PMLS LESSON 4

• General Blood Collection Equipment and Supplies

  • Blood - Drawing Station
  • Phlebotomy Chair
  • Equipment carrier
  • A new pair of gloves and glove liners
  • Antiseptics
  • Disinfectants
  • Hand sanitizer and wall-mounted hand sanitizer dispenser
  • Gauze Pads
  • Bandages
  • 1x3 inches glass microscope slides
  • Pen with non smear ink  Watch with timer
  • Needle and sharps disposal containers
  • Biohazard bags
• Waste Storage and Disposal

  • BLACK - non-infectious dry waste
• WASTE STORAGE AND DISPOSAL

  • GREEN - non-infectious dry waste
• Waste Storage and Disposal

  • YELLOW - infectious and pathologic waste
• Waste Storage and Disposal

  
  

  YELLOW WITH BLACK BAND - chemical waste with heavy metals
• Waste Storage and Disposal

  
  

  ORANGE - Radioactive Waste
• Waste Storage and Disposal

  
  

  RED - Sharps and Pressurized Containers
• Appropriate gauge is 20-23, but the ideal gauge is 21.
• Length of the needle used for venipuncture is 1 to 1.5 inches
• Environmental Protection Agency (EPA)- registered sodium hypochlorite with 1:100 dilution. For spills, 1:10 dilution is used. Contact time required is 10 minutes.
• There are different antiseptics that are used in blood collection.

  • 70% ethyl alcohol
  • 70% isopropyl alcohol
  • Benzalkonium chloride
  • chlorhexidine gluconate
  • hydrogen peroxide
  • povidine-iodine and tincture iodine
• Three types of phlebotomy needles:

  1. Multi-sample
  2. Hypodermic (Syringe)
  3. Winged Infusion (Butterfly)
• Evacuated Tube System

  • Allows numerous tubes to be collected in a single venipuncture.
  • Composed of multi-sample needles, tube holders and evacuated tubes which prevent the exposure of the specimen from contaminants.
  • are color coded tubes filled with predetermined volume of blood by vacuum.
• Winged Infusion (Butterfly)

  • This is used for difficult veins such as those of pediatric or elderly patients because it is more flexible than the needle or syringe.
  • It is composed of ½ to ¾ inch stainless needles; 23 to 25 gauge, with 5 to 12 inches tubing.
  • It has Luer attachment for syringes or multisampler Luer adapter for ETS.
• Anticoagulants


  • commonly called blood thinners and prevent blood clots.
  • Two mechanism involved in anticoagulants: precipitation of calcium or by preventing thrombin formation.
  • Examples: ethylenediaminetetraacetic acid (EDTA), citrates, heparin and oxalates.
• Special-use anticoagulants

  • include acid citrate dextrose, citrate phosphate dextrose and sodium polyanethol sulfonate (SPS)
  • ACD is used for whole blood and erythrocyte survival, routinely used for blood storage. 21 days is the ideal shelf life.
  • CPD is used in apheresis procedure to prevent platelet activation and coagulation as blood moves throughout the unit.
  • inhibits the antimicrobial systems of blood.
• Antiglycolytic Agents

  • prevent the breakdown of glucose by blood cells or glycolysis.
  • Most common is sodium fluoride which preserves glucose and prevents growth of bacteria.
  • It is usually used with potassium oxalate for rapid response.
• Clot activators

  • enhance coagulation in serum specimen tubes.
  • There are two types of activators: - Clotting factors such as thrombin. - Substance that provide more surface for platelet activation such as glass (silica) particles and inert clays (celite).
• Thixotropic gel separator


  inhibits cells from metabolizing substances and moves between cells and serum or plasma when centrifuged.
• Trace element-free tubes

  • made of materials that are free of trace element contamination.
  • They have royal-blue stoppers and are used for a variety of purposes such as trace element tests, toxicology studies and nutrient determination
• An additive is any substance that is placed within the tube and they can be used in ETS tubes to prevent clotting and preserving the components.
• RED - No additive

  
• ORANGE - Coagulation

  
• YELLOW - Coagulation and Separation Gel

  
• GREEN - Heparin Sodium

  
• LIGHT GREEN - Heparin Lithium

  
• PURPLE - EDTA Coagulant

  
• LIGHT BLUE - Sodium Citrate 1:9

  
• BLACK - Sodium Citrate 1:4

  
• GREY - Potassium Oxalate Monohydrate and Sodium Fluoride

  
• Refers to the specific order that must be followed by a phlebotomist when collecting blood samples to prevent any cross-contamination especially when dealing with multiple collection tubes. Not following the prescribed sequence affects the test results due to cross contamination.

  Order of Draw
• Order of Draw

  • Blood Culture (sterile collections) - Yellow SPS
  • Coagulation tube - Light Blue
  • Glass non-additive tube - Red
  • Plastic clot activator tube - Red
  • Serum separator tube (PSTs) - Red and grey rubber, Gold plastic
  • Heparin tube - Green and grey rubber, Light green plastic
  • EDTA tube - Lavender, pink or purple
  • Plasma-preparation tube (PPTs) - Pearl top
  • Oxalate/fluoride tubes - Gray