PMLS2 Lab

• 3 Major Veins

  • Median cubital vein
  • Cephalic vein
  • Basilic vein
• Median Cubital vein


  • Known as the vein of choice, located at the center of the antecubital fossa, large, not movable, closer to the skin surface, more isolated and least painful
• Cephalic vein

  • Located in the thumb side, second vein of choice if the median cubital vein is not visible, difficult to locate and has the tendency to move
• Basilic vein


  • Known as the vein close to the body, last vein of choice if the median cubital and cephalic veins are not visible, most painful because it is closer to the medial nerve and brachial artery, least firmly anchored vein, has a larger tendency to roll
• Phlebotomist is a person trained to collect blood samples primarily by venipuncture and micro techniques
• Phlebotomist


  • Should have technical, intrapersonal, and storage organizational skills
• Dermal Puncture


  1. This is also known as capillary blood collection

  2. Blood is obtained by skin puncture from capillaries, arterioles, and venules

  3. In this type of collection, the blood obtained is similar to arterial blood
• Guidelines for blood collection

  • Puncture perpendicular to fingerprint lines
  • Do not puncture swollen, bruised, infected area, or area that has been already punctured
  • Do not perform with a patient who has edema, dehydration, and peripheral circulation
  • Do not collect blood from the fingers on the side of mastectomy
• Locations for POINT OF CARE TESTING

  • Satellite laboratories
  • Physician offices
  • Ambulatory clinics
  • Ambulances or helicopters
  • Long-term facilities
  • Workplace screenings
  • Health fairs
  • Dialysis centers
  • Home setting
• INFECTION: Condition that results when a microorganism invades the body, multiplies, and causes injury
• CHAIN OF INFECTION

  Continuous link of 6 components crucial to understand and break
• Breaking the chain of infection is important to know how to effectively break the chain
• INFECTIOUS AGENT

  Bacteria, parasites, fungi, and viruses
• Breaking the chain for infectious agents

  Early detection and treatment
• RESERVOIR


  Place where infectious agents live
• Breaking the chain for reservoirs

  Disinfecting the work area
• PORTAL OF EXIT


  Where the infectious agent exits
• Breaking the chain for portal of exit

  Proper disposal of healthcare wastes
• MODE OF TRANSMISSION

  Way to reach a susceptible host
• Modes of transmission

  • Direct contact
  • Droplet
  • Airborne
  • Vehicle
  • Vector
• Breaking the chain for mode of transmission

  Hand hygiene, Standard Precautions, PPE, Patient isolation
• PORTAL OF ENTRY

  Where the infectious agent enters
• Breaking the chain for portal of entry

  Disinfection, sterilization, adherence of Standard Precautions
• SUSCEPTIBLE HOST


  Patients or healthcare providers who can be infected
• Ideal susceptible hosts

  • Patients
  • Patients receiving chemotherapy
  • Immunocompromised patients
  • Newborns and infants
  • Geriatric population
• Breaking the chain for susceptible hosts

  Immunization, patient isolation, nursery precautions, healthy lifestyle
• HEALTHCARE ASSOCIATED INFECTION (HAI): Infections associated with healthcare delivery in any healthcare setting
• NOSOCOMIAL INFECTION: healthcare-associated acquired in hospitals that can be prevented by appropriate measures with Standard Precautions
• STANDARD PRECAUTIONS

  Recommendations by CDC combining UP and BSI procedures
• HAND HYGIENE


  First line of defense to reduce transmission of infectious agents
• 5 Moments of Hand Hygiene

  • Before touching a patient
  • Before a procedure
  • After a procedure or body fluid exposure risk
  • After touching a patient
  • After in contact with patient and touching patient surroundings
• HAND WASHING


  Routinely done in 1 minute, important for infection control to remove transient micro-organisms
• Hand washing is routinely done in 1 minute
• Hand washing


  • Is one of the most important elements of infection control
  • The aim is to remove transient micro-organisms acquired through everyday tasks in the clinical setting from the surface of the hands
• Good hand hygiene protects both patients and staff
• If handwashing facility is not available, CDC/HIPAC recommends using alcohol-based antiseptic hand cleaners if hands are not visibly soiled
• Handwashing procedure

  1. Stand back, do not let your body or arms touch the sink

  2. Wet your hands with clean, running water

  3. Apply enough soap to cover all surfaces of your hands and form a lather

  4. Rub your hands palm to palm

  5. Rub your right palm over the back of your left hand, interlacing your fingers, then repeat with the other hand

  6. Rub palm to palm again with fingers interlaced

  7. Rub the back of your fingers to your opposing palms with fingers interlocked, repeat on both hands

  8. Clasp your left thumb in your right palm and rub rotationally, repeat with the other hand

  9. Rub your clasped fingers of one hand in the palm of the other hand, rotating back and forth, repeat with the other hand

  10. Rinse your hands in a downward motion

  11. Dry your hands thoroughly with a single-use towel

  12. Use a new paper towel to turn off the faucet
• Personal Protective Equipment (PPE)

  • Gloves
  • Safety goggles
  • Proper footwear
  • Respirators
  • Lab gown
• Donning of PPE

  1. Gown

  2. Goggles

  3. Mask

  4. Gloves
• Doffing of PPE


  1. Gloves

  2. Gown

  3. Goggles

  4. Mask