week 3 chapter 9 blood specimen

how to transport a specimen within a facility?

pneumatic tube system
dumbwaiter
automated tracks
robotics
conveyor belts

how to transport a specimen outside a facility?

courier service
- specimens placed in locked box
- may need to be processed before transport
- policy needed for time and temperature

how to transport specimen to other facilities?

reference laboratories
- courier service
shipping

what are the packaging requirements?

shipping container
specimen documentation
secondary container
primary container
absorbent material
ice pack

what is specimen transit tracking?

transit information entered in LIS
- manual entry
- bar code reader

what is pre-examination errors?

errors that occur before, during, or after blood collection
- patient identification errors
- specimen collection errors
- specimen handing errors

what are specimens that require warming?

testing for cold agglutinins
must be kept at 37 c

what specimens that require chilling?

- arterial blood gases
- ammonia
- lactic acid
transport in crushed ice and water
do not freeze

what are light sensitive specimens?

tests
- bilirubin
- carotene
use amber tube
wrap in foilthat must be protected from light exposure to prevent degradation. These specimens are often collected in special containers to ensure accurate test results.

what are specimens for legal matters?

results may be used in court of law
chain of custody
- uninterrupted control of authorized personnel
- if broken, specimen and tests are invalid

what is blood alcohol specimens?

proceeding without patient permission or court order = assault and battery
requires chain of custody procedure
do not use alcohol to cleanse site
- alcohol prep pad
- iodine swab

what is forensic specimens?

usually for legal cases
require chain of custody procedure
check specific guidelines at your facility
- special evidence kits
- proper training

what is toxicology specimens?

reasons for toxicology specimens
- detect poisons , drugs, or medications
- detect trace elements
follow your facility's protocols

what is a no tourniquet blood collection?

required for lactic acid tests
tourniquet may be applied briefly to locate vein
remove tourniquet before collection
arm must be at rest for 2 minutes before collection
place specimen on ice
deliver to laboratory STAT

what is special coagulation studies?

types of coagulation studies
- factor assay
- platelet function studies
- coagulation inhibitor assays
follow strict order of draw
perform procedure quickly
invert tubes to mix
deliver to laboratory immediately

what is separated specimens?

separation procedures
- centrifuging
- aliquoting
for most tests, separation should be done within 2 hours of collection
wear PPE during specimen processingafter blood collection to obtain serum or plasma for analysis.

what is centrifuging specimens?

separates blood cells from liquid components
speed and time depend on specimen requirements
typical speed: 1,000 to 3,000 revolutions per minute

what are requirements for a centrifuge specimen?

balance the centrifuge
set for the correct speed
close the lid securely
set timer for correct time
wear face shield when removing tubesand handle specimens with care to avoid spillage or contamination.

what is aliquoting specimens?

take great care not to mix up samples
- label transfer tube
- compare to specimen tube label
use pipet to transfer serum or plasma
store properly for delivery to lab

what is specimen rejection?

recollection may be required if abnormalities are detected
accurate test results depend on specimens
- errors may go unnoticed
- questionable results obtained

what is hemolysis?

destruction of red blood cells
can result from improper collection or handling

what is clot anti-coagulated specimens?

blood must not be clotted for some tests
blood may clot even in tubes that have an anticoagulant
often due to collection issues

what is incomplete collection?

may be rejected as "quantity not sufficient" (QNS)
causes improper additive to blood ratio

what is the other cause of rejection?

incorrect tube collected
incorrect order of draw
hemoconcentration
- not easily detected
- results may be questioned if delta check fails
contamination by IV fluids

what are some more other cause of rejection?

icterus
- dark-yellow to greenish-yellow color
- caused by billrubin
lipemia
- cloudy plasma
- caused by abnormal amount fats
special requirements not followed
inadequate or missing documentation