Cheat Sheet (study night before and morning of exam)

PPE Doffing Order

Gloves → Gown → Mask → Hand hygiene.

Most Contaminated PPE Item

Gloves.

How should a gown be removed?

Turn it inside out while removing.

How should a mask be removed?

Handle only by the straps.

Final PPE Removal Step

Perform hand hygiene.

Syncope

Patient faints; stop the draw, remove the needle, and lower the patient's head.

Hematoma

Blood leaks under the skin; release the tourniquet, remove the needle, and apply pressure.

Nerve Injury

Remove the needle immediately.

Seizure During Draw

Protect the patient from injury and stop the procedure.

Needlestick Injury

Wash immediately, report, and document.

Persistent Bleeding

Maintain direct pressure until bleeding stops.

Standard Precautions

Treat all blood and body fluids as potentially infectious.

Hand Hygiene

Perform before and after every patient.

Sharps Disposal

Dispose immediately into a sharps container.

Needle Recapping

Never recap needles by hand.

Exposure Incident

Wash the area, report it, and document it.

Safety Data Sheet (SDS)

Contains information about chemical hazards.

OSHA Bloodborne Pathogens Standard

Provides exposure control requirements.

Engineering Controls

Built-in devices that reduce exposure risk.

Standard Precautions vs Transmission-Based Precautions

Standard applies to every patient; transmission-based adds extra precautions for known infections.

When are gloves required?

During every blood collection.

When is a gown required?

When fluid exposure is possible.

When is a mask required?

For droplet precautions or splash risk.

When are goggles required?

When there is a risk of eye splashes.

Contact Precautions

Gloves and gown.

Droplet Precautions

Mask required.

Airborne Precautions

Respirator required.

Reverse Isolation

Protects immunocompromised patients.

Two Patient Identifiers

Name and date of birth.

Patient Identification Steps

Ask the patient, match the wristband, verify the requisition, and label before leaving.

Requisition Form

Verify ordered tests before collection.

Consent

Explain the procedure and obtain patient agreement.

Allergies

Ask about latex, adhesive, and antiseptic allergies.

Fasting

Confirm fasting status before collection.

Patients with Syncope History

Collect while seated or reclining.

Language Barrier

Use a qualified interpreter.

Maximum Tourniquet Time

1 minute.

Correct Arm Position

Supported with the arm pointing downward.

Should patients pump their fist?

No; make a gentle fist only.

Skin Cleansing Technique

Clean outward in circles.

Why allow alcohol to dry?

Prevents stinging and hemolysis.

Needle Bevel Position

Bevel up.

Venipuncture Angle

15–30 degrees.

After Needle Removal

Apply pressure until bleeding stops.

Order of Draw

Blood cultures → Light blue → Red/SST → Green → Lavender → Gray.

Blood Culture Tube

Sterile collection with SPS.

Light Blue Tube

Sodium citrate; coagulation tests.

Red/SST Tube

Serum testing.

Green Tube

Heparin; plasma testing.

Lavender Tube

EDTA; hematology tests.

Gray Tube

Sodium fluoride/potassium oxalate; glucose testing.

CBC Tube

Lavender (EDTA).

Coagulation Tube

Light blue (sodium citrate).

Serum Chemistry Tube

Gold SST or red.

Blood Culture Tube

Yellow SPS.

Glucose Tube

Gray.

Plasma Chemistry Tube

Green.

Blood Bank Tube

Pink (EDTA).

Butterfly Before Light Blue

Use a discard tube first.

Median Cubital Vein

First choice for venipuncture.

Cephalic Vein

Second choice.

Basilic Vein

Last choice because it is close to arteries and nerves.

Patient with IV

Use the opposite arm if possible.

Mastectomy Patient

Avoid the affected side.

Burns or Scar Tissue

Choose another site.

Sodium Citrate

Binds calcium for coagulation testing.

Clot Activator

Speeds clot formation.

Thrombin

Produces rapid serum.

Heparin

Prevents clotting by inhibiting thrombin.

EDTA

Preserves blood cells.

Sodium Fluoride

Stops glycolysis.

Potassium Oxalate

Works with fluoride as an anticoagulant.

Gel Separator

Forms a barrier between serum/plasma and cells.

Butterfly Needle

Best for small or fragile veins.

Straight Needle

Best for routine venipuncture.

Syringe Collection

Provides controlled suction.

Evacuated Tube System (ETS)

Uses vacuum tubes.

Needle Gauge Rule

Lower gauge number = larger needle.

Routine Venipuncture Needle

20–22 gauge.

Butterfly Needle Gauge

23 gauge.

Hematoma

Blood collects under the skin.

Hemolysis

Red blood cells rupture.

Collapsed Vein

Usually caused by excessive suction.

Petechiae

Small red spots caused by capillary bleeding.

Rolling Vein

Anchor the vein firmly.

Reflux

Additive flows back into the vein.

QNS

Quantity Not Sufficient.

Venipuncture

Venous blood collection for larger volumes.

Capillary Collection

Skin puncture for small-volume specimens.

Adult Capillary Site

Side of the middle or ring finger.

Infant Capillary Site

Lateral or medial heel.

Maximum Infant Heel Depth

2.0 mm.

First Drop During Capillary Collection

Usually wipe away.

Why warm the site?

Increases blood flow.

Microtainer

Tube used for capillary specimens.

Milking the Finger

Can cause hemolysis.

Capillary Order of Draw

Blood gases → EDTA → Other additive tubes → Serum.

Blood Culture Collection

Requires strict aseptic technique.

Glucose Tolerance Test (GTT)

Timed glucose collections.

Timed Specimen

Must be collected at the exact scheduled time.