Collecting Specimens and Diagnostic Testing

Tourniquet

a device used to make veins easier to find for venipuncturej; these non-latex bands usually measure .5 to 1 inch wide and 15 inches long

Vacutainer tubes

the most used tubes for laboratory blood collection, are color coded based on the presence of any additives within the tube. Anticoagulants, clot activators, and preservatives are a few of the additives that may be present in the tube.

Random Urine Specimens

collected for urinalysis; no special measures are needed; collected anytime

Midstream Specimen

also called a clean-voicded specimen or a clean-catch specimen; the perineal area is cleaned before the collected specimen is collected

24-hour Specimen

collected during a 24-hour period; urine is trypically chilled or refrigerated to prevent the growth of microbes

Urinalysis

a test used to identify components of the urine, is usually conducted on patients that are pregnant, have an illness, or are suspected of having abused an illegal substance

Sputum Specimens

sputum - not saliva - is tested usually due to disorders of the lungs, bronchi, etc.; studied for blood, microbes and abnormal cells

Stool Specimens

collected to identify any type of bacteria or virus that may be responsible for a patient experiencing diarrhea, abdominal pain or other related symptoms; must be collected in a clean, dry container and transported to the testing area in a container with a tightly fitted lid

Culture and Sensitivity

testing that refers to the process of cultivating a specimen in order to determine whether the developed organism is sensitive to antibiotics; the process begins with the collection of a direct specimen which is then cultivated in a special media, or agar; the special media functions to encourage the growth of present microorganisms in the specimen; when the growth of a microorganism is detected, the organism is tested against different antibiotics for sensitivity to antibiotics; an antibiotic is considered effective if it can stop or slow down the organism's growth in a controlled situation

Throat Culture

"performed on a patient to detect a disease-causing organism and determine an appropriate method of treatment; throat cultures are performed to identify bacteria that

may cause any of the following: strep throat, whooping cough, and epiglottitis

"

Wound Culture

performed to identify the pathogen that is responsible for an infection of a patient's wound; specimens may be collected from animal bites, ulcers, and skin wounds; performed by swabbing the inside of a wound and placing the swab in a transport container

Special Procedures - 2-hour Post Prandial Glucose

(PP) means after a meal; glucose specimen is collected 2 hours after a patient eats a meal

Special Procedures - Glucose Tolerance Test

(GTT) is used to diagnose carbohydrate metabolism problems; patients must eat well balanced meals 3 days prior to the test and must fast at least 12 hours before the test; p[atients must drink glucose prior to testing and have 5 minutes to finish the drink; levels will peak within 30 minutes to an hour following glucose ingestion

Special Procedures - Lactose Tolerance Test

same procedures as GTT but the patient must drink lactose rather than glucose

Special Procedures - Bleeding Time Test

(BT) performed on the forearm and uses a blood pressure cuff inflated to 40 mm Hg; phlebotomists will use an automated incision device to puncture skin and will use filter paper to blot the blood drops; this is a timed test and phlebotomist will blot blood every 30 seconds until the patient stops bleeding

Special Procedures - Arterial Blood Gas (ABG)

most common site radial artery; use a Modified Allen Test to see if patient has adequate circulation; you must cleanse the site with alcohol and then clean with iodine; insert syringe needle at a 45-degree angle; when complete apply pressure for at least 3 to 5 minutes; this test is drawn in an inpatient setting and analyzed immediately after collection

Clinical Laboratories

an area in a healthcare facility where inpatient and outpatient diagnostic testing is conducted; certain areas of the medical laboratory are designated for clinical analysis, while others are for surgical and anatomical pathology analysis

Hematology Laboratory

this department deals with the handling of various blood specimens; tests performed in this department include WBC counts, RBC counts, hemoglobin, hematocrit (HCT), RBC indices, and platelet counts; the results of these tests indicate conditions such as dehydration, anemia, leukemia, and a wide variety of other diseases

Chemistry Laboratory

the most performed tests within this department include those for blood glucose levels, electrolytes (sodium, potassium, chloride), total protein etc.; the results of these tests can range from the confirmation of pregnancy to the presence of a liver disorder

Blood Bank Laboratory

this is the section of the laboratory where blood is collected, stored, and prepared for transfusion; it is essential for all staff members to comply with the standards for patient identification and specimen handling to ensure the safety of all the patients

Collection Tube Additives - EDTA and NA Citrate

anticlotting chemicals

Collection Tube Additives - Serum Separator gels

used to separate red blood cells and clotting factors from serum to maintain correct chemistry levels found in blood

Collection Tube Additives - Lithium Heparin

used as an anticlotting factor and preservative for some chemistry analysis

Collection Tube Additives - Sodium Fluoride

used to maintain glugose levels

Collection Tube Additives - Blood Culture Media

used to nourish microbes in blood culture tubes and bottles for identification and remediation of infections

Blood Collection Tubes - Red topped

No additive required. Commonly used for serum determinations in the following: Chemistry testing & Blood bank testing

Blood Collection Tubes - Blue topped

additive used is sodium citrate. Additive prevents coagulation by binding calcium; it is advised to draw 2 to 3 ml of blood in a tube without additives before drawing this tube; commonly used for coagulation tests/heparin therapy (PT, APTT, fibrinogen)

Blood Collection Tubes - Lavender and Pink topped

additive used is ethylenediaminetetraacetic acid (EDTA); additive binds the calcium needed for clot formation; commonly used for hematology testing (CBC, reticulocyte count) Used for ESR testing (Erythrocyte sedimentation)

Blood Collection Tubes - Dark(er) Green topped

additive used is Heparin, a natural anticoagulant that inhibits thrombin; commonly used for routine chemistry testing.

Blood Collection Tubes - Light Green topped

additive used is Lithium Heparin; this additive action is as an anticoagulant; not to be used for lithium levels; used for many chemistry tests

Blood Collection Tubes - Gray topped

additives used are sodium fluoride, a preservative that inhibits glycolytic action, and potassium oxalate, an anticoagulant that binds calcium; commonly used for glucose tolerance tests and lactic acid measurement

Blood Collection Tubes - Red/Gray (camouflage) topped

additives used are clot activator and serum gel separator; activator encourages clot formation while gel creates a barrier between the serum and the cells which prevents contamination of the serum; commonly used for chemistry and immunology testing

Blood Collection Tubes - Blood Culture tubes or bottles

microbial growth media; there are two major types: aerobic growth media and anaerobic growth media; there are also microbe specific tubes and bottles which are ordered by the provider

Blood Collection Tubes - Dark (Royal) Blue topped

additive is EDTA; EDTAQ inhibits clot formation; used for trace metal levels including lead

Smears

performed for visual examination of cells under a microscope; can be performed on blood (peripheral smear) and cervical epithelium (pap smear)

Snellen test

measures visual acuity which determines the amount of visual details at given distances on the Snellen eye chart

Ishyihara test

a color perception test that uses specialized color plates with numbers to assess for red-green color blindness