Phleb (Lab)

• (15-17)Special needle attached to collection bag


  collection of donor units, autologous blood donation, and therapeutic phlebotomy
• (18) Hypodermic


  Used primarily as a transfer needle rather than for blood collection, safety issues have diminished use
• (23) Butterfly 


  Used on the veins of infants and childrens, and on difficult or hand veins of adults
• (20) Multisample hypodermic


  Sometimes use when large volume tubes are collected or large volume of syringes are used in patients with normal sized veins
• (21) Multisample Hypodermic


  The standard venipuncture needle for routine venipuncture on patients with normal veins or for syringe blood culture collection
• (22) Multisample Hypodermic


  Used on older childer and adult patients with small veins or for syringe draws on difficult veins.
• Most multisample needles come in 1-1.5 inc in lengths
• Syringe needles comes in many lengths but 1- and 1.5 inch are most commonly used for venipuncture
• Butterfly needles are commonly 1/2 3/4 in long
• Many phlebotomists prefer to use 1-in. needles in routine situations

  because it is less intimidating to the patient
• The FDA is

  responsible for clearing medical devices for marketing
• The most common and effi cient system and that preferred by the CLSI for collecting blood

  samples is the evacuated tube system (ETS
• ETS needles are called multisample needles because they allow multiple tubes of blood to be collected during a single venipuncture
• A tube holder is a clear, plastic, disposable cylinder with a small threaded opening at one end

  (often also called a hub) where the needle is screwed into it and a large opening at the other

  end where the collection tube is placed
• The most common

  anticoagulants are ethylenediaminetetraacetic acid (EDTA), citrates, heparin, and oxalates.

  Memory joggers to help you learn the most common anticoagulants
• Heparin inhibits thrombin formation (additive)
• purple tubes go to hematology and contain EDTA
• Sodium Citrate go to coagulation, have light blue stoppers and yields plasma
• Green tubes contain Heparin for chemistry test on plasma
• Gray tubes typically contain oxalate
• Lavender is drawn last unless a gray tops is ordered (note: always drawn last)
• Edta is primarily use to provide a whole blood specimens for hematology test ( can also be used in blood banks)
• Coagulation Inversion?

  3-4 inversion
• Light blue–top tubes contain a 9:1 ratio of blood to anticoagulant when fi lled to the stated

  volume and must be fi lled to within 90% of that volume for accurate coagulation results.
• Heparinized plasma is usually used in chemistry test especially stat tests (e.g., electrolytes) and in other rapid￾response situations when a fast turnaround time (TAT) for chemistry tests is needed. Faster

  TAT is possible because time is eliminated that would normally be required for a specimen to

  clot before serum could be obtained.
• Heparinized plasma is preferred over serum for potassium tests because when blood clots,

  potassium is released from cells into the serum and can falsely elevate results.
• Lithium

  heparin causes the least interference in chemistry testing and is the most widely used antico￾agulant for both plasma and whole-blood chemistry tests
• royal-blue stoppers

  indicate trace element–free tubes. These tubes are made of materials that are as free of trace

  element contamination as possible; they are used for trace element tests, toxicology studies,

  and nutrient determinations.
• The most common antiglycolytic agent is sodium fluoride. It preserves glucose for up to 3 days

  and also inhibits the growth of bacteria
• Sodium fluoride tubes have gray stoppers and require between fi ve and ten inversions,

  depending on the manufacturer, for proper mixing.
• antiglycolytic agent is a substance that prevents glycolysis, the breakdown or metabo￾lism of glucose (blood sugar) by blood cells.
• Potassium oxalate is the most widely

  used. It is commonly added to tubes containing glucose preservatives (see “Antiglycolytic

  Agents,” below) to provide plasma for glucose testing
• Potassium Oxalate (8-10 Inversion)
• CPD is used in collecting units of blood for transfusion
• Test Requisition - Forms on which tesrs are entered, can be manual or computerized, either may contain barcode
• Test Accession -

  • Process of recording in the order received.
  • It is assigned a unique number used to identify the specimen and all associated processes and papdr and connect them to the patient.
• Yellow Top - Paternity Testing Dna Testing
• Red Top - CBC, Blood Count, Hematocrit, Hemoglobin, Rbc Index, Wbc count, Plt count, MCV, MCHC, MCH, RdW, Reticulocyte count, ESR, Buffy Coat Preparation, Peripheral Smear
• Lavender/Purpe Top- Hematology (CBC) and blood bank (crossmatch) requires full draw- invert 8 times to prevent clotting and platelet clumping
• Tiger Top- Blood Type screening and chemistries