PBT

• Vein


  Carry blood to heart
• Vein


  Carries deoxygenated blood
• Artery


  Carries oxygenated blood
• Oxygenated blood is carried by arteries except pulmonary artery
• Arteries carry blood from heart
• Pulmonary vein carries oxygenated blood
• Pulmonary artery carries deoxygenated blood
• Phlebotomy


  Collecting blood by making a cut in a vein
• Phlebos


  Greek word for veins
• Tome


  Making a cut/hole to take blood
• Phlebotomy is collecting blood
• The Heart

  • Hollow muscular organ
  • Size of the first
  • Weight about 1 lbs
  • Placed on the left chest/lung
• Heart structure

  • Top of the heart is called the Base
  • Bottom of heart is called the Apex (points towards the hip)
  • 3 layers of the heart: Pericardium, Myocardium, Endocardium
• Pericardium infected

  Becomes pericarditis or tuberculosis
• Myocardium infected

  Becomes myocarditis or COVID
• Endocardium infected

  Becomes endocarditis or Rheumatic (common in 5-15 year old)
• Artery


  • Carry blood away from the heart
  • Carry oxygenated blood (pure blood)
  • Except the pulmonary artery
  • The aorta is the largest artery in body found in the left ventricle (LV)
  • The Arterio is the smallest artery
• Vein


  • Carry blood to the heart
  • Carry deoxygenated blood (impure blood)
  • Except the pulmonary vein
  • The Largest vein is the Superior Vena Cava (SVC)
  • The Inferior Vena Cava (IVC) brings blood from the lower limb and abdomen
  • The smallest vein is called the Venule
• SVC and IVC


  Carry deoxygenated blood on the right side to the right ventricle and into the lung, which is the body's "factory"
• Left ventricle


  The most hard working changer because it has to pump blood in the whole body
• Capillary


  • The "transition blood vessel"
  • In the middle of the artery and vein
  • Exchanges oxygen and carbon dioxide
• Methods to collect blood

  • Arterial puncture (only done by RN, RT and MD)
  • Venipuncture (PBT only do 2 and 3)
  • Capillary puncture aka "skin/dermal puncture" or "finger slick"
• Venipuncture


  • For large amounts of blood (made of mass test)
  • Methods: Vacuum tube, Butterfly method, Syringe method
• Vacuum tube


  • Aka evacuated tube system
  • Made of plastic or glass and vacuumed sealed with a stopper
  • Stoppers protect seal and are color coded to indicate chemical or additive is used to mix in with the blood
  • Once blood is collected, flip it but don't shake it, slow so chemical is mixed uniformly with the blood
  • Expire dates- tubes are sealed to collect correct amount of blood, if tube is expired, the vacuum air is lost (same with cracks in tube)
• Butterfly method


  • Aka winged infusion method
  • Easiest and least painful method but costly
  • Color coded wings: Green- 21g (adult), Blue- 23g (kids)
  • Indications: Children, Obese (narrow veins), Elderly, Cancer patients, Burn's patients
• Syringe method


  • Rarely done in the MO (medical office)
  • Used if vacuum doesn't work (vein collapsed)
• General Guidelines for any method

  • Identify patient
  • Preparation of patient
  • Position of patient
  • Select site for venipuncture
  • Application of tourniquet
  • Obtain the type of blood specimen required
  • OSHA (occupational safety and health administration)
• Identify patient

  Most important, Pt is always right, confirm (ask pt to confirm DOB, first/ last name, addresses BUT never ask for photo ID)
• Preparation of patient

  Normally no prep is required to draw blood, unless MD ask for blood sugar level, lipid profile (cholesterol or triglyceride). Then Pt. must fast for 8-10 hrs before blood is drawn
• Position of patient

  Pt must be comfortably seated, Never collect the blood of Pt. standing or on a stool, Tell Pt. to keep hands down so blood flows down, Pt. can faint after procedure (if pt. Fainted during previous procedures and was filed, place pt. Laying down (supine position) however if pt. doesn't like supine place in 45 degree fowler's position)
• Select site for venipuncture

  • Antecubital space (front of the elbow joint) *most common
  • Dorsum of the hand
  • Medial aspect of the forearm * least common because its painful
  • Upper part of the extended thumb
• Antecubital space

  Veins found there (from outer to inner vein) are cephalic vein, median cubital vein and basilic vein. Median vein is the most common for procedures because it is the most anchored and superficial, Cephalic vein is the second common, Basilic vein is the least common because you are more prone to puncture the Brachial artery
• Application of the tourniquet

  Acts like a dam and blocks flow of blood to the heart as a result vein becomes prominent and can be seen and felt, always palpate (feel) the vein (Bouncing, Dept of the vein, Direction of the vein), 3-4 inches above of the site, must fit right, not to tight or loose, should not be left for more than 1-2 min. For the fear of hemoconcentration (concentrated blood and not regular blood), must be removed first before removing the needle. For the fear of hematoma (accumulated blood under skin)
• what separate right atrium from left atrium?

  atrial septum
• which is the largest blood vessel that originates from the left ventricle?

  aorta
• blood cells are called

  formed elements
• formed elements are formed in

  lymphatic tissue (lymph nodes) and bone marrow in long bones (femur and sternum ribs)
• Red GLASS tube

  no additives
• Petechiae is

  capillary bleeding from T. being on to tight for long time
• sodium citrate is a

  anticoagulated in light blue