chapter one introduction to blood collection
TRANSCRIPT
INTRODUCTION TO BLOOD COLLECTION
Blood Collection: A Short Course
Learning Objectives State the importance of correct blood
collection techniques in managing total patient care.
List the factors that influence the integrity of a blood specimen.
Discuss safety precautions as related to blood collection.
Differentiate between whole blood, plasma, and serum.
Learning Objectives Explain the action of anticoagulants to
prevent blood coagulation. Describe the appearance of a hemolyzed,
icteric, and lipemic specimen. Differentiate between arterial, venous, and
capillary blood. State the purpose of quality assurance in
blood collection.
Redesigning the Healthcare System
Shifting of phlebotomy responsibility. New skills required.
Blood Collection: A Short Course Purpose
Collection of quality specimens Instructive information Technique Procedures in accordance with the
Clinical and Laboratory Standards Institute, (CLSI) (Standard H3-A6) and Occupational Safety & Health Administration (OSHA) guidelines
Blood Collection: A Short Course Course Overview
Equipment Site selection Technique Complications Specimen handling Phlebotomy errors Venipuncture practice
IMPORTANCE OF CORRECT SPECIMEN COLLECTION AND HANDLING
QUALITY SPECIMENS = QUALITY RESULTS
Diagnosis Treatment Monitoring Laboratory results constitute 70% of the
objective information for health-care providers
IMPORTANCE OF CORRECT SPECIMEN COLLECTION AND HANDLING
Specimen Integrity Laboratory guidelines
Never hesitate to check with laboratory
Clinical Laboratory Improvement Amendments of 1988 (CLIA, 1988) Laboratory is responsible
IMPORTANCE OF CORRECT SPECIMEN COLLECTION AND HANDLING
Preanalytical Factors 56% of lab errors occur before the
specimen is tested Monitoring of specimen ordering Patient identification Patient communication and safety Patient preparation Timing of collections Collection technique Specimen labeling Specimen handling and transport
SAFETY PRECAUTIONSStandard Precautions
Personal protective equipment (PPE) Isolation Procedures Hand washing Properly activating needle safety devices Biohazard disposal Decontamination
Sodium hypochlorite (1:10)
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SAFETY PRECAUTIONSAccidental Puncture
Significant exposure potential Report all needlesticks
Follow institution’s protocol for source and employee testing
SAFETY PRECAUTIONSSyringe-To-Tube Transfer
Recommended procedure Use blood-transfer device Removal of stoppers not
recommended Direct puncture of tube with syringe
needle not recommended
SAFETY PRECAUTIONSSpecimen Processing
Centrifugation Capped, balanced tubes
Separation Removal of stoppers Aerosol production
SAFETY PRECAUTIONSSpecimen Transport
Primary container Secondary container Labeling
TYPES OF SPECIMENSWhole Blood
Consists of: Erythrocytes Leukocytes Platelets Plasma
Use anticoagulated (unclotted) specimen
TYPES OF SPECIMENSPlasma
Liquid portion of unclotted blood Contains fibrinogen Use anticoagulated specimen
TYPES OF SPECIMENSSerum
Clotted blood Does not contain fibrinogen Use “clot” tube
TYPES OF SPECIMENSCentrifugation
TYPES OF SPECIMENSAnticoagulants
Calcium binding EDTA Sodium citrate Potassium oxalate
Thrombin inhibition Heparin
TYPES OF SPECIMENS
MIX ANTICOAGULATED SPECIMENS THOROUGHLY
IMMEDIATELY AFTER COLLECTION
TYPES OF SPECIMENSNormal Plasma & Serum
Appear clear & pale yellowHemolyzed Specimens
Appear pink-red Erythrocyte destruction
TYPES OF SPECIMENSIcteric Specimens
Appear dark yellow Increased bilirubin
Lipemic Specimens Appear milky Increased lipids
TYPES OF SPECIMENSVenous Blood Specimen of choice Used to establish Normal values
Arterial Blood Blood gases Require special collection training
TYPES OF SPECIMENSCapillary Blood Dermal puncture collection Mixture of arterial and venous blood Note on requisition if blood is collected by
dermal puncture