Lesson 4

• Blood-drawing station


  A dedicated area of a clinical laboratory equipped for performing phlebotomy procedures on patients, primarily outpatients sent by their physicians for laboratory testing
• Phlebotomy chair


  • Important equipment
• Equipment carriers


  • Handheld carrier
  • Phlebotomy cart
• Gloves


  Required by CDC/HICPAC standard precautions and OSHA when performing phlebotomy
• Types of gloves


  • Nonsterile
  • Disposable latex
  • Nitrile
  • Neoprene
  • Polyethylene
  • Vinyl examination
• Gloves with powder are not recommended, as the powder can be a source of contamination for some tests
• Antiseptics


  Substances used to prevent or inhibit the growth and development of microorganisms but do not necessarily kill them
• Commonly used antiseptics


  • 70% isopropyl alcohol (isopropanol)
  • Benzalkonium chloride (Zephiran chloride, 1:750)
  • 70% isopropyl alcohol followed by an iodophor
  • Chlorhexidine gluconate
• Antiseptic prep pads


  Needed/used if you prepare bacteria blood sample
• Antiseptics used in blood collection

  • 70% Ethyl alcohol
  • 70% Isopropyl alcohol (Isopropanol)
  • Benzalkonium chloride
  • Chlorhexidine gluconate
  • Hydrogen peroxide
  • Povidone-iodine (0.1%-1% available iodine)
  • Tincture of iodine
• Disinfectants


  Chemical substances regulated by the Environmental Protection Agency (EPA) that are used to remove or kill microorganisms on surfaces and instruments
• Preferred EPA-registered disinfectants


  • Solutions made from generic 5.25% sodium hypochlorite (household bleach)
• Outpatients


  Able to go to the laboratory for blood extraction
• Inpatients


  Not able to go to the laboratory, the medical technologist will go to bedside to extract blood
• Neoprene and polyethylene


  Has the same type of material as blood bag
• Vinyl examination gloves


  Transparent, usually used in the laboratory
• Latex gloves


  May cause allergy
• Powdered latex gloves are not allowed because it can contaminate samples
• 95% ethyl alcohol


  Used in histopathology but it is corrosive to the skin
• Benzalkonium chloride


  Used for antiseptic for skin
• 3.70% isopropyl alcohol followed by an iodophor


  Betadine with ratio of iodophor
• Chlorhexidine gluconate


  Acetone; antiseptic for nails
• Antiseptic


  Cleaning area for extraction
• Disinfectants


  Solutions needed for cleaning area after extraction of blood
• Acetone


  One of the ingredients to make drugs
• 100mL is the maximum amount of acetone that can be sold
• Need permit to buy acetone
• Process for transfusion


  1. Alcohol - 1 minute

  2. Iodine - Povidone; 1 minute

  3. Alcohol - to clean area for 1 minute
• Disinfectant dilutions


  • 1:100 for nonporous surfaces after cleaning up blood or other body fluid spills
  • 1:10 is applied prior to cleanup when spills involve large amounts of blood or other body fluids
  • At least 10 minutes of contact time
• Hand sanitizers


  CDC/HICPAC recommends the use of alcohol-based hand sanitizers for routine decontamination of hands (when hands are not visibly soiled)
• Gauze pads/cotton balls


  Clean 2- by 2-inch gauze pads folded in fourths are used to hold pressure over the site following blood collection procedures
• Use of cotton balls to hold pressure is not recommended
• Bandages


  Used to cover a blood collection site after the bleeding has stopped
• Adhesive bandages should not be used on babies younger than 2 years of age because of the danger of aspiration and suffocation
• Needle and sharps disposal containers


  Sharp objects must be disposed of immediately in special containers referred to as "sharps" containers
• Biohazard bags


  Leakproof plastic bags that are commonly used to transport blood and other specimens from the collection site to the laboratory
• Slides


  Precleaned 25- by 75-mm (1- by 3-in.) glass microscope slides used to make blood films for hematology determinations
• Pen


  A phlebotomist should always carry a pen with indelible (permanent) nonsmear ink to label tubes and record other patient information
• Watch


  Needed to accurately determine specimen collection times and time certain tests
• Venipuncture equipment


  • Evacuated tube system (ETS) - most preferred
  • Syringe system - used on small, fragile and damaged veins
  • Butterfly system - can be used with the ETS and syringe