Role as a Phlebotomist
Safety, accuracy, work well under pressure and communicates effectively
Do patients have the right to decline medical treatment?
Yes
If they refuse medical treatment what do you do?
report to supervisor
Point of care testing
diagnostic testing at or near the site of patient care
Quality Assurance
a program that guarantees quality patient care by tracking that outcomes through scheduled audits
Primary role of phlebotomist
To obtain blood specimen from patients
what is negligence defined as?
failure to exercise the standard of care
Materials needed before normal venipuncture
get 2 cotton balls, needle, needle adapter, antiseptic wipe, vacutainer, tourniquet
Antecubital fossa
preferred site of venipuncture, is the ditch or impression opposite the elbw
Vein selection is based on...
the sized and condition of the vein
3 major veins that are located in the antecubital fossa are..
median cubital vein, cephalic vein, basilic vein
Median Cubital Vein
this vein is the most commonly used
Cephalic Vein
easiest vein to palpate in obese patients
Basilic Vein
least firmly anchored located near brachial artery
Only veins have........
VALVES!
Laboratory requisition; labels will include
an order form that specifies what tests are being requested. Labels will include an accession number
Accession number
a unique tracking number different for each sample
Antiseptic
70% isopropyl
Tourniquet
slows the venous outflow of blood from the arm causing veins to bulge making them easier to locate
gloves must always be
worn
Winged infusion set also known as
butterfly needle
Identify patient. They must state their
name and birthday.
Most critical mistake a phlebotomist can make
is failing to properly identify the patient
concentric
clean in circular motion, starting in center and spiraling outward
Bevel faces
Upward
Slopes down =
Bevel is up (pink cap up)
Fill the needed tubes according to the
order of draw
Tourniquet should not be left on for more than
2 minutes (entire length of draw)
The proper way to ...................... of a needle is to ................ it and put it into a ............ immediately after withdrawing it from the arm.
dispose; safety cap, sharps container
The diagnosis should never be written on the patients
blood tubes
If a specimen has been collected from the wrong patient....
immediately report the incident to your supervisor
The proper steps to complete a blood draw are
tourniquet, tube, cotton ball, safety cap!
Microcapillary collection is also known is
dermal puncture or a Finger stick
A capillary is a ...............
microscopic blood vessel
Excessively milking the finger during a skin puncture can result in ............ and ............... of the specimen with tissue fluids
hemolysis; contamination
Site selection for infant microcapillary collection
great toe
Heel punctures for infants should not exceed
2.0 mm
In a Dermal puncture always wipe away
first drop of blood
Vanupuncture problems
Failure to obtain blood and inappropriate puncture sites
Edema
excess water in tissue under skin
Fistula
surgical connection between artery and vein. Dont poke!
Hematoma
most common complication from phlebotomy
How to prevent a hematoma
after the needle has been removed a hematoma can be prevented if pressure is placed on the venipuncture site until the bleeding stops
first thing to do if patient faints
get needle out of arm of patient
Hemoconcentration
Caused by tourniquet being left on too long
Petechiae
tiny non-raised red spots that appear on the skin from rupturing capillaries due to the tourniquet being left on too long or too tight
phlebitis
inflammation of vein as a result of repeated venipuncture
Hemostasis
Healing process of blood vessles
Vascular phase
injury to blood vessel causes blood vessel to constrict
Sclerosed veins
scarred veins
Coagulation phase
coagulation factors that converts temporary platet plug to a stable fibrin clot
The average person weighing 15 pounds has approximately
5 liters of blood in their system
The heart has 3 layers
Endocardium, myocardium, epicardium
endocardium
the inner endothelial lining of the heart
myocardium
the muscular middle layer, contractile element of heart
epicardium
fibrous outer layer of the heart, coronary arteries which supply blood to heart are found here
Heart has two upper chambers (........) and tow lower chambers (..........)
Atriums; ventricles
The Left side has 2 valves
Mitral valve and aortic valve
Mitral valve also known as
the bicuspid valve
Pulmonary circulation (Deoxygenation Cycle)
This carries deoxygenated blood from the right ventricale to the lungs
oxygenation takes places
in the alveoli within the lungs
Systemic Circulation (Oxygenation Cycle)
carries oxygenated blood from the left ventricle throughout the body
In Pulmonary Circulation, Arteries carry .......... blood ............ from the heart and veins carry ............... blood .......... to the heart.
deoxygenated; away; oxygenated; back
In systemic circulation arteries carry .......... blood .......... from the heart and veins carry ............... blood ............. to the heart.
oxygenated; away; deoxygenated ; back
Capillaries are
microscopic vessels
blood vessels in the body are
aorta, arteries, arterioles, capillaries, venules, veins, superior and inferior vena cava
capillaries connect
arterioles and venules and allows a rapid exchange of O2 and CO2, nutrients and waste between the blood and tissue cells
Whole blood consists of
55% plasma, 45% FCE
plasma
pale yellow fluid which carries nutrients lipids glucose NA Mg2+ Ca2+ K+ O2 CO2 N and antibodies vitamins hormones
What is the primary function of the capillary network?
exchange material between blood and tissue
Plasma
liquid portion of unclotted blood
primary function of erythrocyte
carry oxygen to tissue, and expell CO2
NPO
nothing per oral
Basal State
fasting
post-prandial
after a meal
Therapeutic Drug Monitoring
used to monitor the blood levels of certain medications to ensure patient safety and maintain therapeutic plasma level