phlebotmy exam 1 (sara)

Phlebotomy

When a needle is used to take blood from a vein for laboratory testing.

Post Analytical

Lab analysis and measurements in the lab of the blood after it’s been drawn and sent to the lab.

Pre analytical

Procedures before the test, identity confirmation, prepping and drawing, handling and transport

Anemia

A blood disorder, not enough hemoglobin to carry oxygen through RBC’s, can cause patients in the lab to get light headed.

Edema

Excess fluid in body tissue.

Phlebitis

Vein inflammation from blood clot

OSHA

Occupational safety and health administration

PPE

Personal protective equipment (gloves)

How to call a patient back to drawing chair.

Call their name, greet them, when they come up ask for their full name and date of birth.

How do you talk to patients?

Communication and compassion.

What are the patients rights?

They have the right to refuse treatment, access billing information, say no

What should you do if you’re leaving the computer in the lab?

Log off computer when not around

Types of disinfectants to use.

70% alcohol

What is the sterilization procedure?

70% alcohol in a circle motion, allow to dry 30-60 seconds, iodide for blood cultures back and fourth motion for 60 seconds.

Antiseptic technique

prevents the spread of infection by minimizing contamination.

When do you use antiseptic technique?

Blood cultures, venipuncture, arterial puncture.

When do you use a discard tube on a butterfly needle?

When using the butterfly needle to remove any air.

Which bottle goes first in blood culture?

Aerobic

What is the order of draw?

Aerobic

1st in blood culture, detects bacteria or other organisms that grow in presence of oxygen.

Anaerobic

2nd in blood culture test. Detects anaerobic bacteria in the bloodstream

What is blood culture stat?

Because I doctor wants to get patient on antibiotics as soon as possible so getting blood draw done asap

Contact precautions

Air, droplets, gloves, PPE, proper waste disposal, gowns/lab coats

Why is there a time limit for the tourniquet? How long should it be on?

Because it could cause harm to the limb because the blood flow is lacking, it should only be on for 1 minute or less.

Phlebotomy job types

Supervisor, blood donor, transport

Where do you dispose needles

In a non poke container

What can happen if you don’t to 2 step identifier?

Could cause wrong procedure, misdiagnosis, wrong medication

When should you use hand sanitizer and when should you wash your hands?

Hand sanitize after removing gloves, you can wash hands after as well

When should you change your gloves?

Between every patient

Needle stick accidents, what do you do?

If accidentally a needle stick follow policy and procedure at facility and have your form with you. Send form to Dorinda and let her know as well. Immediately wash the wound and enforce bleeding.

Ethical standards

Treating everyone fairly and not forcing them into something they say no to

Plasma vs serum

plasma (unclotted blood, contains fibrogen, uses anticoagulated samples), serum (clotted blood, no fibrogen, use clot tube)

Anticoagulant

Calcium binding, prevents blood from clotting

Which anticoagulant should you use in certain situations

Blood bank, black (western green sedimentation rates), orange (stat)

What color tubes have anticoagulants?

Light blue, lavender, black, green, red

What tubes do you reject if it’s not completely full

Light blue top Na citrate, anticoagulants, sometimes lavender

What is the amount of blood needed in each tube?

2 and 8.5 mL

Hemolysis

Break down of RBC’s (erythrocyte destruction), can appear pink red

Tarich

Phlebotomy training

Lipemic

Patience blood appears milky white due to high concentration of fat.

What do you do after you get blood in tube?

Shake the amount of times needed and label

What’s the cheapest way to draw blood?

Straight needles

What are the gauge sizes smallest to largest?

20G, 21-22G (standard), 23G, 25G (needle stays in longer, hemolysis can occur)

What size needle do you use on small fragile veins?

20-23G

Palpitate

Feel the vein even if you see it, use index finger bc thumb has a pulse, veins are spongy and tendons are rigid a, arteries have a pulse.

Importance of anchoring and stabilizing vein

Prevents the vein from moving so no damage or pain is caused.

What should you do before patient leaves?

Hold pressure with cotton piece and finish labeling tubes.

Fistula

Access the blood stream for dialysis or other medical treatments. Permanent artery vein connection.

Mastectomy

Try to avoid, should be done on opposite arm or below iv. Ask doctor or do finger prick.

Where do you draw if a patient has a iv in their arm?

Opposite arm or below the iv don’t stick the same vein.

septicemia

Blood poisoning

What to do if tube needs chilled right after draw?

Ice slurry, water and ice not just ice.

Chain of custody, when do you use it?

Documented paper that collects what time patient came in and what time blood was collected and the date. Drug testing, forensic toxicology, and clinical trials.

Cold of glutin

Will start a cooling process after leaving body the blood will agglutinate and clot. We want to keep blood warm if tube doesn’t specify being refrigerated.

Post analytic

After test is gone through the lab, reporting of results, entering the data in the system.