Week 1

• Medical procedures


  • Venepuncture
  • Urine Dipstix
• Venepuncture


  1. Blood sample of adequate volume in the correct tubes for the tests required

  2. Safety for both yourself and the patient

  3. Minimal patient discomfort

  4. Minimal pre-analytical interference

  5. Practice
• Fasting


  Glucose/Cholesterol
• Time of day


  Cortisol
• Time since drug ingestion

  Drug levels
• Haemolysis


  Falsely Raised Potassium
• Common Venepuncture Sites


  • Antecubital Fossa
  • Forearm and Hand
  • Femoral
• Equipment needed for venepuncture

  • Biohazard bins
  • Yellow sharp bins
  • Capillary tube
  • Needle and Syringe
  • Vacutainer
• Small veins may collapse or burst under pressure
• Paediatric patients may require Panado syrup or Emla for analgesia
• Needle must be removed at the end of the procedure
• Techniques for drawing blood should not be used in adult patients
• Needle bevel must face upwards at a 30-45 degree angle
• Stabilise the entry site below with non-dominant hand
• Rotate the Vacutainer 8 times to mix blood with substrate
• Black needle causes less pain to patient but won't haemolyse blood
• Safe disposal of needles is crucial
• Homeostasis should be maintained after the procedure
• Needlestick injuries should be rinsed with water and soap and reported to Occupational Health
• Tests conducted with blood tubes

  • DVT or clot detection
  • CRP - inflammation or infection
  • LFT's - liver function
  • Amylase - pancreas health
  • Sugar levels
  • CD4 counts
  • ESR - TB detection
• Types of blood culture bottles

  • Grey - for blood culture
  • Blood culture bottles on left side - for septicaemia detection
• ESR


  TB detection
• Safety precautions


  • Wash hands before procedure
  • Always wear gloves
  • Wash hands after procedure
• Needlestick Injuries


  1. Rinse with copious running water and soap and allow to bleed freely

  2. Report to Occupational Health Immediately to initiate HIV, Hep B and C, Syphilis prophylaxis

  3. Patient also to be tested for HIV, Hepatitis B and C
• Risk of Transmission
• First dispose
• When taking ARV’s
• Pitfalls


  • Always get consent from patient
  • Same arm as IV/transfusion
  • Arterial puncture
  • Nerve Injury
  • Syncope
  • Failure
• Make sure they know it will be a bit uncomfortable or even painful so that fluids in IV do not contaminate blood
• Urine Dipstix


  1. Produced by the kidneys

  2. Ultrafiltration of plasma by renal glomeruli
• Types of urine samples

  • Early morning sample (Qualitative)
  • Random sample (Routine)
  • 24hrs sample (Quantitative)
  • Midstream sample (UTI)
  • Post prandial sample (DM)
• Urine Examination


  1. Macroscopic Examination: Colour, Clarity, Odour, Volume

  2. Chemical Examination: Dipstix

  3. Microscopic Examination: MCS
• Volume
• Appearance
• Clarity
• Odour
• Dipsticks
• Chemistry: Specific Gravity
• Chemistry: pH
• Chemistry: Protein