Introduction to Blood Collection

Blood collection - crosstraining for STNAs

1. INTRODUCTION TO BLOOD COLLECTION Blood Collection: A Short Course

2. 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.

3. 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.

4. Redesigning the Healthcare System Shifting of phlebotomy responsibility. New skills required.

5. 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

6. Blood Collection: A Short Course Course Overview Equipment Site selection Technique Complications Specimen handling Phlebotomy errors Venipuncture practice

7. 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

8. 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

9. 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

10. SAFETY PRECAUTIONS Standard Precautions Personal protective equipment (PPE) Isolation Procedures Hand washing Properly activating needle safety devices Biohazard disposal Decontamination Sodium hypochlorite (1:10)

11. SAFETY PRECAUTIONS

12. SAFETY PRECAUTIONS

13. SAFETY PRECAUTIONS

14. SAFETY PRECAUTIONS

15. SAFETY PRECAUTIONS Accidental Puncture Significant exposure potential Report all needlesticks Follow institution’s protocol for source and employee testing

16. SAFETY PRECAUTIONS Syringe-To-Tube Transfer Recommended procedure Use blood-transfer device Removal of stoppers not recommended Direct puncture of tube with syringe needle not recommended

17. SAFETY PRECAUTIONS Specimen Processing Centrifugation Capped , balanced tubes Separation Removal of stoppers Aerosol production

18. SAFETY PRECAUTIONS Specimen Transport Primary container Secondary container Labeling

19. TYPES OF SPECIMENS Whole Blood Consists of: Erythrocytes Leukocytes Platelets Plasma Use anticoagulated ( unclotted ) specimen

20. TYPES OF SPECIMENS Plasma Liquid portion of unclotted blood Contains fibrinogen Use anticoagulated specimen

21. TYPES OF SPECIMENS Serum Clotted blood Does not contain fibrinogen Use “clot” tube

22. TYPES OF SPECIMENS Centrifugation

23. TYPES OF SPECIMENS Anticoagulants Calcium binding EDTA Sodium citrate Potassium oxalate Thrombin inhibition Heparin

24. TYPES OF SPECIMENS MIX ANTICOAGULATED SPECIMENS THOROUGHLY IMMEDIATELY AFTER COLLECTION

25. TYPES OF SPECIMENS Normal Plasma & Serum Appear clear & pale yellow Hemolyzed Specimens Appear pink-red Erythrocyte destruction

26. TYPES OF SPECIMENS Icteric Specimens Appear dark yellow Increased bilirubin Lipemic Specimens Appear milky Increased lipids

27. TYPES OF SPECIMENS Venous Blood Specimen of choice Used to establish Normal values Arterial Blood Blood gases Require special collection training

28. TYPES OF SPECIMENS Capillary Blood Dermal puncture collection Mixture of arterial and venous blood Note on requisition if blood is collected by dermal puncture