Phlebotomy Chp 7
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Created by:
Ms_oSoSweet on June 18, 2012
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Ruth E. McCall (Health Training Center)
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66 terms
Terms | Definitions |
|---|---|
 Antiseptic | Substances used to prevent sepsis, which is the presence of microorganisms or their toxic products within the bloodstream. |
| Traditional Antiseptic | Povidone-iodine in the form of swab sticks or sponge pads for blood culture collection and prep pads for blood gas collection. |
| Traditional Antiseptic | The use of alcohol-based preparations for these procedures is increasing because many patients are allergic to povidone-iodine. |
| Disinfectant | Chemical substances or solutions regulated by the Environmental Protection Agency (EPA) that are used to remove or kill microorganisms on surfaces and instruments. |
| Disinfectants | Not safe to use on human skin. 1:10 dilution is applied prior to cleanup for large blood spills. At least 10 minutes of contact time is required for disinfectants to be effective. |
| Antiseptics used in blood collection (pt2) | • Chlorhexidine gluconate • Hydrogen peroxide • Povidone-iodine (0.1%-1% available iodine) • Tincture of iodine |
| Antiseptics used in blood collection (pt1) | • 70% Ethyl alcohol • 70% Isopropyl alcohol (isopropanol) • Benzalkonium chloride (e.g., Zephiran chloride) |
| Gauze pads vs Cotton balls | 2- by 2-inch gauze pads folded in fourths are used to hold pressure over the site follow-ing blood collection procedures. |
| Gauze pads vs Cotton balls | Use of cotton balls to hold pressure is not recommended because they tend to stick to the site and reinitiate bleeding when removed because they dislodge the platelet plug that seals a puncture site. |
| Sharps Container | Used needles, lancets, and other sharp objects must be disposed of immediately in special containers referred to as: |
| Tourniquet | A device that is applied or tied around a patient's arm prior to venipuncture to restrict blood fl ow. A properly applied tourniquet is tight enough to restrict venous flow out of the area but not so tight as to restrict arterial flow into the area. |
| Tourniquet (pt2) | Restriction of venous flow distends or infl ates the veins, making them larger and easier to fi nd, and stretches the vein walls so they are thinner and easier to pierce with a needle. |
| Types of Needles | Phlebotomy needles are sterile, disposable, and designed for a single use only. They include Multisample needles, Hypodermic needles, and Winged infusion (butterfly) needles. |
| Multisample needles | Evacuated Tube System |
| Hypodermic needles | Syringe System |
| Winged infusion (butterfly) needles | Both Evacuated Tube & Syringe System |
| (Needle) Bevel | The end that pierces the vein |
| (Needle) Shaft | The long cylindrical portion |
| (Needle) Hub | The end that attaches to the blood collection device |
| Sheath | Shields that cover the needle after use |
| Lumen | Internal space of the needle |
| Gauge | (Opposite Relationship) The higher the gauge number, the smaller the actual diameter of the needle. |
| Gauge | A 21-gauge needle is considered the standard for most routine adult antecubital venipunctures. |
| Length | Most multisample needles come in 1- or 1.5-in |
| Evacuated Tube System (ETS) | A closed system in which the patient's blood flows through a needle inserted into a vein and then directly into a collection tube without being exposed to the air or outside contaminants. |
| Evacuated Tube System (ETS) | Preferred by the CLSI for blood collection. The system allows numerous tubes to be collected with a single venipuncture |
| Evacuated Tube System (ETS) | ETS systems have three basic components: a special blood-drawing needle, a tube holder, and various types of evacuated tubes. |
| Multi-sample needles (Rubber sleeve) | It is covered by a sleeve that retracts as the needle goes through the tube stopper so that blood can flow into the tube. When the tube is removed, the sleeve slides back over the needle to prevent leakage of blood. |
| Evacuated Tubes | Selection is based on the age of the patient, the amount of blood needed for the test, and the size and condition of the patient's vein. |
| Evacuated Tubes | Used with both the ETS and the syringe method of obtaining blood specimens. Tubes fill with blood automatically because there is a vacuum in them. The vacuum is artificially created by pulling air from the tube. |
| Evacuated Tubes | With the syringe method: blood is collected in a syringe and must be immediately transferred into the tubes. |
| Additive | Any substance placed within a tube other than the tube stopper.They have one or more specific functions, such as preventing clotting or preserving certain blood components. |
| Additive | Blood collected in additive tubes may or may not clot. If the additive prevents clotting, the result is a whole-blood specimen. |
| Non-additive Tube | Most that do exist are used for clearing or discard purposes only. |
| Blood collection Additives | Blood collection tubes and other collection devices often contain one or more additives |
| Blood Collection Additive | Never transfer blood collected in an additive tube into another additive tube, even if the additives are the same. |
| Syringe System (2 parts) | Used for patients with small or difficult veins.Those appropriate for phlebotomy procedures are generally gauges 21 to 23, in 1- or 1.5-in. lengths. |
| Syringe System | This system consists of a sterile syringe needle called a Hypodermic needle and a sterile plastic syringe with a Luer-lock tip. |
| (Syringe) Barrel | This system consists of a sterile syringe needle called a Hypodermic needle and a sterile plastic syringe with a Luer-lock tip. |
| (Syringe) Plunger | A plunger, a rod-like device that fits tightly into the barrel. |
| Winged Infusion Set | An indispensable tool for collecting blood from small or difficult veins such as hand veins and veins of elderly and pediatric patients. Allows for flexibility and precision. |
| Winged Infusion Set | The first tube collected with a butterfly will under fill because of the air in the tubing. If the tube contains an additive, the blood-to-additive ratio will be affected. |
| Winged Infusion Set: Hint | Always use a Red Tube first when drawing with a Butterfly needle (due to no additive ration). |
| Anticoagulants | Substances that prevent blood from clotting by either of two methods: 1.Chelating (binding) or 2.Precipitating calcium so it is unavailable to the coagulation process |
| Anticoagulants | The most common anticoagulants are Ethylenediaminetetraacetic acid (EDTA), Citrates, Heparin, and Oxalates. |
| 1. Which additive prevents glycolysis? | Sodium fluoride |
| 2. The following supplies were gathered for a routine venipuncture. Which item is incorrect? | Lodine swab |
| Which of the following tubes can be used to collect a serum specimen? | Red top |
| 4. A tourniquet is used in venipuncture to? | Concentrate the blood specimen. Find and enter veins more easily. Keep the vein from collapsing. |
| 5. You are about to perform routine venipuncture on a patient with no known allergy to antiseptics. Which of the following substances would you use to clean the site? | 70% isopropyl alcohol |
| Which of the following needles has the largest diameter? | 18 gauge |
| What causes evacuated tubes to fill with blood automatically? | Premeasured tube vacuum |
| Lavender-top tubes are most commonly used to collect? | Hematology tests |
| 10. A butterfly is typically used for? | Difficult and hand veins. |
| Order of Draw (ETS) | 1. Sterile 2. Red 3. LT. Blue 4. DK. Blue, Green, Yellow, Gray 5.(EDTA) Purpe, Pink, Tan Top 3: Red, LT Blue, Purple |
| Order of Draw (Syringe) | 1. Sterile 2. LT. Blue 3. (EDTA) Purple, Pink, Tan 4. DK. Blue, Green, Yellow, Gray 5. Red Top 3: LT. Blue, EDTA, Red |
| Red Tube | No additive (Thixotrophic Gel) 1.Chemistry, 2.Serology |
| Green Tube | Additive: Heparin 1. Chemistry, 2. Amonia (NH3) |
| Yellow Tube | Additive: Citrate (ACD) 1. Hematology & (Blood Banks) |
| Lavender Tube | Additive: EDTA 1. Hematology (CBC) Child Lead |
| LT. Blue Tube | Additive: Sodium Citrate 1. Coagulation (PT/PTT) |
| DK. Blue Tube | Additive: Varies on label color (EDTA/Heparin) 1. Cooper, Manganese, Heavy Medals |
| Grey Tube | Additives: Oxalate & Flouride 1. Glucose, 2. Ethanol, 3. Chemistry |
| Tan Tube | Additive: EDTA & Heparin 1. Adult Lead |
| Pink Tube | Additive: EDTA 1. Blood Bank |
| Most used Tube color | Red. Lavender, LT. Blue Tube expiration date must be checked Bi-wkly |
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