PMLS2 LAb

• Laboratory Rules


  • Hand Hygiene
  • PPE
  • Cleanliness & order
  • Waste disposal
  • Equipment care
  • No eating/drinking
  • Noise control
  • Follow instructions
• Hand contact


  Primary method of infection transmission
• Hand hygiene


  1. Sanitize hands before patient contact

  2. After gloves are removed

  3. Before leaving work area

  4. When hands are contaminated

  5. Before break areas

  6. Before and after bathroom
• Hand hygiene


  Includes hand washing and using alcohol-based antiseptic cleansers
• Hand washing


  1. Performed before and after activities

  2. Bring tissue and hand soap

  3. Most effective way to stop infection spread
• Hand Rub using alcohol


  Can be done when hand washing cannot be performed
• Hand Rub using alcohol-based cleansers

  1. Apply to palm

  2. Rub hands together over entire area

  3. Continue rubbing until alcohol dries
• PPE required


  • Lab gowns
  • Gloves
  • Face mask
  • Haircap
  • Shoe cover
• Donning PPE


  1. Ensure hands are clean

  2. Put on gown

  3. Put on face mask

  4. Put on goggles

  5. Put on gloves
• Doffing PPE


  1. Remove gloves

  2. Remove gown

  3. Remove goggles

  4. Remove face mask
• Cleanliness & order must be maintained inside the laboratory
• Observe proper waste disposal
• Take care of equipment

  • Handle with care
  • Ask for help if unsure how to operate
• No eating and drinking inside the laboratory
• Keep noise to a minimum
• Always be attentive and always follow instructions
• Blood collection equipment and supplies

  • Blood-drawing station
  • Phlebotomy chair
  • Equipment carrier
  • Gloves
  • Antiseptics
  • Disinfectants
  • Gauze pads
  • Bandages
  • Microscope slides
  • Pen
  • Watch
  • Sharps disposal
  • Biohazard bags

  
• Vein-locating devices


  • Use infrared light to help locate and assess veins
• Tourniquet


  Constricting device applied to arm to inflate veins
• Needles used in venipuncture

  • Multi-sample
  • Hypodermic
  • Winged infusion
• Needle gauge


  • Classified by diameter of lumen
  • Higher number = smaller diameter
  • 20-23 gauge commonly used, 21 gauge most common
  • 1-1.5 inch length
• Evacuated tube system (ETS)


  • Closed collection system with multi-sample needle, tube holder, and evacuated tubes
  • Allows multiple tubes to be collected in single venipuncture
• Antiseptics used in venipuncture

  • 70% ethyl alcohol
  • 70% isopropyl alcohol
  • Benzalkonium chloride
  • Chlorhexidine gluconate
  • Hydrogen peroxide
  • Povidone-iodine
  • Tincture iodine
• Disinfectants used in venipuncture

  • EPA-registered sodium hypochlorite (1:100 dilution for spills, 10% for cleanup)
• Syringe system


  • Alternative method for drawing blood from small/difficult veins
  • Uses syringe to draw blood and transfer to tubes
• Evacuated tube system


  • Closed collection system considered most efficient
  • Involves piercing needle into vein and tube stopper
  • Enables multiple tubes to be collected in single venipuncture
• Evacuated tube system components

  • Multi-sample needle
  • Tube holders
  • Evacuated tubes
• Evacuated tubes


  Color-coded tubes filled with predetermined blood volume
• Evacuated tube system (ETS) for blood collection

  1. Piercing one end of the double-pointed needle into the vein

  2. Piercing the other end into the stopper of the evacuated tubes

  3. Enables numerous tubes to be collected in a single venipuncture
• ETS components


  • Multi-sample needle
  • Tube holders
  • Evacuated tubes that prevent the exposure of the specimen to contaminants
• ETS needle


  • Threaded in the middle and the bevel point on each end
  • Threaded portion is attached to a tube holder with a sleeve that retracts when the needle goes through the tube stopper
  • Sleeve slides back once the tube is removed to prevent leakage
• Tube holders


  Can accommodate different-sized tubes
• If the ETS lacks safety features, the phlebotomist must make sure the needle used has a safety feature
• The needle and the tube-holder device are permanently attached as a unit or come preassembled
• Evacuated tubes


  • Color-coded tubes filled with predetermined volume of blood by vacuum
  • Used in both the ETS and syringe method
  • Can be an additive or non-additive tube
  • Available in different sizes and volumes and can be made of glass or plastic
  • Usage depends on factors like age of patient, size and condition of vein, and volume of blood needed
• Categories of Additives Used in Blood Collection

  • Anticoagulants
  • Antiglycolytic agents
  • Clot activators
  • Thixotropic gel separator
  • Trace element-free tubes

  
• Anticoagulants

  • Commonly called blood thinners, are chemical substances that prevent blood clots
  • Work by precipitation of calcium or by preventing thrombin formation
• Types of anticoagulants


  • EDTA
  • Citrates
  • Heparin
  • Oxalates
  • Acid citrate dextrose
  • Citrate phosphate dextrose
  • Sodium polyanethol
• Antiglycolytic agents


  • Substances that prevent the breakdown of glucose by blood cells or glycolysis
  • Most common is sodium fluoride which preserves glucose and prevents growth of bacteria
• Clot activators


  • Enhance coagulation in serum specimen tubes
  • Types are clotting factors like thrombin, and substances that provide more surface for platelet activation like glass (silica) particles and inert clays(celite)