol
70% isopropyl alcohol (isopropanol)
benzalkonium chloride (e.g. zephiran chloride)
chlorhexidine gluconate
hydrogen peroxide
povidone-iodine (0.1%-1% available iodine)
tincture of iodine
Why is the use of cotton balls not recommended to hold pressure after blood collection?
They tend to stick to the site and re-initiate bleeding when removed.
Adhesive bandages should not be used on who because of risk of aspiration and suffocation?
Babies younger than 2 y.o. and the elderly
A sharps container should have these qualities...
Clearly marked with a biohazard symbol
Rigid
Puncture resistant
leakproof
disposable
locking lids to seal the contents
The purpose of a tourniquet is to what?
Distend or inflate the veins, making them larger and easier to find and stretches the vein walls so they are thinner and easier to pierce.
If a blood pressure cuff is used as a tourniquet the pressure should be maintained where?
Below the patient's diastolic pressure
The end of the needle that pierces the vein is called what?
Bevel
The long cylindrical portion of the needle is called what?
Shaft
The internal space of the needle is called the what?
Lumen
The diameter of the lumen of the needle is called what?
Gauge
The higher the gauge the _______ the needle?
Smaller the diameter
Appropriate needles for most blood specimens for lab testing is what gauges?
20 - 23
Who has the regulation that if the needle does not have a safety feature the equipment it is used with must?
OSHA
The most common and efficient system and that is preferred by the CLSI for collecting blood samples is what?
Evacuated Tube System (ETS)
What can happen if you mix components from different manufactures for the ETS?
Needles come unscrewed and tubes pop off the needle during venipuncture
Who requires that the tube holder with the needle attached be disposed of as a unit after use and never be removed from the needle and reused?
OSHA
Describe a tube holder.....
Clear, plastic cylinder with a small threaded opening at one end (hub) where the needle is screwed into it and a large opening at the other end where the collection tube is placed. The large end has flanges or extensions on the sides that aid in tube plac
What is an evacuated tube vacuum?
Negative pressure in the tube created by pulling air from the tube. Measured precisely by the manufacturer
What causes premature loss of vacuum?
Improper storage
opening the tube
dropping the tube
advancing the tube too far on to the needle before venipuncture
if the bevel partially comes out of the skin
What is an additive?
Any substance placed within the tube other than the stopper.
Non-additive tubes yield serum or plasma?
Serum
Light Blue Stopper
(additive and department)
Sodium citrate
Coagulation
Red Stopper
(additive and department)
None
Chemistry, Blood Bank, Serology/Immunology
Green Stopper
(additive and department)
Heparin (Lithium, Sodium or Ammonium)
Chemistry
Lavender Stopper
(additive and department)
EDTA
Hematology
Grey Stopper
(additive and department)
Sodium Fluoride and Potassium Oxalate
Chemistry
Used for legal blood alcohols
Royal Blue Stopper (free of trace elements)
(additive and department)
None, EDTA or Soduim Heparin
Chemistry
When would you use a syringe system to collect blood?
For patients with small or difficult veins
What is a syringe transfer device used for?
Allow the safe transfer of blood into the tubes without using the syringe needle or removing the tube stopper.
When would you use a winged infusion or butterfly collection set?
For collecting blood from small or difficult veins such as hand veins and veins of elderly and pediatric patients.
If the first tube to be filled while using an butterfly has and additive what should you do and why?
Collect a discard tube first because of the air in the tubing.
What can happen when using a needle smaller than a 23 gauge?
The chances increase of the blood hemolyzing.
What are the 4 most common anticoagulants?
EDTA
Citrates
Heparin
Oxalates
Which anticoagulant(s) binds or chelates calcium?
EDTA (lavender tube) and
Citrates (light blue tube)
Which anticoagulant inhibits thrombin?
Heparin (green tube)
Which anticoagulant precipitates calcuim?
Oxalates (grey tube)
What are Acid Citrate Dextrose (ACD) tubes used for?
DNA testing, paternity and transplant compatibility
What is Citrate Phosphate Dextrose (CPD) used for?
Collecting units of blood for transfusion. Prevents clotting, stabilizes pH, and provides cells with energy.
What is Sodium Polyanethol Sulfonate (SPS) used for?
Blood culture collection bottles
What is the purpose of an antiglycolytic agent?
It prevents glycolysis. The breakdown or metabolism of glucose.
The most common antiglycolytic agent is?
Sodium fluoride
What is a clot activator?
A substance that enhances coagulation
An example of a clot activator and how it works?
Silica. Provides more surface for platelet activation.
What forms a physical barrier between the cells and the serum or plasma?
Thixotropic gel
What do royal-blue stoppers indicate?
The tubes are trace element free.
What is the source of more carryover problems than any other additive?
EDTA