safety to hematology

• What are critical aspects of blood collection?

  Excellent communication skills, proper patient preparation, accurate test requisition requests, valid patient identification, appropriate blood specimen collection, and criteria for specimen acceptance and rejection.
• Why are excellent communication skills important in blood collection?

  They help ensure that patients and healthcare providers understand the procedure and requirements.
• What is the purpose of a tourniquet in venipuncture?

  To restrict blood flow and make veins more prominent for easier access.
• What are the types of additives used in blood collection tubes?

  • Antiglycolytic agent: inhibits glucose use by blood cells
  • Clot activator: glass or silica particles, thrombin
  • Separation gel / Thixotropic gel: inert gas that changes viscosity
  • Anticoagulants: EDTA, Heparin, Citrate
• What is the most commonly used anticoagulant in hematology?

  EDTA
• How does EDTA inhibit blood coagulation?

  By chelating calcium ions.
• What is the optimal concentration of EDTA for blood collection?

  1. 5 mg/mL
• How does citrate inhibit blood clotting?

  By binding calcium in a soluble complex.
• What is the role of heparin in blood collection?

  It inhibits coagulation by inactivating thrombin.
• What is the optimal concentration of heparin for blood collection?

  15 to 20 U/mL
• What are some complications encountered in blood collection?

  • Ecchymosis (Bruise)
  • Syncope (Fainting)
  • Hematoma
  • Failure to Draw Blood
  • Petechiae
  • Edema
  • Obesity
  • Intravenous Therapy
  • Hemoconcentration
  • Hemolysis
  • Burns
  • Seizures
  • Mastectomy patients
• What are the indications for skin puncture in blood collection?

  • Newborns
  • Pediatric patients under 1 year
  • Severely burned adults
  • Patients reserving veins for therapeutic purposes
  • Elderly patients with fragile veins
• What are the collection sites for infants and older children/adults?

  • Infants: Lateral or medial surface of the plantar side of the heel
  • Older children/adults: Palmar surface of the distal portion of the third or fourth finger on the non-dominant hand
• What are the requirements for a quality specimen?

  1. Proper patient identification
  2. Proper patient preparation
  3. Correct order and labeling of specimens
  4. Correct anticoagulants and preservatives used
  5. Proper mixing of specimens
  6. Specimens not hemolyzed
  7. Timely collection of fasting specimens
  8. Timed specimens drawn at the correct time
• What are the reasons for specimen rejection?

  • Test order requisition and tube identification do not match
  • Tube is unlabeled or incorrectly labeled
  • Specimen is hemolyzed
  • Wrong time or wrong tube for collection
  • Specimen is clotted when whole blood is required
  • Contamination with intravenous fluid
  • Specimen is lipemic
• What are the methods for blood smear preparation and staining?

  1. Cover Glass smear (Erhlich)
  2. Cover Glass and slide (Beacom)
  3. Wedge Smear
  4. Spun smear
  5. Automated Methods
• What are the characteristics of a well-stained peripheral blood film?

  • Macroscopically: Pink to purple
  • Microscopic: RBCs orange to salmon pink, WBC nuclei purple to blue, neutrophil cytoplasm pink to tan with violet granules, eosinophils with bright orange granules
• What are common staining problems in blood smear preparation?

  • Excessively Blue Stain: Thick films, prolonged staining, inadequate washing, high alkalinity
  • Excessively Pink Stain: Thin smears, insufficient staining, prolonged washing, coverslips mounted before drying, high acidity