Chapter 15 Arterial, Intravenous (IV), and Special Collection Procedures

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Phlebotomy, Miami-Jacobs Career College, Independence, Ohio

arterial blood gases (ABGs)

analytical test that measures oxygen and carbon dioxide in the blood. Provides useful information about respiratory status and the acid-base balance of patients with pulmonary disorders

autologous transfusion

a patient donates his or her own blood or blood components for use later; this is the safest type of transfusion (i.e., using one's own blood). It prevents transfusion-transmitted infectious diseases and eliminates the formation of antibodies from other donors

bacteremia

presence of bacteria in the blood; an infection of the blood

blood cultures

tests that aid in identifying the specific bacterial organism causing infections in the blood. In the case of a patient that is experiencing fever spikes, it is recommended that the blood culture specimens be collected before and after the fever spike, when bacterial are most likely present in the peripheral circulation. Care must be taken by the phlebotomist not to contaminate the specimen, so special preparation of the collection site is required.

brachial artery

an artery locates in the cubital fossa of the arm and used as an alternative site for ABG collections. Phlebotomists must be specially trained to perform collections from this site.

cannula

a tube that can be inserted into a cavity or blood vessel and used as a channel for transporting fluids. The term is most commonly used in dialysis for patients with kidney disease. The cannula is used to gain access to venous blood for dialysis or for blood collections. Specialized training and experience are required to draw blood from a cannula

central intravenous line

central venous catheter (CVC), a commonly used VAD. Refer to vascular access devices.

femoral artery

located in the groin area of the leg and lateral to the femur bone, it is the largest artery used as an alternative site for ABG collections. Phlebotomists must be specially trained to perform collections from this site

fevers of unknown origin (FUO)

indicates the patient has an undiagnosed infection, which usually results in ordering blood cultures

fistula

an artificial shunt or passage, commonly used in the arm of a patient undergoing kidney dialysis; the vein and artery are fused through a surgical procedure. Only specially trained personnel can collect blood from a fistula

glucose tolerance test

diagnostic test for detecting diabetes. The test is performed by obtaining blood and urine specimens at timed intervals after fasting, then after ingesting glucose. Each specimen is analyzed for its glucose content to determine if the glucose level returns to normal within 2 hours after ingestion. Diabetic patients' glucose is metabolized differently and may need to be analyzed up to 5 hours after ingestion. Special instructions are needed for the patient, and special training for the phlebotomist patient should occur if they will be collecting such specimens

hyperventilation

a condition whereby chemoreceptors in the brain cause a faster and deeper rate of respiration in order to blow off excess carbon dioxide.

intravenous (IV) catheter

vascular access device inserted into a blood vessel for administration of medications, nutrients, and blood collection.

lactose tolerance tests

a test to determine lactose intolerance. Some individuals have difficulty digesting lactose, a milk sugar. This test is similar to the glucose tolerance test (which is usually performed on day before) and requires timed testing for lactose after fasting, then after ingestion of lactose at 1-, 2-, and 3-hour intervals

Modified Allen test

see Allen test. A procedure used prior to drawing specimens (for ABGs) from the radial artery. It assures that the ulnar and radial arteries are providing collateral circulation to the hand area. Basically, it entails compressing the arteries to the hand and emptying the hand of arterial blood, then releasing the compression to see if the circulation is immediately restored. A negative test would indicate that collateral circulation is not sufficient and an alternative artery (brachial or femoral) should be used for ABG collections.

peripherally inserted central catheter (PICC)

type of vascular access device (VAD) inserted into the peripheral venous system with a lead into the central venous system. A PICC is usually placed in the arm in the basilica or cephalic vein. A PICC should not be used for blood collections because it may collapse during aspiration of the blood.

postprandial glucose test

a glucose test performed after ingestion of a meal; useful for screening patients for diabetes, because glucose levels in serum specimens drawn 2 hours after a meal are rarely elevated in normal patients. In contrast, diabetic patients have elevated glucose values 2hours after a meal

radial artery

located on the thumb side of the wrist, this artery is most commonly used to collect blood specimens for arterial blood gases. Phlebotomist must be specially trained to perform collections from this site.

septicemia

formally called "blood poisoning," the term now means the presence of toxins or multiplying bacteria in the blood.

sodium polyanethole sulfonate (SPS)

an additive typically used in blood culture bottles to prevent clotting.

therapeutic phlebotomy

removal of blood fro therapeutic reasons (i.e., in conditions where there is an excessive production of blood cells).

trace metals

evidence found at the scene of a crime or on a person involved in a crime (e.g., fingerprints, hairs, fibers, glass fragments, drugs, firearms, etc.).

vascular access devices (VADs)

a variety of specially designed devices to allow entrance into a vein or artery. One of the most commonly used VADs is a central venous catheter (CVC), which is usually inserted into the subclavian vein (in the chest area below the clavicle), the jugular vein, or the superior vena cava. VADs are used for chemotherapy administration, hyperalimetation, IV fluids, or for procedures like hemodialysis.

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