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Kansas City School of Phlebotomy Final
Terms in this set (176)
A physical object that serves to transmit an infectious agent from person to person.
Contamination or invasion of body tissue by pathogenic organisms
the potency of a pathogen
A strict form of infection control that is based on the assumption that all blood and other body fluids are infectious.
Laboratory acquired infection
an infection that is acquired in the laboratory from a needle stick or contamination from an infected surface passed from the patient to the healthcare worker.
Isolation is necessary when a patient has an increased risk of contracting an infection (burn victims), or risk of spreading infection to others (TB).
All PPE should be put on
BEFORE entering the patients' room and taken off before exiting the room, including gloves that should always be discarded in the room where they were used even if the patient is not in isolation.
*Why- a contagious disease or infection present that can be spread through air or direct contact.
*Examples- Measles, Staph infection
*Remember to always wear a mask!
*Requirements-private room/bathroom. Gloves/gown/mask/leave equipment in the room or clean to facility protocol. Always use GOOD HAND HYGIENE.
*Why- a contagious disease or infection present that can be spread through droplets of mucous.
*Examples- Pertussis, Meningitis
*Remember to always wear a mask!
*Requirements- Private room-pt. can leave the room wearing a mask. Mask/other PPE necessary to perform task, GOOD HAND HYGIENE!
Blood and Body fluid precautions
*Why- infection present that can be transmitted through body fluids.
*Remember to always wear gloves!
*Requirements-Gloves should be worn if there is risk of contact with blood, feces, urine, and mucous. Gowns, eyewear, mask should be worn if risk of splattering is present. Private room/bathroom when necessary. GOOD HAND HYGIENE.
*Why- risk of infection through exhaled particles.
*Examples- Tuberculosis, Whooping cough
*Remember to always wear a mask or N95 Respirator as appropriate.
*Requirements- Everyone entering the room should wear a mask. Glove use when contact with the pt. GOOD HAND HYGIENE.
*Why-infection that can be transmitted through direct contact.
*Examples- skin or wound infections. (scabies)
*Remember to always wear gloves.
*Requirements- private room/gloves/sometimes a gown/Equipment left in the room or cleaned according to facility policy. GOOD HAND HYGIENE.
*Why-Pt. is susceptible to infection.
*Examples- Transplant patients, immune compromised patients
*Remember- follow posted signage.
*Requirements- Depends on the needs/function of the pt. GOOD HAND HYGIENE.
Safety and infection control
The safest way to avoid infecting yourself or spreading infection from one patient to another is to assume that all patients and their bodily fluid are infectious. Using Standard Precautions and good hand washing are the most effective way to prevent infection to yourself or to other patients. Using alcohol-based hand sanitizer that is 60-95% alcohol in between washes helps also.
Any piece of equipment that has been directly exposed to a patient's blood could pose a risk of infection. Anything sharp or glass that could puncture skin-microscope slides, lancets, needles, syringes, and evacuated tubes.
Never recap a needle and always throw it away in a sharps' container. Engage the safety after use.
Biohazard waste and sharps waste
Sharps containers are mostly red labeled with the words bio-hazardous waste and have the international bio-hazard symbol on the front. Bio hazard bags are red and are also labeled. non-sharp items such as clothing, linen, and non-sharp trash that are soiled with blood or infectious body fluids should be placed in bio-hazard bags. Anything sharp should be placed in the sharps' containers.
FDA- Food and Drug Administration
a federal agency that oversees the regulation of drugs and the claims made by pharmaceutical companies.
CDC-Centers for Disease Control and Prevention
Federal agency under The Department of Health and Human services- is responsible for monitoring occupational safety and health and providing education and standards for public health.
OSHA-Occupational Safety and Health Administration
Is a federal agency under the Department of Labor who sets guidelines for workplace safety and employee training to reduce workplace accidents.
MSDS-Material Safety Data Sheets
Information sheets on each of the chemicals used in a facility.
Steps to proper hand washing
3. Wet both hands
5. Apply & lather soap
6. Scrub 20 seconds
7. Dry hands
8. Turn off faucet with paper towel.
If hands are contaminated with blood, what should be the correct procedures taken?
Wash hands with anti-microbial soap. After washing with soap once, coat hands with 50% isopropyl or Ethyl alcohol and air dry for 60 seconds.
This is in addition to the hand washing steps.
PPE Types and Uses
-Gloves- should be worn during venipuncture or when contact with body fluids is possible.
-Lab coat- should be worn while drawling a blood sample.
-Gowns- should be worn when splashing of body fluids is possible, usually when a patient is in isolation.
-Face shield- should be worn if splattering of blood or body fluids is possible.
-Masks- should be worn if indicated when a patient is in isolation.
-N95 respirator mask- worn when indicated if a patient is in isolation.
Evacuated blood collection system
Double ended needle
Needle Holder (Barrel/Hub)
- a needle with a rubber coated end that connects into the hub- this is the end the tube connects to. Bevel end is the part that pierces the skin to collect the sample.
Needle holder (hub)
holds the double ended needle together so tubes can be connected to collect the sample. This is the part that is held while performing the venipuncture and changing of tubes.
Tubes with air removed to produce a vacuum
can be used if the vein collapses during a draw because the vacuum pressure is to strong for the vein.
2.4mm long and disposed into sharps container.
smaller is 23-25 (small or fragile veins), medium is 21-22 (most common), larger is 16-18 (blood donation)
the part of the needle that pierces the skin, bevel should always face upwards
70% isopropyl alcohol- iodine or betadine are good alternatives and may be required- especially for blood alcohol testing.
Should be worn about 15 minutes. Don't bandage babies
used to engorge the veins for palpation. Should be placed 3-4 inches above the AC, should not be left on longer than 2 minutes.
Venipuncture Procedure (preparing)
• Preparing for the draw-knock, introduce yourself wash hands, identify the patient by checking hospital id band, asking for id, asking a nurse or parent to identify pt. with name and D.O.B., insure any pre-draw instructions have been followed. (fasting, not exercising, ask if pt. has any questions, ask if they have a vein preference.
• Gathering supplies- tourniquet, double ended needle, hub, 2x2's, tubes, bandage, alcohol wipes.
• Put on gloves
• Put on the tourniquet tightly then palpate (feel veins) for the best option. Mark your entry- point, determine the needle gauge size you will need, then release the tourniquet.
Performing the venipuncture procedure
• Clean the area with 70% isopropyl alcohol in a spiral starting from the center outward.
• Retie the tourniquet after alcohol has dried.
• Remove needle cap that is attached to your hub, anchor the vein and insert at a 15-30-degree angle, bevel side facing up into the vein. Keep an eye on the patient.
• Insert tube, fill tube full, remove and invert a few times, insert next tube.
• When blood starts filling on the last tube, release tourniquet.
• Remove the last tube, invert a few times-then lay it down, hover the needle with 2x2's, remove the needle and immediately apply pressure to draw site, click safety device on needle, dispose in sharps container. Finish remaining inversions while holding pressure on site. Check site to insure bleeding has stopped then bandage area and instruct pt. to keep bandage on for 15 minutes.
• Label tubes with: Last name, first name, pt. D.O.B., draw time, date, and phlebotomist initials.
inside of elbow
Vein selection criteria
• Turgor (bounce)
Median cubital vein- middle of arm, 1st choice
Cephalic- towards the thumb (ceiling), 2nd choice
Basilic- towards the pinky finger (basement), last choice- near the median cutaneous nerve and brachial artery.
Other draw sites
Back of the hand- use smaller or butterfly needle if needed, tie tourniquet 3-4 inches above draw site- adjust if necessary, have pt. hold on to something for stability, avoid valves, adjust entry angle because hand veins are more superficial, anchor firmly.
Importance of order of draw
To keep later tubes from becoming contaminated with additives.
Order of draw
• Yellow (SPS)- Blood cultures (boys)
• Light Blue (love)
• Red, Red Tiger Top, Gold, Orange (ravishing)
• Green top or Green tiger top tube (girls)
• Lavender, purple, pink, white (like)
• Gray (greek)
* pale yellow (yogurt)
• All others
PTT, PT, PT/INR
Liver and clotting tests
CBC- Complete blood count
• (WBC) White Blood Cell count
• WBC differential count
• (RBC) Red blood cell count
• (Hct) Hematocrit
• (Hbg) hemoglobin
• (MCV) Mean corpuscular volume
• (MCH) Mean corpuscular hemoglobin
• (MCHC) Mean Corpuscular Hemoglobin Concentration
• (RDW) Red Cell Distribution Width
• Platelet Count
• (MPV) Mean Platelet Volume
Tests the blood sugar over a six-week (120 day) period
Chem 7/BMP (Basic Metabolic Panel)
• Blood Urea Nitrogen (BUN)- Kidney function
• Carbon Dioxide (CO2)-check how well kidneys and lungs are managing CO2 levels in the body.
• Creatinine-A protein in the blood caused by muscle breakdown. Checks for kidney dysfunction and muscular dystrophy.
• Glucose-tests sugar in the blood for diabetes or another endocrine disorder.
• Serum Chloride (Cl)-checks hydration levels, kidney function, and blood pH.
• Serum Potassium (K)- checks the function of cells and muscles for heart function.
• Sodium (Na)- checks kidney function, diet, hydration, endocrine function, trauma, bleeding, and water retention problems.
Lipid layer of sample after separation; found in between formed elements and plasma.
The symbol used to depict the hydrogen ion concentration of blood
the production of blood cells and platelets, which occurs in the bone marrow of the long bones.
The difference between plasma and serum
plasma contains fibrinogen; serum does not
Connective tissue made of plasma, erythrocytes, leukocytes, and platelets.
The water like portion of you blood that carries many vital components including glucose, fats, metabolic waste, and antibodies. The liquid portion of the blood that is responsible for transporting blood cells, dissolved gases and other chemical substances. 90% water, 10% dissolved solutes.
liquid portion of the blood that remains after clotting
the condition of the blood when it leaves the body
--Red Blood Cells
-Makes up majority of formed elements
-only cell that carries O2
-Do not have Nucleus (holds more O2)
-Life span 100-120 days
immature red blood cell
White Blood Cells
-Do have nucleus
-5 different types
WBC that defends against bacterial/fungi
-forms pus--> first responder
WBC that defends against parasitic infection
WBC that is responsible for allergic reaction
WBC that defends against foreign matters
-move 8-12 days.
WBC that is responsible for immuno-response
-two types: B (releases immunoglobulins) and T cells (directly attacks).
Thrombocytes- thrombo=clot cytes=cells/ clotting cells. Cells on the scene when injury occurs.
protein that forms the basis of a blood clot
lack of a normal number of red blood cells
higher than normal white blood cells in the circulatory system, characterized by many abnormal cell forms.
abnormally low levels of white blood cells
production of too many red blood cells
increased platelets in the circulatory system
decreased platelets in the circulatory system
Steps of hemostasis-
1. Fibrin clot formation- a permanent clot is formed out of fibrin using a complex sequence of interactions.
2. Fibrinolysis- once the tissue has repaired itself, the clot is no longer needed. A substance called plasmin breaks up the fibrin clot into small pieces called fibrin degradation products, which are then removed by specialized cells.
Hematoma causes and prevention
a pool of blood in the tissue surrounding the blood vessel. Applying pressure to the puncture site will suppress the hematoma formation.
The point where arteries join other arteries
The point where veins join other veins.
muscular, middle layer of the heart
The smooth glass-like innermost tissue layer of the heart.
The outside layer of the heart containing coronary arteries that supply blood to the heart.
The site where cells exchange products of metabolism with adjoining cells.
A fluid between cells where substances are added and subtracted and transported through the body to be broken down into parts like proteins that can be used elsewhere
Glands where immunity cells destroy pathogens.
(Carbon dioxide) waste that is carried back to the lungs to be expelled during exhalation of air.
Pressure exerted on the walls of the arteries as the heart contracts. Measurement of force applied on the arterial walls.
The system that is responsible for destroying and ridding pathogens and infections from the body. Transports lymph (white blood cells) throughout the body. Part of the circulatory system.
Responsible for the flow of blood, nutrients, hormones, oxygen and other gases to and from cells.
Transports oxygen to all tissues of the body and removes metabolic waste. Transports cells to aid in nourishment and immunity and regulation of body temperature.
Systemic circulation system
Carries oxygenated blood from the left ventricle through the arteries to the capillaries in the tissue of the body. Then the deoxygenated blood is returned from the capillaries through veins to the right atrium of the heart to the lungs where the carbon dioxide is exhaled
4 chambers of the heart
Right atrium, right ventricle, left atrium, left ventricle
Blood collects in the right atrium then passes to the right ventricle is reoxygenated then is sent to the left atrium then goes to the left ventricle.
- (the outer layer of the blood vessel)- is thinner on veins than arteries
(middle layer)- smooth muscle- is much thinner on veins than arteries
(inner layer)- same in veins and arteries
Accidental artery puncture
Remain calm, remove the tourniquet, remove the needle, immediately apply pressure, raise the arm above the heart while applying pressure for a minimum of 10 minutes. Lower the arm and check the site to ensure bleeding has stopped, apply pressure bandage and provide the patient with aftercare instructions such as applying ice to dull the soreness
Vessels that carry blood away from the heart.
Vessels that carry blood to the heart.
Where cells exchange products of metabolism
Are intracellular. They don't reproduce, instead they hijack the cells reproductive machinery
Very small microorganisms
Dangerous microbes that pose a potential risk to cause disease
Most outer superficial layer of the skin
middle layer of skin, Contains collagen fibrils, and elastic connective tissue that support the epidermis, capillaries, hair follicles, apocrine, and sebaceous glands.
innermost layer of the skin, containing fat tissue, Fatty layer of tissue that provides protection for muscle and blood vessels.
Attach muscles and bones together.
A protein found in red blood cells responsible for transporting oxygen in the blood.
Line the circumference of arteries and the GI tract. Involuntary muscles
the body's normal rhythm for balancing functions of the body without having to think about it. Regulation of temperature or blood pressure are examples.
The role of the respiratory and cardiovascular system in the movement of O2 and CO2
The heart pumps blood to the lungs which oxygenates it then it moves the oxygenated blood throughout the body. The lungs inhale oxygen and exhale the carbon dioxide.
to digest food and absorb nutrients and water into the body then expel the waste.
system is to regulate the body through hormones (homeostasis)
system is to protect the body from disease by destroying pathogens.
system is to protect the body from outside threats-Physical and environmental.
system is to provide form, support, stability, and movement to the body.
system is to transmit information to and from the spinal cord and brain- this process allows the body to receive information about the environment and respond appropriately.
This system allows males and females to reproduce children
system is responsible for taking in oxygen and expelling carbon dioxide.
2 kidneys, 2 ureters, 1 urinary bladder, 1 urethra, system is to produce, store, and eliminate urine produced by filtration of waste and extra water from the blood.
when the needle enters one side of the vein and goes through the other side. (Goes through.) Pulling back on the needle will often remedy this situation however will likely cause a hematoma.
Happens when the vacuum pressure of the tube is too much. The vein will shrink away or look flattened and blood flow will stop. Remove the tube and if the vein refills then proceed with a smaller tube (if it will provide a sufficient sample) or a syringe.
Pt has the right to refuse. Remind them of the importance of the tests ordered and if they still refuse- document it and notify the nurse or physician that ordered the tests.
The procedure if a phlebotomist fails to obtain blood
Think through possible problems and solutions and stay calm and reassuring
Expired or damaged tubes. Try another and make sure it is not expired.
Missed or "rolling" vein
Re-palpate, if the needle is close to the vein and redirect is possible, carefully pull the needle back slightly, angle it appropriately and push it into the vein.
When the patient has fasted and not exercised in 12 hours
Limit of attempts to collect
A phlebotomist should only stick a pt. 2 times. If still unable to draw, they should get another phlebotomist to try or notify the supervisor.
Alternative collection methods
Winged collection (butterfly), or a syringe draw
Patient caused errors
• Exercise- physical exercise can raise the levels of sugars, electrolytes, and lactic acid that can cause testing errors. Notify the patient of the of the possible errors, if they wish to continue, document that the patient has been active immediately prior to the draw.
• Failure to fast- some tests require the patient to be in total basal state (fasting for 12 hours and not active). Notify the patient of the possible test errors and if they wish to continue, document that the patient was not fasting at the time of the draw.
• Hemolysis- Damage to cells can be caused by using a needle that is too small, a partially filled tube or from a tourniquet being left on greater than 2 minutes.
• Hemoconcentration- occurs when a tourniquet is left on more than 2 minutes.
• Quality insufficient sample- not enough blood in tubes causes error in blood to additive ratio.
• Incorrect draw order.
3 conditions of basal state
Early morning draw after 12 hr. fasting, no food, drink, gum for 12 hours, no exercise for 12 hours.
The medical term for fainting
Tiny red dots around the draw site
A pool of blood collected in the tissue
Recognizes a patient's right to know about and agree to the risks, benefits, process, and statistical outcomes of a procedure, medication, or treatment.
Most common in phlebotomy- the patient gives verbal permission or extends the arm for the medical professional to perform or continue with the procedure
Speaking in a quiet manner so others can't hear what you are talking with the patient about. Not sharing the patients identifying or personal information with anyone who is not authorized
Instilling patient confidence
Always stay calm and composed in front of the patient.
Patient's bill of rights
• Information for patients- to understand information related to their health care.
• Choice of providers and plans- to chose who they want to be treated by.
• Access to emergency services- to receive emergency services regardless of ability to pay.
• Taking part in treatment decisions- to make decisions about their care.
• Respect and non-discrimination- to receive care in a non-discriminatory manner based on race, ethnicity, national origin, religion, sex, age, mental or physical disability, sexual orientation, genetic information, or source of payment.
• Confidentiality (privacy) of health information- the right to have your private information protected, and to read your own medical record and request that it be changed if something is incorrect. Irrelevant, or not complete.
• Complaints and appeals- the right to file a complaint against any medical professional, insurance company or facility and the right to a timely response.
• Consumer responsibilities- to provide full and accurate information to the best of the patient's knowledge and to follow treatment plans agreed on with healthcare professionals.
usually a M.D. specialized in pathology
a bachelor's degree in biological science
a medical technologist with an additional education in management.
Medical laboratory technician
a graduate of a two-year program.
usually required to have a high school diploma or GED. May become certified by passing a program at a state approved school or by taking the National Certification Test. General duties include:
- Collects blood specimens by venipuncture or micro-techniques on adults, children, and infants.
- Identifies the patient before blood is drawn and correctly labels specimens that have been collected.
- Shows concern for the patient and promotes the comfort and well-being of the pt.
- Picks up and delivers to the lab a variety of clinical specimens.
- Maintains an orderly and timely flow of specimens to the technical area.
- Maintains accurate and orderly records.
- Projects an image of professionalism in appearance and conduct.
1. Health insurance access, portability, and renewal- allows continuance and transfer of insurance even with pre-existing conditions.
2. Preventing health care fraud and abuse- establishes penalties for fraud and abuse and improves the Medicare program by establishing standards.
3. Tax-related provisions-encourages the use of private medical savings accounts (MSA's) to be used for medical expenses only.
4. Group health plan requirements- sets standards for how group health care plans must ensure portability, access and transferability of health insurance to participants.
5. Revenue offsets- provided funding for HIPPA related regulatory expenses by changing the Internal Revenue Code.
6. General provisions- To prevent duplication of coverage, this section outlines how Medicare-type plans must be carried out.
7. Assuring portability- to ensure portability of coverage, health insurance plans must be able to cover employees from one plan to another.
-Reason for collection
screens for septicemia (a serious and fatal condition caused by bacteria in the blood).
sterile procedure, requires 2 glass bottles each from 2 different sites. Palpate vein and then scrub with betadine or iodine, change gloves and draw 1st bottle set, palpate 2nd site and clean then change gloves again then draw for 2nd bottle set. Bottles should be inverted 8-10 times.
Glucose Tolerance Test (GTT)-Reason for collection
assists in diagnosing of diabetes mellitus, hypoglycemia, and mal-absorption syndrome
Glucose Tolerance Test (GTT)-Procedure
-Duration of fast- fasting for 10 hours before draw.
-Procedure- use a recent height and weight measurement to determine the amount of glucose syrup to give the patient, fasting sample may be required before pt. drinks syrup. Have pt. drink all of syrup within 5 minutes and note the time syrup was finished. Draw at 30 min. from the time pt. finished syrup, 1 hr., 2 hrs., and 3 hrs. note the time at each draw on the appropriate tube.
-Complications- if the pt. does not consume the drink within 5 minutes, patient cannot sleep, cannot exercise. Pt may become lethargic. If pt. starts vomiting, loses consciousness, or shows signs of a diabetic attack- contact the physician immediately on how to proceed.
Cold Agglutinins -Reason for collection
assists in the diagnosis of primary atypical pneumonia, viral infections, or complications of lymphoma.
Cold Agglutinins -Procedure
- prewarm the tube to 37 degrees C.
-handling- specimen should be kept warm at body temperature until the test is ran on the specimen.
Bleeding Time Test- Reason for collection
Used to check for platelet function disorders
Bleeding Time Test-Procedure
- Place the arm in the supine position, clean below the AC with betadine or an iodine swab in circular motion, after dried clean again with alcohol, place BP cuff on the upper arm set at 40mmHg, with sterile incision instrument- make a 5 cm incision below the AC, start the stopwatch as soon as you press the release on the incision making device, blot the blood every 30 seconds until bleeding stops, clean and bandage the site with a butterfly bandage and instruct the pt. to leave it on for at least 24 hrs.
the ratio of the volume of red blood cells to the total volume of blood
Composition of capillary blood
a mixture of blood from arterioles, venules, capillaries, and interstitial fluid
lined with ammonium heparin when testing the hematocrit. Plain unlined tubes are used to test the serum.
Capillary puncture (procedure and use)-
A finger stick used on geriatrics and pediatrics.
1. Select the puncture site.
2. Clean the site
4. Dispose the lancet in sharps
5. Wipe away the first drop
6. Apply pressure
7. Collect blood in a microtube, capillary tube, or slide
8. Label the sample
Pinky-side of the ring finger on the non-dominate hand
Heel stick sites
Medial or lateral sections
Syringe order of draw
1. Blood cultures
2. Sodium citrate (light blue)
3. Sodium heparin (green) or lithium heparin (green tiger top)
4. K2 EDTA (lavender) or K3 EDTA (purple)
5. Sodium fluoride (gray) or Potassium Oxalate (gray)
6. Serum (red or red tiger top)
Reason for syringe draw
Small, collapsed or frail veins
Common situations/population for syringe draws
Sometimes evacuated tubes are too strong and collapse a vein, geriatrics, cancer pts, some facilities require it for certain tests.
Special considerations with syringe-draws
Order of draw is different
Syringe draw moves at a slower pace and may cause the blood to clot
Don't exert too much pressure
Don't pull too slowly
Must be careful when transferring into tubes- high risk of accidental needle stick.
Lavender or purple top Tube
Additive- K2 EDTA, K3 EDTA
Test - Hematology (CBC) most common, WBC, Hct, ESR, Platlet count, Ammonia (on ice), HgbA1c, RBC, Hgb, Diff, Prevents artifacts for up to 12 hours. Partially filled tubes damages cells. invert 8-10 times.
red top tube
Additive - none
Type- clot tube
Used for - obtaining serum (chemistries), Blood typing-ABO/RG factor, Crossmatch, Digoxin, Tegretol, Dilantin/Phenytoin. Blood Alcohol testing. Invert 5-6 times.
Light blue top tube
Additive- sodium citrate
Type- reversible anticoagulant
Test- coagulation-plasma, PT, PTT, Fibrinogen, PT/INR. Partially filled tubes damage cells.
Green top or Green tiger top tube
Type- anticoagulant or separator tube
Test- serum or plasma chemistry - electrolytes, BMP, CMP, Glucose, Potassium, Troponin, Lactase (on ice), Blood alcohol testing
Red Tiger Top or Gold SST top tube
Test- BMP, CMP, Bilirubin, Thyroid testing, Hormone levels, Antibotics, Hepatitis, General chemistry testing, CKMB, PSA, CK
used for- obtaining serum. Invert 5-6 times.
Orange top tube
Obtains serum. Invert 5-6 times.
Yellow top tube (SPS)
Preserved for 2-4 hours, then needs to be transferred to a blood culture bottle. Invert 8-10 times.
Yellow top tube (ACD)
Acid , citrate and dextrose
Preserves red blood cells
Genetic DNA testing. Invert 8-10 times.
Black top tube
Often sodium citrate
Erythrocytes sed rate
Westergren sed rate. Invert 8-10 times.
Tan top tube
Testing Lead. Invert 8-10 times.
White top tube
Molecular diagnostics, Performed on Proteins. Invert 8-10 times.
Pink top tube
Blood typing. Invert 8-10 times.
Gray top tube
Plasma glucose testing
Preserves 1-5 days, Hemolysis in partially filled tubes. Invert 8-0 times.
Royal blue top tube
Low trace element testing
Trace metal analysis
invert EDTA tubes 8-10 times, Serum tubes invert 5-6 times.
Clear/light gray / red tiger top tubes
No inverts necessary
red blood cells, white blood cells, platelets
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