First test of new six weeks

What information goes in the lab requisition?

Patient registration information, billing information, specimen information, barcoded specimen labels and a provider order for confirmation of testing.

What is the gauge range and length for butterfly or syringe needles?

21 to 23 gauge with a needle length of ½ to ¾ inch.

Why is the ETS method used the most?

Helps to obtain multiple tubes of blood with one venipuncture stick.

What type of veins benefit from the winged infusion method?

Patients who have small or fragile veins.

Why do we use the syringe method?

When a patient has easy to collapse veins.

What are critical/panic values?

Values that require immediate attention, handled by calling the provider's office and confirming understanding of the information.

What are complications with venipunctures?

Nerve damage, hematoma, phlebitis, thrombosis, petechiae, hemoconcentration, diaphoresis, syncope, shock, nausea.

What questions are asked before performing a venipuncture?

Name and DOB, fear of needles, allergies, history of fainting, and recent food/drink intake.

What is the % of alcohol in sanitizer?

70%.

When is a chain of custody form required?

During drug tests, forensic specimens, and rape testing for court cases.

How is bilirubin handled when collected?

Should be protected from light, using amber colored containers or wrapped in foil paper.

How often is quality control/checking your equipment done?

Daily, and before use.

What is the order of draw for blood samples?

Yellow top, light blue, red, red/gray marbled (tiger top), green, green/gray marbled, lavender, gray, royal blue.

What are the additives for serum/plasma tubes?

Yellow - SPS, light blue - Sodium citrate, Red - none, tiger top - Silica serum, Green - heparin, lavender - EDTA, gray - Potassium Oxalate/sodium fluoride.

Yellow additive

SPS

Light blue additive

Sodium citrate

Red additive

None

tiger top additive

Silica, serum

Green additive

Heparin

lavender additive

EDTA

gray additive

Potassium Oxalate/sodium fluoride

How long should serum tubes be left to clot?

30-45 minutes, but no longer than 1 hour.

Name the veins in the antecubital fossa in order?

1st - Median cubital, 2nd - Cephalic, 3rd - Basilic.

What are the instructions for a patient having a lipid panel?

Not eating, drinking certain beverages, and taking medications for 12 hours.

How to care for a patient with a history of syncope during venipuncture?

Have the patient in semi-fowlers position or supine during the procedure.

What supplies are needed for a venipuncture?

Sharps container for needle disposal, arranged in order of use with tubes placed correctly.

Why do we invert tubes after filling?

To mix blood with the additives within the tube and maintain accuracy of results.

Describe a light blue tube.

Contains Sodium citrate; removes calcium to prevent blood clotting and is for coagulation testing.

What is a disadvantage of performing a hand draw for venipuncture?

The risk of deep vein thrombosis (DVT).

What happens if a tourniquet is left on too long?

Hemoconcentration and alteration of test results.

Where should you avoid performing a venipuncture?

On burns, scars, and sclerosed areas.

How to cleanse a site before inserting a needle?

Wipe in an upward and downward motion with friction, do not blot, and allow to air dry.

What are the steps for performing a venipuncture?

Anchor the vein, insert needle smoothly at the proper angle, and ensure bevel faces upward.

Why do we remove the first drop of blood during a capillary puncture?

To obtain a clean sample without tissue or fluid contaminants.

Which test is the only one where the first drop of blood is not removed?

Obtaining a prothrombin test (PT).

Define preanalytical phase in laboratory testing.

Before the collection of specimen.

Define analytical phase in laboratory testing.

The actual testing phase.

Define postanalytical phase in laboratory testing.

Testing is done; specimen is discarded, reports are logged in; provider interprets results and patient is notified.

What is a laboratory directory/reference manual?

Includes a list of orderable tests and information on specimen requirements, patient preparation, container types, and transport/processing requirements.

What is lumen in terms of a needle?

The hollow bore of the needle shaft where liquid flows through.

What is bevel in needle terms?

The point or tip of the needle.

What is hemostasis?

The body's normal reaction to an injury that causes bleeding to stop the bleeding and begin repairs.

What is the capillary order of draw?

1- Blood Gas, 2- EDTA, 3- Heparin, 4- Any other additive, 5- Clot Activator/No Additive if PT test is being performed.

What should be done after a venipuncture?

Leave pressure on the bandage for 15 minutes; don’t put a band-aid on an infant's heel as they can choke.

What to document after reporting a critical value to a provider?

Document who you spoke to.